Systems and methods for intraoperative surgical scope cleaning

A system for cleaning a surgical scope of an endoscopic imager includes a control system communicatively connected to an apparatus for supplying fluids to a surgical scope cleaner, the control system configured to receive one or more images of a surgical field generated by the endoscopic imager, detect a deposit on a lens of the surgical scope by analyzing the one or more images, and send a command to the apparatus to provide one or more fluids to the surgical field for cleaning the surgical scope.

FIELD OF THE INVENTION

The present disclosure relates generally to endoscopic surgery, and more particularly to cleaning a surgical scope during a surgical procedure.

BACKGROUND OF THE INVENTION

Although laparoscopic surgery has been performed going back as far as 1901, it became more widespread upon the introduction of the rigid laparoscope with a rod lens optical train and glass fiber optic illumination in the mid 1980's. Since then, laparoscopic surgery has evolved into the standard of care for many types of abdominal surgery.

Since a surgeon is dependent on the image provided by the laparoscope, the surgeon's performance is impaired if the lens at the distal end of the laparoscope is not kept clean while in the surgical cavity. For example, the surgeon can have difficulty viewing the surgical field when any of the following occurs: the surface temperature of the lens is lower than the temperature of the surgical cavity and condensation forms on the lens, which is referred to as “scope fogging”; the lens touches tissue in the surgical cavity during the course of the surgery and becomes soiled with fat, blood, pieces of tissue, bile, etc., which is referred to as “scope smudging”; fluids splash or squirt at the laparoscope during the surgery and accumulate on the lens, such as blood from a perforated artery, irrigation fluid while washing the surgical site with pressurized saline, etc., which is also referred to as “scope smudging”; and the laparoscope is passed through a trocar in order to enter the surgical cavity and the lens touches blood, fat, pieces of tissue, or lubricant from the seals of the trocar, which is also referred to as “scope smudging”.

Many attempts have been made to address the problems of lens fogging and scope smudging. However, these attempts have been largely unsuccessful and surgeons continue to remove the laparoscope from the surgical cavity for cleaning and then subsequently re-insert the laparoscope into the surgical cavity to continue the surgery. Often, re-insertion into the surgical cavity through a trocar smudges the scope again, and the cleaning process must be repeated until the surgeon is able to obtain a clear image of the surgical cavity.

Attempts to solve scope smudging and fogging have often been ineffective for several reasons. Designs with lens-cleaning features built into the scope itself have the benefit of not requiring the surgeon to remove the scope from the surgical cavity during surgery but can substantially complicate the design of the scope and make cleaning and sterilizing the scope difficult and can affect the scope's reliability and useful life. Designs having a mechanism for mechanically cleaning the scope, such as wipers or sponges, have difficulty keeping the mechanism clean and dry enough to be effective at cleaning the lens over the course of a surgery. Such designs may also require the surgeon to move the scope back and forth past the cleaning mechanism, which can distract the surgeon from the surgery.

Designs that have a sheath for preventing the lens from being contacted by fluids and debris substantially complicate the process of cleaning the lens should the lens be smudged because access to the lens is made more difficult, often requiring removal of the sheath to properly clean the lens. Designs that include a sheath that, together with the outer surface of the scope, forms a lumen for fluid or gas to pass through for cleaning the lens can generally only be configured to work with a particular make and model of laparoscope because the fit between the scope and the sheath is critical. The manufacturing tolerances of the scope and the sheath as well as the fact that the mating surface of one or the other over time will get damaged due to reprocessing by hospital staff can make such design impractical.

Designs that have a film that protects the lens from making contact with the fluids and tissue during surgery can suffer from a number of drawbacks. Anything positioned in front of the lens of the scope will cause some level of image degradation. The film may not always be able to seal perfectly and prevent the lens from getting smudged and fluid from penetrating the sheath and remaining there, which can cause any new film that is advanced in front of the lens to also become smudged. Further, the film may not help prevent fogging, which means that the scope must be properly warmed directly before installing the sheath and inserting into the surgical cavity. If the scope is removed during the surgery for any reason, it must be warmed again before being reinserted into the surgical cavity or else it will get fogged again.

Designs that spray a cleaner at the lens and suction the waste away have not been successful in laparoscopic surgery since it is often difficult to rely on a suction flow to always pull the tiny drops of fluid across the lens for removal due to the surface tension between the glass and the fluid droplets.

SUMMARY OF THE INVENTION

According to some embodiments, a surgical scope cleaner includes a sheath that is configured to slide over the surgical scope and at least one nozzle located at the end of the sheath for spraying a cleaning liquid and a gas onto the lens at the end of the surgical scope to clean the lens. The sheath is configured to fit over the tube of the scope and through the lumen of a trocar, so that the sheath remains in place on the scope during the surgical procedure. When the lens becomes smudged and/or fogged, liquid can be sprayed onto the lens and then the gas can be blown at the lens to remove any remaining liquid. The sheath includes conduits for the liquid and gas that may be formed into one side of the wall of the sheath to maintain a small diameter so that the sheath can fit through a standard size trocar while mounted to a standard size scope.

The surgical scope cleaner can be connected to a fluid management apparatus that can control the delivery of the liquid and gas from the scope cleaner to the lens. The fluid management apparatus can also manage the supply of other fluids to the surgical field, including for example, serving as an insufflator for supplying insufflating gas for insufflating the surgical cavity. An integrated tube set can be used to transport fluids between the surgical field and the apparatus and/or other equipment, which can reduce the clutter in the surgical field. The tube set can include a connector for connecting at least some of the tubes of the tube set to the apparatus for efficient pre-operative set-up.

According to some embodiments, an apparatus for cleaning a surgical scope includes a sheath for removably receiving a tube of the surgical scope, the sheath including a wall defining a channel for receiving the tube, where a distal portion of the wall is configured to extend only partially around a circumference of the tube, a first conduit that defines a liquid flow path, and a second conduit that defines a gas flow path; and at least one nozzle located at a distal end of the distal portion of the wall and configured for directing a flow of liquid from the first conduit across a lens of the surgical scope and directing a flow of gas from the second conduit across the lens of the surgical scope to clear the liquid from the lens.

In any of these embodiments, at least the distal portion of the wall may be configured for positioning in a trocar during use.

In any of these embodiments, the apparatus may further include a first port for connecting a liquid supply line to the first conduit and a second port for connecting a gas supply line to the second conduit.

In any of these embodiments, the liquid flow path from the first port to the first nozzle and the gas flow path from the second port to the second nozzle may be valve-free.

In any of these embodiments, the apparatus may further include a receiver located at a proximal end of the sheath for receiving a housing of the surgical scope.

In any of these embodiments, a proximal portion of the wall may be configured to extend completely around a circumference of the tube of the surgical scope.

In any of these embodiments, only the distal portion of the wall may be positioned in the trocar during use.

In any of these embodiments, the distal end of the wall may be further away from a longitudinal axis of the tube of the surgical scope than a proximal end of the wall when the surgical scope is received in the sheath.

In any of these embodiments, the wall may be configured so that the distal portion of the wall can bend toward the longitudinal axis of the tube of the surgical scope during insertion into a trocar and can then return to a position further away from the longitudinal axis of the tube of the surgical scope when the distal portion is through the trocar.

In any of these embodiments, the first conduit may be adjacent to the second conduit.

In any of these embodiments, the at least one nozzle may be a first nozzle that is adjacent to a second nozzle.

In any of these embodiments, the first and second conduits may be formed into a thickness of the wall.

In any of these embodiments, the thickness of the wall may be non-uniform around a circumference of at least a portion of the wall.

In any of these embodiments, the at least one nozzle may be located for cleaning the surgical scope while the surgical scope views a surgical field.

In any of these embodiments, the at least one nozzle may be located so that a field of view of the surgical scope is unobstructed.

In any of these embodiments, the at least one nozzle may be located at a distal end of the sheath.

In any of these embodiments, at least the sheath may be made of a plastic.

In any of these embodiments, the apparatus may be disposable.

According to some embodiments, a method for cleaning a surgical scope while the surgical scope is inserted in a surgical cavity includes inserting the surgical scope into a sheath of a surgical scope cleaner, wherein a distal portion of the sheath extends only partially around a tube of the surgical scope; inserting the surgical scope and sheath into the surgical cavity; observing the surgical cavity using the surgical scope that is inserted in the sheath of the surgical scope cleaner; and cleaning deposits from a lens of the surgical scope by: spraying the lens with a liquid from at least one nozzle of the surgical scope cleaner to remove the deposits from the lens, and blowing the lens of the surgical scope with a gas from the at least one nozzle of the surgical scope cleaner to remove the liquid from the lens.

In any of these embodiments, the sheath may include a first conduit that defines a liquid flow path, and a second conduit that defines a gas flow path.

In any of these embodiments, inserting the surgical scope and sheath into the surgical cavity may include inserting the surgical scope and sheath through a trocar.

In any of these embodiments, the deposits may be cleaned from the lens in response to a user input to an endoscopic imager connected to the surgical scope.

In any of these embodiments, the deposits may be cleaned from the lens based on a detection of the deposits by an image processing system via one or more images generated by an endoscopic imager connected to the surgical scope.

In any of these embodiments, the deposits may include condensation.

In any of these embodiments, the deposits may include one or more of bodily fluids, tissue, and one or more fluids introduced into the surgical cavity.

In any of these embodiments, the lens may be sprayed with the liquid for a first predetermined period and the lens may be blown with the gas for a second predetermined period.

According to some embodiments, an apparatus for supplying fluids to a surgical field includes a gas inlet port for connecting a supply line for supplying a gas to the apparatus; a first outlet port for supplying a first flow of the gas for insufflating a surgical cavity during a surgical procedure; an actuator for controlling a liquid flow for cleaning a surgical scope during the surgical procedure; and a second outlet port for supplying a second flow of the gas for clearing liquid from the surgical scope during the surgical procedure.

In any of these embodiments, the actuator may include a solenoid.

In any of these embodiments, the actuator may be configured to close a flow path in the apparatus.

In any of these embodiments, the actuator may be configured close a flow path in a device connected to the apparatus.

In any of these embodiments, the actuator may actuate a valve in the apparatus.

In any of these embodiments, the apparatus may include a third outlet port for pressurizing a reservoir for the liquid flow.

In any of these embodiments, the first, second, and third outlets may be located in a receiver configured for receiving a connector that connects the apparatus to a tube set for supplying fluids to the surgical field.

In any of these embodiments, the actuator may be configured to close off a flow path for the liquid flow in the connector.

In any of these embodiments, the actuator may actuate a valve in the connector for controlling the liquid flow.

In any of these embodiments, the apparatus may include a motor for driving a pump in the connector.

In any of these embodiments, the actuator may be configured to pinch a liquid flow tube for controlling the liquid flow.

In any of these embodiments, the apparatus may further include a second actuator that is configured to pinch a gas flow tube for controlling the second flow of the gas.

In any of these embodiments, the apparatus may further include a first regulator for supplying the first flow of the gas at a first pressure and a second regulator for pressurizing a reservoir for the liquid flow at a second pressure that is different than the first pressure.

In any of these embodiments, the apparatus may further include a liquid inlet port for receiving the liquid from a reservoir.

In any of these embodiments, the apparatus may further include a gas inlet port for receiving a gas flow from the surgical cavity during the surgical procedure.

In any of these embodiments, the apparatus may further include a communication port for receiving control commands for actuating the actuator.

In any of these embodiments, the apparatus may further include a controller that is configured to control the liquid flow and the second flow of the gas for cleaning the surgical scope.

In any of these embodiments, the controller may be configured to control a cleaning sequence that includes providing the liquid flow for a first period and providing the second flow of the gas for a second period that is at least partially subsequent to the first period.

In any of these embodiments, the apparatus may be configured for receiving a scope cleaning command from an external system.

In any of these embodiments, the external system may include an image processing system.

In any of these embodiments, the external system may include an endoscopic imager comprising the surgical scope.

In any of these embodiments, the apparatus may further include a user interface for receiving a scope cleaning command from a user.

According to some embodiments, a tube set for supplying fluids to a surgical field includes a connector for connecting the tube set to a fluid supply system; a first supply tube for supplying a first gas flow for insufflating a surgical cavity during a surgical procedure, the first supply tube connected to a first port of the connector; a second supply tube for supplying a liquid for cleaning a surgical scope during the surgical procedure, the second supply tube connected to a second port of the connector; and a third supply tube for supplying a second gas flow for clearing the liquid from the surgical scope during the surgical procedure, the third supply tube connected to a third port of the connector.

In any of these embodiments, the tube set further includes an outer tube for housing the first, second, and third supply tubes.

In any of these embodiments, the tube set may be a single use tube set.

In any of these embodiments, the first, second, and third supply tubes may be made of plastic.

In any of these embodiments, a length of the tube set may allow one end of the tube set to extend into the surgical field and an opposite end to connect to at least one piece of equipment for supplying a fluid to the surgical field.

In any of these embodiments, the tube set may further include an evacuation tube for evacuating smoke from the surgical cavity during the surgical procedure.

In any of these embodiments, the connector may include at least one filter for filtering smoke evacuated from the surgical cavity.

In any of these embodiments, the connector may include a housing that comprises ports for connecting the first supply tube and the third supply tube to the fluid supply system.

In any of these embodiments, the housing may be configured for latching to a receiver of the fluid supply system.

In any of these embodiments, the tube set may further include a reservoir connection tube for connecting to a reservoir of the liquid for cleaning the surgical scope.

In any of these embodiments, the tube set may further include a pressurization tube for supplying pressurization gas for pressurizing the reservoir.

In any of these embodiments, the pressurization tube may be connectable to a pressurization sleeve for pressurizing a bag comprising the reservoir.

In any of these embodiments, the connector may include a valve for controlling flow from the reservoir connection tube to the second supply tube.

In any of these embodiments, the connector may include a reservoir of the liquid for cleaning the surgical scope.

In any of these embodiments, the tube set may further include an irrigation supply line for supplying the liquid for irrigating the surgical cavity, the irrigation supply line connected to the connector.

In any of these embodiments, the tube set may further include a surgical scope cleaning apparatus that is connected to the second and third supply tubes for cleaning the surgical scope during the surgical procedure.

According to some embodiments, a method for supplying fluids to a surgical field includes connecting a connector of a tube set to a fluid supply system, wherein the tube set comprises a first supply tube connected to a first port of the connector, a second supply tube connected to a second port of the connector, and a third supply tube connected to a third port of the connector; supplying a first gas flow for insufflating a surgical cavity during a surgical procedure via the first supply tube; supplying a liquid for cleaning a surgical scope during the surgical procedure via the second supply tube; and supplying a second gas flow for clearing the liquid from the surgical scope during the surgical procedure via the third supply tube.

In any of these embodiments, the first gas flow and the second gas flow may include the same gas.

In any of these embodiments, the tube set may be a sterilized and packaged tube set.

In any of these embodiments, the tube set may be a single use tube set.

In any of these embodiments, the method may further include evacuating the surgical cavity via an evacuation tube connected to a fourth port of the connector.

According to some embodiments, a system for cleaning a surgical scope of an endoscopic imager includes a control system communicatively connected to an apparatus for supplying fluids to a surgical scope cleaner, the control system configured to: receive one or more images of a surgical field generated by the endoscopic imager, detect a deposit on a lens of the surgical scope by analyzing the one or more images, and send a command to the apparatus to provide one or more fluids to the surgical field for cleaning the surgical scope.

In any of these embodiments, the system may include the apparatus and the apparatus may be configured for supplying a liquid flow and a gas flow for a surgical field for cleaning a lens of the surgical scope during a surgical procedure.

In any of these embodiments, the apparatus may be configured to perform a cleaning sequence in response to receiving the command from the control system, the cleaning sequence including supplying the liquid flow for a first period and supplying the gas flow for a second period that is at least partially subsequent to the first period.

In any of these embodiments, the control system may be configured for analyzing the one or more images at least partially by comparing at least one of the one or more images to at least one previously generated image.

In any of these embodiments, the control system may be further configured to: provide a notification to a user that a deposit on the lens has been detected, receive a confirmation from a user to clean the surgical scope, and in response to receiving the confirmation from the user, send the command to the apparatus to provide the one or more fluids to the surgical field for cleaning the surgical scope.

In any of these embodiments, the confirmation from the user may be received from an endoscopic imager that is communicatively connected to the control system.

In any of these embodiments, the apparatus may be configured for supplying an insufflating gas flow to the surgical field.

According to some embodiments, a method for cleaning a surgical scope of an endoscopic imager via a control system communicatively connected to an apparatus for supplying fluids to a surgical scope cleaner includes receiving one or more images of a surgical field from the endoscopic imager at the control system; detecting by the control system a deposit on a lens of the surgical scope by analyzing the one or more images; and sending a command from the control system to the apparatus to provide one or more fluids to the surgical field for cleaning the surgical scope.

In any of these embodiments, the method may further include, in response to receiving the command from the control system, supplying a liquid flow and a gas flow from the apparatus for cleaning a lens of the surgical scope during a surgical procedure.

In any of these embodiments, supplying the liquid flow and the gas flow may include supplying the liquid flow for a first period and supplying the gas flow for a second period that is at least partially subsequent to the first period.

In any of these embodiments, the method further includes providing a notification to a user that a deposit on the lens has been detected; receiving a confirmation from a user to clean the surgical scope; and in response to receiving the confirmation from the user, sending the command to the apparatus to provide the liquid flow and the gas flow to the surgical field for cleaning the lens of the surgical scope.

In any of these embodiments, the confirmation from the user may be received from an endoscopic imager that is communicatively connected to the control system.

In any of these embodiments, the method may further include supplying an insufflating gas flow from the apparatus to the surgical field.

According to some embodiments, an endoscope includes a main body comprising a light port and at least one fluid port; and a shaft extending distally from the main body and including: a first wall portion that houses fiber optics for directing light introduced through the light port, a second wall portion extending partially around the first wall portion, an optical component located at a distal end of the shaft, at least one fluid channel located between the first wall portion and the second wall portion and configured for conveying fluid along the shaft, and at least one fluid outlet located at the distal end of the shaft and configured to direct fluid from the at least one fluid channel onto the optical component.

In any of these embodiments, the shaft may include a non-cylindrical outer surface defined by an outer surface of the first wall portion and an outer surface of the second wall portion.

In any of these embodiments, a width of the shaft in a first direction may be equal to an outer diameter of the first wall portion.

In any of these embodiments, the first wall portion may extend into the main body.

In any of these embodiments, a seal may be located in the main body for sealing against the first wall portion.

In any of these embodiments, the second wall portion may extend distally from the main body.

In any of these embodiments, the at least one fluid outlet may be formed by a distal end of the second wall portion.

In any of these embodiments, the shaft may include a single fluid channel and a single fluid outlet.

In any of these embodiments, the endoscope may be a sinuscope.

DETAILED DESCRIPTION

Reference will now be made in detail to implementations and embodiments of various aspects and variations of systems and methods described herein. Although several exemplary variations of the systems and methods are described herein, other variations of the systems and methods may include aspects of the systems and methods described herein combined in any suitable manner having combinations of all or some of the aspects described.

Described below are systems and methods, according to various embodiments, for cleaning a surgical scope during a surgical procedure with minimal interruption of the surgical procedure. According to some embodiments, a surgical scope cleaner includes a sheath that slides over the surgical scope and includes at least one nozzle for flushing the surface of the lens with a spray of a liquid such as saline and then blowing the lens with a burst of a gas such as carbon dioxide. Conduits running along the sheath lead from input ports at an end of the cleaner that can be connected to pressurized liquid and gas sources via a tube set. The sheath can be configured to slide over a standard size scope and to fit through the lumen of a standard size trocar. The surgical scope with mounted scope cleaner can be inserted through a trocar into the surgical cavity, and the cleaner can be used to clean the scope during the surgical procedure with minimal disruption to the procedure.

The at least one nozzle incorporated into the end of the sheath can point towards the lens of the scope to spray the cleaning liquid and blow gas with a high velocity directly at the lens. The at least one nozzle can be configured so that the high-velocity liquid spray clears off the entire surface of the lens—i.e., pressure washing the lens. The burst of gas can be provided after the liquid spray is complete to blow the surface of the lens dry and can also be provided at the same time as the liquid spray to enhance the liquid spray, increasing its velocity and hence its cleaning power. According to some embodiments, the sequence of the liquid spray and the gas burst, as well as the length of time they are activated, can be controlled by electromechanical valves in a fluid management system to which the scope cleaner is connected.

In some embodiments, the liquid and gas used for the scope cleaner are saline and carbon dioxide, which are used in most laparoscopic surgeries—the saline is often used to flush or irrigate when needed during surgery and carbon dioxide is often used to insufflate (or distend) the abdomen. Saline has been shown to be able to sufficiently clean blood, fat, and tissue debris from the lens of scopes used in surgery. Thus, surgical scope cleaning, according to some embodiments, can be incorporated into existing surgical systems.

According to some embodiments, a fluid management system to which the scope cleaner is connected can also be used to manage other fluids used in a surgical procedure. A fluid management system that provides, for example, carbon dioxide to the scope cleaner can also serve as an insufflator, providing the carbon dioxide to insufflate the surgical cavity. In some embodiments, the pressurized carbon dioxide gas that is received and regulated by the system for insufflation can also be used to pressurize the saline for the lens flushing and to blow the lens dry after the flushing cycle. Thus, scope cleaning can be provided without having to add an additional piece of equipment to the operating room.

According to some embodiments, the scope cleaner can be integrated into an insufflator tube set, which can help reduce clutter in the sterile field where the surgeon is operating. Clutter caused by the many hoses and wires that are attached to instruments in the sterile field and to control units and supply lines from outside the sterile field can restrict the movement of the surgical team during surgery as they try to avoid accidentally pulling or tripping on the hoses and wires and also increases the likelihood that an important instrument will be pulled onto the floor, causing damage and interruption to the surgical procedure. Thus, according to some embodiments, tubes, hoses, wires, etc., including those for the surgical scope cleaner, are combined into a single tube set, which reduces the clutter in and around the sterile field. A tube set that includes a scope cleaner can be disposable and single-use, or could also be reusable in order to reduce long-term costs to the user.

According to some embodiments, since the control of flow of the liquid and gas for the scope cleaner can be provided by a fluid management system, the surgical scope cleaning can be controlled by other equipment in the operating room through device control. The fluid management system can be connected to a control unit that can receive commands from surgical staff in several different ways and can transmit those commands to the fluid management system. These commands originate, for example, as voice commands, button presses on an endoscopic camera head for scrolling through menus and selecting options via the operating surgeon's display (OSD), button presses by the support staff outside of the sterile field on the touchscreen of the control unit, or on a touchscreen of a remote tablet that can be used with the control unit. According to some embodiments, the liquid and gas for scope cleaning can also be controlled by button presses on the touchscreen of the fluid management system itself.

In some embodiments, the control unit or other device can analyze video from the endoscopic camera connected to the surgical scope with scope cleaner to detect when the image becomes blurry due to scope smudging and/or scope fogging. Upon detecting scope smudging and/or fogging, the control unit can send a command to the fluid management system to initiate a cleaning sequence.

In the following description of the various embodiments, reference is made to the accompanying drawings, in which are shown, by way of illustration, specific embodiments that can be practiced. It is to be understood that other embodiments and examples can be practiced, and changes can be made without departing from the scope of the disclosure.

Certain aspects of the present disclosure include process steps and instructions described herein in the form of an algorithm. It should be noted that the process steps and instructions of the present disclosure could be embodied in software, firmware, or hardware and, when embodied in software, could be downloaded to reside on and be operated from different platforms used by a variety of operating systems. Unless specifically stated otherwise as apparent from the following discussion, it is appreciated that, throughout the description, discussions utilizing terms such as “processing,” “computing,” “calculating,” “determining,” “displaying,” “generating” or the like, refer to the action and processes of a computer system, or similar electronic computing device, that manipulates and transforms data represented as physical (electronic) quantities within the computer system memories or registers or other such information storage, transmission, or display devices.

Furthermore, the computers referred to in the specification may include a single processor or may be architectures employing multiple processor designs for increased computing capability.

FIGS.1A and1Billustrate a surgical scope cleaner100mounted on a surgical scope150, according to some embodiments. The surgical scope cleaner100can be configured for mounting on a standard size surgical scope and for insertion through the cannula of a standard size trocar into a surgical cavity. With the surgical scope cleaner100mounted, the surgical scope150can be used for imaging in the surgical cavity (along with an attached endoscope) during a surgical procedure. The surgical scope cleaner100can be used to remove smudging and/or condensation from the lens at the end of the surgical scope while the surgical scope remains in place in the surgical cavity during the surgical procedure.

In the illustrated embodiments, the surgical scope150includes an elongated and generally hollow tube152with a distal end153that is inserted into a body cavity, such as through the lumen of a trocar. The tube152extends from a housing154to which an eyepiece155is fitted to provide a viewing port through which the surgeon views the surgical field (for example, directly or through a connection between a viewing port, an endoscopic camera, and a display screen). A light port157extends from the housing154for connecting the scope150to an illuminator via a light cable to transmit light to a target via the scope150. The surgical scope150can be, for example, a laparoscope. The surgical scope can be any type of surgical scope, including, for example, a surgical scope with an integrated camera.

The surgical scope cleaner100includes a sheath102that slides over the tube152of the surgical scope150. The sheath102may define a generally cylindrical bore126that may be configured to fit to a tube of a standard size scope. The bore126may be sized so that the tube152can slide in and out of the sheath102while remaining radially fixed in position relative to the sheath102such the tube152and the bore126share substantially the same longitudinal axis124.

A nozzle head110is located at a distal end103of the sheath102and extends past the distal end153of the tube152of the surgical scope150. As explained further below, liquid and gas can be sprayed/blown from the nozzle head110to clean the lens at the end of the tube152. The scope cleaner100is configured to remain mounted on the surgical scope as the surgical scope is being used throughout a surgical procedure. The lens can be cleaned as needed without the surgical scope needing to be removed from the surgical cavity.

The sheath102extends from a receiver104that is configured to receive a housing154of the surgical scope150. The receiver104may include one or more retention features (not shown) for retaining the housing154of the surgical scope150. In some embodiments, retention features may orient the scope with respect to the sheath102, which may be important for the angular scopes (scopes having an angled distal end and a lens that points at an angle from the central axis of the scope, such as 30 or 45 degrees from the axis) in order to ensure that the nozzles are directed correctly at the angled lenses. In some embodiments, the receiver104may be shaped to receive the housing154in the correct angular orientation for ensuring that the nozzle head110is properly oriented with respect to an angled scope.

A liquid port106and a gas port108are provided in the receiver104and may be connected to a liquid supply line130and a gas supply line132, respectively, that are connected to liquid and gas supplies. In some embodiments, the liquid and gas ports106,108extend from the sheath102. As described further below, liquid and gas supplied through the respective ports flows through at least one conduit in the sheath to at least one nozzle in the distal end103of the sheath102for spraying liquid and blowing gas onto the lens at the distal end153of the tube152of the surgical scope150to clean the lens of smudges and/or condensation.

FIG.1Cillustrates the distal end103of the sheath102with the distal end153of the tube152of the surgical scope150received therein. The distal end103has a nozzle head110that extends past the distal end153of the surgical scope150. In the illustrated embodiment, the nozzle head110includes two nozzles located side-by-side—liquid nozzle112and gas nozzle114. In other embodiments, the nozzles are spaced longitudinally, rather than circumferentially. The nozzles are configured to direct their respective flows onto the lens156at the distal end of the tube152of the surgical scope150. In some embodiments, a single nozzle is provided and both the liquid and gas conduits feed into the single nozzle.

FIG.1Dis a cross-section of the sheath102that illustrates the liquid conduit118and gas conduit120that extend longitudinally through the sheath102of the cleaner100, according to some embodiments, to provide flow paths from the liquid and gas ports106,108to the liquid and gas nozzles,112,114at the distal end103of the sheath102. The sheath102includes a wall116, and the conduits118,120are formed in the wall116such that the conduits are completely enclosed around their longitudinal perimeter. In the illustrated embodiment, the conduits118,120are non-circular in cross-section and curve in a circumferential direction about the longitudinal axis124through a portion of the circumference of the wall. Curved conduits enable the outer diameter of the wall to be minimized while still providing a sufficient flow rate through the conduit. In other embodiments, the conduits may be circular or any other suitable shape depending on the wall thickness and the desired flow rate and pressure drop through the conduits. The conduits118,120can extend longitudinally through the wall from the liquid and gas ports106,108to the nozzle head110. In some embodiments, the liquid and gas conduits merge prior to reaching the nozzle head such that a single conduit extends from a merging of the two conduits to the nozzle head110. In some embodiments, the liquid and gas flow paths merge at or near the liquid and gas ports106,108such that a single conduit extends substantially the entire longitudinal extent of the sheath102.

The bore126of the sheath102may be cylindrical and may be configured to fit to a standard tube of a surgical scope. The outer surface122of the sheath102may also be cylindrical. In some embodiments, the outer surface122of the sheath102may extend about a longitudinal axis125that is different than the longitudinal axis124of the bore126of the sheath102(seeFIG.1E). This off-center arrangement results in one side of the wall116being thicker than the other size of the wall116, with the thicker portion of the wall accommodating the conduits118,120. This is shown inFIG.1D. Thus, the wall can accommodate the conduits while keeping the outer diameter of the sheath102to a minimum so that the sheath102can fit within a standard size trocar while being mounted on a standard size surgical scope.

FIG.1Eis a cross-section of distal portions of the scope cleaner100and surgical scope150. The distal end153of the tube152of the surgical scope150includes a lens156. Each nozzle112,114may be include a channel136in the nozzle head110. A distal wall138of the channel136may be angled so that fluid moving longitudinally from the conduits118,120is directed by the wall138toward the lens of the scope.

According to some embodiments, the nozzle head110is configured so that the field of view of the scope150is not obstructed by the scope cleaner100. The field of view of the scope150is represented by dashed lines158inFIG.1E. The nozzle head110may extend radially inward of the outer diameter160of the tube152, but the radially innermost portion128of the nozzle head110may be positioned with respect to the longitudinal axis124of the tube152so that the innermost portion128does encroach into the field of view.

In some embodiments, the nozzle head110may be configured to reduce the amount of light that may be reflected onto the lens156. For example, at least the portion of the nozzle head110that faces the lens156may be made from a light absorbing material and/or may be colored to absorb light (e.g., colored black).

FIGS.1F and1Gillustrate an alternative embodiment for locating the nozzle head110outside of the field of view of the surgical scope. In the illustrated embodiment, the distal portion134of the sheath102is angled away from the longitudinal axis124of the bore126of the sheath102so that the distal end103of the sheath102is spaced away from the distal end153of the tube152in the radial direction when the cleaner100is mounted to the scope150. As a result, the nozzle head110is well outside of the field of view of the scope150. The sheath102is configured so that the distal portion134can be bent back against the tube152so that the distal portion134can fit within a trocar when inserting the cleaner100into the surgical cavity, as shown inFIG.1G. Once the distal portion134is through the trocar and into the surgical field, the distal portion springs back outward. In some embodiments, the compliance of the material that forms the sheath102enables the sheath to be elastically deformed inwardly toward the tube152and to then spring back outward to a repeatable position.

As shown inFIG.1A, the distal portion134of the sheath102extends only partially around the tube152so that the distal portion of the sheath102can move inward and outward relative to the tube152. In some embodiments, the proximal portion of the sheath102can extend fully around the tube152while the distal portion extends only partially around the tube152. This enables the distal portion of the sheath102to angle away from the tube152while still allowing the sheath102to be securely mounted on the tube152. In some embodiments, the sheath102extends only partially around the circumference of the tube152along the entire length of the tube152. According to various embodiments, the length of the distal portion of the sheath102that extends only partially around the tube152is selected such that only the distal portion of the sheath—the portion that extends only partially around the tube152—is located in a trocar during use. By having the portion of the sheath that is positioned in the trocar during use extend only partially around the tube152, the overall size of the sheath with inserted tube152can be less such that a smaller trocar can be used as compared to a sheath that extends fully around the tube152.

In embodiments in which the sheath102is configured to angle away from the tube152, the nozzle head110may be made larger relative to embodiments in which the sheath102remains adjacent to the tube152along its entire length, which can increase manufacturability of the nozzle head110and/or increase nozzle performance.

FIG.1Hillustrates an embodiment in which the sheath is not configured to angle away from the tube152. In this embodiment, the sheath102can extend fully around the tube152the full length of the sheath102. Embodiments in which the sheath102remains adjacent to the tube152along the full length of the sheath can also include a sheath that does not extend fully around the tube152for at least a portion of the length of the sheath.

In some embodiments, the scope cleaner100is made to be disposable and can be discarded after being used in a surgical procedure. In other embodiments, the scope cleaner may be configured for reuse and, as such, may be sterilizable. The scope cleaner100can be made of any suitable material, including any suitable plastic or metal. Examples of suitable plastics include Polycarbonate, Acrylic, Polyethylene terephthalate, Cyclic olefin copolymer, and Fluorinated Ethylene Propylene. In some embodiment, the scope cleaner is made via extrusion of one or more of these plastics or another suitable plastic. In some embodiments, the sheath102can be extruded out of a first plastic and the nozzle head110can be molded out of a different plastic and the two pieces bonded together. This might be desirable in embodiments in which the sheath102(in addition to the receiver104in some embodiments) has a first color and the nozzle head110has a second color, allowing for more material options for the extrusion and reduced costs and easier manufacturing. The scope cleaner can be molded, machined, 3D printed, or any combination thereof. The scope cleaner can be made of multiple components that are assembled together. For example, the nozzle head110may be affixed to the distal end103of a separate sheath102which may be attached to the receiver104.

According to some embodiments, the surgical scope cleaner100can be connected to a liquid and gas supply system that controls delivery of liquid and gas to the surgical scope cleaner during use. As such, the surgical scope cleaner100can be free of any valving, which can provide greater simplicity and cheaper manufacturing, which may be especially advantageous for disposable scope cleaner embodiments. In other embodiments, the surgical scope cleaner can include one or more valves that may control flow of the liquid and/or gas. For example, the scope cleaner may include one or more push-button actuated valves that a user can actuate to provide the liquid spray and/or the burst of gas. One or more valves may be positioned, for example, in the receiver downstream of the ports106,108or may be positioned upstream of the ports, such as in a tube set connecting the cleaner to the liquid and gas supplies.

FIGS.11and1Jillustrate the operation of the surgical scope cleaner100according to some embodiments. First, as shown inFIG.1H, liquid, such as saline, is sprayed from the nozzle head110onto the lens156to remove deposits on the lens. The deposits can be, for example, blood, fat, pieces of tissue, or bile from the surgical cavity, lubricant from the seals of the trocar through which the surgical scope was inserted, fluids sprayed in the surgical cavity during the surgical procedure, such as saline for flushing or therapeutic agents, or any other substance that may deposit on the lens. The liquid may be provided to the scope cleaner100from a pressurized source so that the liquid impacts the lens at a velocity that is sufficient to mechanically remove the deposits. The liquid may also serve to dissolve at least some of the deposits to aid in removal. In some embodiments, the liquid pressure at the pressurized source is at least 1 psi, at least 3 psi, at least 5 psi, or at least 10 psi. In some embodiments, the liquid pressure at the pressurized source is 50 psi or less, 30 psi or less, 20 psi or less, or 10 psi or less.

Next, as shown inFIG.1J, a jet of gas is delivered from the nozzle head110onto the lens to remove the liquid and any loosened deposits remaining on the lens. The gas may be, for example, carbon dioxide, which is commonly available in the surgical field such as for insufflating the surgical cavity. As with the liquid, the gas may be provided from a pressurized gas source so that a burst of the gas is blown onto the nozzle with a relatively high velocity. In some embodiments, the gas pressure at the pressurized gas source is at least 5 psi, at least 10 psi, at least 50 psi, or at least 100 psi. In some embodiments, the gas pressure at the pressurized gas source is 500 psi or less, 250 psi or less, 150 psi or less, or 100 psi or less. The burst of the gas blows the sprayed liquid and any remaining deposits off of the lens, leaving the lens clean and clear. To the extent that some deposits remain, the cleaning sequence can be repeated as necessary.

In some embodiments, at least a portion of the period that the gas is delivered can overlap with at least a portion of the period of liquid spray. This can increase the velocity of the liquid spray, increasing its cleaning power.

In some embodiments, the scope cleaner may be configured for preventing fogging of the lens of the scope by warming the surgical scope and/or providing a steady stream of gas to the surgical scope.FIG.2is a cross section of a portion of a scope cleaner200that is configured for warming and for providing a steady stream of gas to a surgical scope, according to some embodiments. One or more resistive heating wires234may be incorporated into the sheath202for warming to prevent fogging. One or more wires234can be molded into the wall216of the sheath202to warm the tube of a surgical scope received therein. Alternatively or additionally, one or more wires236can extend within the gas conduit220to warm the gas as it flows through. The one or more wires234and/or236can be connected to an electrical source via wiring that, for example, is incorporated into a tube set that includes tubes carrying liquid and gas for the scope cleaner100.

In some embodiments, the scope cleaner200is configured for providing a steady stream of gas for preventing fogging while also providing a burst of gas for the cleaning sequence. The cleaner200may include a shuttle valve238that has two separate gas inlets240and242for connecting to two separate gas lines. A first gas inlet240can be used for providing low pressure gas that, when flowing, provides a steady stream of gas down the gas conduit220and out onto the lens of the scope. The low pressure gas could be regulated to be, for example, 2 psi or less. A burst of high pressure gas through the second gas inlet242will force the shuttle valve244to the position closing off the low pressure line, opening the flow path for the high pressure burst, which will flow down the gas conduit220to the lens of the scope. When the high pressure burst is finished, the pressure from the low pressure gas will shuttle the shuttle valve back to the position allowing the low pressure gas to flow.

In some embodiments, the low pressure gas flow can be the insufflating gas flow for insufflating the surgical cavity, which can eliminate the need for a separate insufflating line and insufflating inlet to the surgical cavity. In some embodiments, a scope cleaner is configured for scope heating, gas heating, and/or steady gas flow.

According to some embodiments, the liquid and gas supplies for the surgical scope cleaner can be incorporated into an apparatus that manages the flow of other fluids into and out of the surgical field. In addition to the liquid and gas supplies for the surgical scope cleaner, examples of other fluid management that can be provided, according to various embodiments, include providing insufflating gas for pressurizing the surgical cavity of a patient, evacuating smoke that may be created in the surgical cavity via cauterization, supplying irrigation liquid within the surgical cavity, removing liquid from the surgical cavity, and supplying of therapeutic agents to the surgical cavity.

FIG.3is a block diagram of an apparatus300for managing fluid flow into and out of a surgical field, according to some embodiments. Apparatus300controls the flow of liquid and gas to a surgical scope cleaner, such as scope cleaner100, and the flow of insufflating gas for pressurizing a surgical cavity. Apparatus300can be configured for managing the flow of any other fluids that are needed for the surgical field. A surgical scope cleaner and a device, such as a trocar, for directing insufflating gas into the surgical cavity can be connected to the apparatus300via, for example, flexible tubing that extends from the apparatus300into the surgical field.

Apparatus300includes a first gas supply port302for providing the gas supply to the surgical scope cleaner and a second gas supply port304for supplying an insufflating gas flow to the surgical cavity of a patient. The apparatus300includes a gas inlet port306for supplying gas to the apparatus300. The gas inlet port306can be connected to a pressurized gas supply, such as a carbon dioxide wall or service head outlet or a carbon dioxide canister.

Gas supplies to the first and second gas supply ports302,304can be controlled via first and second gas flow control subsystems308and310, respectively. Each gas flow control subsystem can include, for example, a pressure regulator312for stepping down the pressure of the gas supplied to the apparatus300and a valve314for turning the flow of gas to the respective port302,304on and off. In some embodiments, a single pressure regulator315may be used for both the first and second gas supply ports302,304.

Apparatus300also includes an actuator316for controlling flow of liquid to the surgical scope cleaner. The actuator316may be operatively connected to a flow device318that connects a liquid supply reservoir320to a liquid supply port322. The surgical scope cleaner can be connected to the liquid supply port322via tubing for receiving liquid from the liquid supply reservoir320as controlled by the actuator316and flow device318.

The actuator316and flow device318can be implemented in different ways according to various embodiments. In some embodiments, the flow device318is a valve that is moved between open and closed positions by the actuator316. In other embodiments, the flow device318is a flexible tube that is compressed by the actuator316to close of the flow path through the flow device318. The actuator316can be a linear actuator, such as a solenoid, that operates the valve or compresses the flexible tube. In other embodiments, the actuator316is a rotary actuator, such as a stepper motor or servomotor, that rotates the valve between open and closed positions. In some embodiments, the flow device318is a pump that is actuated by the actuator316. The actuator316may be, for example, a motor that rotates a shaft onto which the pump is mounted.

In the illustrated embodiments, the flow device318is separate from and external to the apparatus300, which results in the liquid flow path being entirely external to the apparatus300. This arrangement can be advantageous in that there are no apparatus components that need sterilization. In other embodiments, the flow device318may be included in or otherwise as part of the apparatus300.

The liquid supply reservoir320can be any suitable reservoir for providing the liquid needed for scope cleaning. For example, the liquid supply reservoir320can be a saline bag that is connected to the flow device318via tubing or can be combined with the flow device318into a single unit. In some embodiments, the liquid supply reservoir320is incorporated into the apparatus300.

The apparatus300can include other fluid supply or discharge components. For example, the apparatus300can include a vacuum controller324for providing vacuum to the surgical field via a vacuum port326. The vacuum can be used, for example, for evacuating smoke from the surgical field and/or suctioning liquid, such as blood, from the surgical field.

In some embodiments, the apparatus300includes a liquid reservoir pressurization subsystem336for pressurizing the liquid supply reservoir320using the same gas as used for the scope cleaning or a different gas. The pressurization subsystem336can provide pressurized gas, such as gas from the gas inlet port306, to the liquid supply reservoir320. In some embodiments, the pressurized gas can create head pressure in the reservoir320. In other embodiments, the pressurized gas can compress the reservoir itself. For example, the reservoir may be a saline bag fitted within a pressurization sleeve338that receives the pressurized gas from the liquid reservoir pressurization subsystem336.

The liquid reservoir pressurization subsystem336can include one or more valves340for controlling flow of pressurized gas, which can be the same gas as provided via the gas inlet port306. In some embodiments, the liquid reservoir pressurization subsystem336can include a pressure regulator342for stepping down the pressure received via the inlet port306or via one or more upstream regulators, such as regulator315. In some embodiments, the apparatus can be configured to control the liquid reservoir pressurization subsystem336to automatically depressurize the pressurization sleeve338at the end of a surgical procedure, such as when the insufflation is stopped.

The gas flow control subsystems308,310, the actuator316, and any other electronic component of the apparatus300can be control via a controller328. The controller328may include one or more processors and memory that stores instructions for execution by the one or more processors for controlling fluid management by the apparatus300. The controller328may provide electrical signals to one or more valves and/or pressure regulators of the control subsystems308,310and to actuator316actuating the actuator316. The controller can also be used to control any other fluid management subsystems, including the vacuum controller324and the liquid reservoir pressurization subsystem336.

The controller328may be communicatively connected to an external control system334via a communication port330for receiving liquid and gas supply control commands from the external system334. For example, the controller328may receive a command to execute a cleaning sequence for the surgical scope cleaner, and in response, the controller may control the actuator316for supplying the liquid to the surgical scope cleaner for a predetermined period of time for spraying onto the lens of the surgical scope, as discussed above, and control the first gas flow control subsystem308for supplying a gas flow to the surgical scope cleaner for a second predetermined period of time for blowing liquid off of the lens of the surgical scope.

The apparatus300may include a user interface332for a user to control one or more aspects of the liquid and gas supply from the apparatus. The user interface332may be used, for example, for receiving commands for starting and stopping the insufflating gas flow and/or changing the insufflating gas pressure or for controlling any other function of the apparatus300, according to various embodiments.

In some embodiments, lines for conducting fluids managed by a fluid supply apparatus, such as apparatus300, to the surgical field are connected directly to the ports of the apparatus. In other embodiments, the supply lines are connected to a connector that is connected to a receptacle of the apparatus.FIG.4Aillustrates a fluid supply apparatus400in which a connector410is used to connect multiple fluid lines to the apparatus400.

The connector410includes a gas supply port412for supplying gas to a surgical scope cleaner via a gas supply line414, a liquid supply port416for supplying liquid to the surgical scope cleaner via a liquid supply line418, and a liquid inlet port420for receiving liquid from an external liquid reservoir for the surgical scope cleaner via a liquid inlet line421. A liquid reservoir pressurization port424can be included for supplying pressurized gas to a liquid supply reservoir, such as reservoir320ofFIG.3, via a liquid reservoir pressurization line422.

The connector410also includes an insufflating gas supply port426for supplying an insufflating gas flow to the surgical cavity via an insufflating gas line428and a smoke evacuation port430for evacuating smoke from the surgical cavity via a smoke evacuation line432. The connector410can include an inflow filter housing434that houses one or more filters for filtering smoke received via the evacuation port430. The connector410can include other filters for filtering fluid provided to and received from the surgical field.

The connector410may be removably received in a receptacle450of the apparatus300. One or more latches452may be used to retain the connector410in the receptacle450. One or more ejection mechanisms454can be used to release the one or more latches452for removing the connector410from the receptacle450.

FIG.4Billustrates the receptacle450, according to some embodiments. The receptacle450includes the first gas supply port402for supplying gas flow to the surgical scope cleaner, a second gas supply port404for supplying insufflating gas flow to the surgical cavity, and a smoke evacuation port430for evacuating smoke from the surgical cavity. The receptacle450also includes a liquid reservoir pressurization port456for providing pressurization gas to a liquid supply reservoir, such as liquid supply reservoir320ofFIG.3.

The receptacle450may include a switch458that is depressed or otherwise actuated when the connector410is received in the receptacle450. The switch458may be connected to a controller, such as controller328ofFIG.3, which may control the flow of one or more fluids based on the status of the switch so that there is no flow through one or more of the ports of the receptacle450when the connector410is not received in the receptacle450. The receptacle450also includes an aperture460through which an end of an actuator for actuating a flow control device in the connector410extends, as discussed further below. The receptacle450may also include an electrical connection462for providing electricity to one or more heated tubes connected to the connector410.

The rear side (not shown) of the connector410includes ports that fit to the ports of the receptacle450described above. One or more seals may be provided on any of the ports of the receptacle450and/or on any of the ports of the rear side of the connector410. The rear side also includes an aperture for receiving the end of the actuator.

FIGS.4C and4Dare cross sections of the connector410located in the receptacle450, illustrating a flow device436incorporated into the connector410. Flow device436includes a valve438that is moved laterally to open and close a liquid flow path440through the flow device436.FIG.4Cillustrates the closed position andFIG.4Dillustrates the open position of the valve438. The valve438is moved from the closed position to the open position by one end439of a lever442and is returned to the open position through the force of a spring444. The lever442pivots about a pivot axis445. To actuate the valve438, a plunger446of a solenoid actuator448in the apparatus400pushes on the other end443of the lever442, causing the lever to pivot about the pivot axis445, pushing the end439of the lever442against the valve438, forcing the valve to move laterally to the open position against the force of the spring444. As shown inFIG.4D, with the valve438in its open position liquid from a liquid supply reservoir can flow through the flow device436via the liquid inlet port420and out to the surgical scope cleaner via the liquid supply port416.

FIGS.5A-5Billustrate a fluid supply apparatus500and tube set connector510in which a liquid supply reservoir for supplying the liquid for the scope cleaner is incorporated into the connector510, according to some embodiments. Similarly to connector410, connector510, as shown inFIG.5A, includes a gas supply port512for supplying gas to a surgical scope cleaner via a gas supply line514, a liquid supply port516for supplying liquid to the surgical scope cleaner via a liquid supply line518, an insufflating gas supply port526for supplying an insufflating gas flow to the surgical cavity via an insufflating gas line528, and a smoke evacuation port530for evacuating smoke from the surgical cavity via a smoke evacuation line532. However, unlike connector410, connector510does not have a liquid supply port for receiving liquid from an external liquid reservoir. Instead, connector510includes a liquid reservoir590built in.

The connector510can include a reservoir filling port592for filling the liquid reservoir590with liquid, such as saline. The filling port592may have a one-way valve for sealing the port when the reservoir590is pressurized, as discussed further below. A bleeder valve594may be provided for bleeding air when filling the reservoir590.

FIG.5Billustrates the receptacle550of the apparatus500that receives the connector510, according to some embodiments. The receptacle550includes the first gas supply port502for supplying gas flow to the surgical scope cleaner, a second gas supply port504for supplying insufflating gas flow to the surgical cavity, and a smoke evacuation port530for evacuating smoke from the surgical cavity. The receptacle550also includes a liquid reservoir pressurization port556for providing pressurized gas to the liquid reservoir590to pressurize the liquid provided to the scope cleaner.

According to some embodiments, a flow device in the form of a valve is provided within the apparatus500for controlling the flow of liquid from the reservoir590. Accordingly, the receptacle550includes a liquid inlet552that receives liquid from the reservoir590(via a connection with an outlet on the back of the connector510, which is not shown) and a liquid outlet554for providing the liquid to the scope cleaner via the connector510. The flow device is provided in a flow line that extends between the liquid inlet552and outlet554. The flow device is actuated by an actuator, such as a solenoid, so that the liquid flow can be turned on and off. Once the reservoir590is pressurized, opening the valve of the flow device allows liquid to flow to the scope cleaner.

FIGS.6A and6Billustrate a fluid supply apparatus600and tube set connector610in which a pump is incorporated into the connector610for pumping liquid from an external liquid supply reservoir to the scope cleaner, according to some embodiments. The connector610includes a gas supply port612for supplying gas to a surgical scope cleaner via a gas supply line614and a liquid supply port616for supplying liquid to the surgical scope cleaner via a liquid supply line618. A liquid inlet port620for receiving liquid from an external liquid reservoir, such as reservoir320ofFIG.3, via a liquid inlet tube622can lead into a pump impeller housed within a pump housing670. The connector610also includes an insufflating gas supply port626for supplying an insufflating gas flow to the surgical cavity via an insufflating gas line628and a smoke evacuation port630for evacuating smoke from the surgical cavity via a smoke evacuation line632.

FIG.6Bshows the receptacle650and the rear side611of the connector610that interfaces with the receptacle650. Extending through the rear side611of connector610is a shaft640for a pump impeller housed within the connector610. Mounted to the shaft640is a first coupler642that couples to and is driven by a second coupler644in the receptacle650. The second coupler644is mounted to a shaft of a motor located within the apparatus600. The motor drives the pump impeller to pump the liquid from the external liquid supply reservoir to the scope cleaner.

The pump can be started and stopped to control flow of liquid to the scope cleaner. Additionally or alternatively, an actuator can be used to open and close a liquid flow path in the connector610. In the embodiment illustrated inFIG.6B, a plunger646of the actuator, which can be in the form of a solenoid, extends from the receptacle650and is received in an aperture648in the rear side611of the connector610. The plunger646extends to a liquid flow line652in the connector610, which leads from the pump to the liquid supply port616. The plunger646can be extended through action of the solenoid to pinch off the liquid flow line652. Thus, in this embodiment, the flow device is the liquid flow line652, which is pinched down by the plunger646of the actuator to shut off flow of the liquid. The pump can run continuously and flow of liquid to the scope cleaner can be controlled by the pinching of the liquid flow line652. In some embodiments, the flow from the pump could also be controlled via a valve, such as valve438ofFIGS.4C-4D. In some embodiments, pump may be continuously pressurizing the liquid and flow can be controlled by, for example, a pinching actuator or a valve.

According to some embodiments, a pinching actuator can also be used for controlling flow of one or more other fluids, including, for example, the gas supply for the scope cleaner.FIG.6Billustrates a second plunger654extending from the receptacle650for pinching a second flow line656in the connector610. The second flow line can be, for example, a portion of the scope cleaner gas flow path through the connector610. This arrangement can eliminate the need for a valve located in the apparatus for controlling the gas flow to the scope cleaner. In some embodiments, a valve is provided for controlling flow through second flow line656.

According to some embodiments, including a pump in the connector610provides the ability for the apparatus to manage supply of liquid to the surgical field for additional purposes, such as for irrigation within the surgical cavity. One or more additional liquid flow path lines can lead from the pump to one or more additional tubes extending from the connector610. Referring back toFIG.6A, an irrigation outflow port672can be included for providing an irrigation outflow from the pump, via an irrigation tube674, to an irrigation supply device used to irrigate the surgical cavity. In some embodiments, the second plunger654or an additional plunger, can be used to pinch a flow line for the irrigation liquid in the connector610for controlling the flow of the irrigation fluid.

According to some embodiments, a connector, such as connector610, can include wires, cables, or other lines for providing electricity and/or data communication. In the embodiment illustrated inFIGS.6A-6B, the connector610includes a monopolar RF connector680and cable682for providing electricity to an electrocautery instrument in the surgical field. The connector680can interface with a power port684in the receptacle650, as shown inFIG.6B. Connector610can also include a control signal connector686for connecting a control signal wire688that can be used to control one or more functions of the apparatus600, such as the delivery of liquid and/or gas, the operation of the pump, or any other function. The wire688can lead, for example, to a switch or other remote control located in the surgical field that can be operated by a user.

According to some embodiments, an integrated tube set can be used to provide fluids managed by a fluid supply management apparatus, such as apparatus300,400,500, or600, to the surgical field. The integrated tube set can reduce the clutter in the surgical field by collecting fluid supply lines together. The integrated tube set can include a connector to which some or all of the lines are connected, such as any of connector410, connector510, or connector610, which can simplify the set-up process for connecting the lines to one or more pieces of equipment. An integrated tube set can also include one or more integrated devices that can be used in the surgical field to deliver fluids to or from the surgical field, such as a surgical scope cleaner and a suction/irrigation device. Integrated tube sets can be disposable, single-use tube sets or can be reusable tube sets that are sterilized between each use.

FIG.7illustrates the use of a tube set700, according to some embodiments, in a surgical field. The tube set700includes surgical scope cleaner702configured in accordance with the principles discussed above, which is connected to a scope cleaning gas supply tube704and a scope cleaning liquid supply tube706. In this embodiment, the surgical scope cleaner702is an integrated component of the tube set in which the scope cleaner and connected supply tubes are pre-connected, but in other embodiments, the scope cleaner is not provided as a part of the tube set, and the supply tubes704and706of the tube set are connected to a scope cleaner in preparation for a surgical procedure, such as in the operating room. The surgical scope cleaner702can be mounted to a surgical scope762fitted to an endoscopic camera746. The surgical scope cleaner702and surgical scope762can be inserted into the surgical cavity750through a first trocar730for visualizing the surgical cavity. When the lens764at the end of the surgical scope762gets smudged or fogs, the scope cleaner702can be used to clean the lens764in accordance with the principles discussed above.

The tube set700can include a suction and irrigation device708that is connected to an irrigation supply tube710and a suction tube712. The suction and irrigation device708can be inserted into a second trocar734for providing suction and irrigation in the surgical cavity750. The suction and irrigation device708can be an integrated component of the tube set or can be connected to the tube set in preparation for a surgery.

The tube set700can also include an insufflation gas supply tube714, which can be connected to a port732of a third trocar735for providing pressurized gas to the surgical cavity750. The tube set also includes a patient outflow tube716that can be connected to a port736of the second trocar734for withdrawing gas, such as smoke, from the surgical cavity750.

The tubes of the tube set700can be held together by an outer tube718, which can help declutter the operating room. In some embodiments, the tubes are held together by one or more straps that are wrapped around the tubes. The tube set can include other lines that extend into the surgical field, such as a monopolar line740for providing current to a cauterization tool742. The tube set could also include one or more data lines744and/or a light cable for connecting a camera control unit and/or an illuminator to an endoscopic camera746that is mounted to the surgical scope762. Tube sets, according to various embodiments, can incorporate a laparoscopic sprayer that can convey pressurized gas from the fluid management apparatus to spray therapeutic agents inside the surgical cavity, such as hemostatic agents.

FIGS.8A and8Billustrate the connection of tube set700to a fluid supply management apparatus800, such as any of apparatus300,400,500, and600discussed above, according to some embodiments. The non-patient end760of the tube set700includes a connector770, such as any of connectors410,510, and610, to which some or all of the tubes of the tube set are pre-attached. The connector770is connected to the receptacle850of the fluid supply management apparatus800. In the illustrated embodiment, the tube set700includes a liquid supply tube720that is connected to a liquid supply reservoir780, which can be for example a saline bag, for supplying liquid to the surgical field, such as for the scope cleaner and/or irrigation supply device.FIG.8Billustrates the connection of a suction line722of the tube set700to a suction apparatus724.

Although not shown, one or more lines in the tube set can be connected to other equipment in the operating room. For example, one or more communication lines for an endoscopic camera can be connected to a camera control unit810and a light cable can be connected to an illuminator820.

In some embodiments, a tube set can be configured so that the gas line connected to the scope cleaner can be disconnected from the scope cleaner and attached to another device used during the surgical procedure, such as a spraying wand to spray, for example, a hemostatic curing agent onto wound sites within the surgical cavity or medications to provide therapeautic healing effects to areas of the surgical cavity. The pressurized gas could be used to provide the power for a gas-driven instrument or power tool. In some embodiments, the liquid line connected to the scope cleaner can be disconnected from the scope cleaner for powering another device used in the surgical field. In some embodiments, both the gas and liquid lines could be disconnected from the scope cleaner and used for powering and/or controlling another device used in the surgical field. In some embodiments, a signal line from the fluid delivery system can be provided to connect to the device that the liquid and/or gas lines are connected to, whether the scope cleaner or any other device that interfaces with the liquid and/or gas lines. Information related to the type of device to which the line(s) are connected to the fluid delivery system can be communicated via this signal line so that the fluid delivery system can provide liquid and/or gas flows that are suitable for the connected device. For example, when the lines are connected to the scope cleaner, the fluid delivery system may register that the scope cleaner is connected (via the signal on the signal line) and may provide the liquid and gas flows per the cleaning sequence, and when the liquid and/or gas lines are connected to a device that is powered by the liquid and/or gas, the fluid delivery system may recognize this connected via the signal line and may provide the liquid and/or gas flows continuously.

FIG.9illustrates a method900for supplying fluid to a surgical field, according to some embodiments. At step902, a connector of a tube set is connected to a fluid supply system. The connector can be, for example, any of connectors410,510, or610and the fluid supply system can be any of apparatus400,500, or600. The tube set can be, for example, tube set700ofFIG.7. The tube set includes a first supply tube connected to a first port of the connector, a second supply tube connected to a second port of the connector, and a third supply tube connected to a third port of the connector. For example, with reference toFIG.4, the tube set can include insufflating gas line428connected to the insufflating gas supply port426, liquid supply line418connected to the liquid supply port416, and the gas supply line414connected to the gas supply port412.

At step904, a first gas flow for insufflating a surgical cavity is supplied during a surgical procedure via the first supply tube. For example, carbon dioxide can be supplied via the insufflating gas line428ofFIG.4for insufflating the surgical cavity. At step906, a liquid for cleaning a surgical scope is supplied during the surgical procedure via the second supply tube. For example, saline or a saline solution can be supplied via the liquid supply line418ofFIG.4to a surgical scope cleaner, such as scope cleaner100. At step908, a second gas flow for clearing the liquid from the surgical scope is supplied during the surgical procedure via the third supply tube. For example, carbon dioxide can be supplied via the gas supply line414to the surgical scope cleaner.

In some embodiments, the method900further includes, prior to connecting the connector to the fluid supply system, unpackaging the tube set, which has been pre-sterilized and packaged. In some embodiments, the packaged tube set includes the scope cleaner. In other embodiments, the method900further includes attaching the second and third supply tubes that are connected to a surgical scope before or after the tube set connector is connected to the fluid supply system. In some embodiments, the method900includes discarding the tube set after use for a single surgical procedure. In other embodiments, the method900includes re-sterilizing the tube set after use.

In some embodiments, the method900further includes evacuating the surgical cavity via an evacuation tube connected to a fourth port of the connector. For example, smoke from the surgical cavity can be evacuated via a smoke evacuation line432connected to a smoke evacuation port430of connector410that is connected to apparatus400.

FIG.10illustrates a method1000for cleaning a surgical scope while the surgical scope is inserted in a surgical cavity, according to some embodiments. At step1002the surgical scope, such as scope150ofFIG.1Ais inserted into a sheath of a surgical scope cleaner, such as sheath102of scope cleaner100. At step1004, the surgical scope and sheath are inserted into the surgical cavity. For example, with reference toFIG.1AandFIG.7, the tube152of the surgical scope150with the mounted sheath102of the cleaner100are inserted through the lumen of a trocar730into the surgical cavity750. At step1006, the surgical cavity is observed using the surgical scope that is inserted in the sheath of the surgical scope cleaner. For example, images generated by endoscopic camera746ofFIG.7can be displayed via a display in the operating room and observed by the surgeon.

At step1008, deposits from a lens of the surgical scope may be cleaned by spraying the lens with a liquid from at least one nozzle of the surgical scope cleaner to remove the deposits from the lens, and blowing the lens of the surgical scope with a gas from the at least one nozzle of the surgical scope cleaner to remove the liquid from the lens. For example, with reference toFIG.1C, deposits from lens156of the surgical scope150may be cleaned by spraying the lens156with saline from nozzle112of the surgical scope cleaner100to remove the deposits from the lens156and then blowing the lens156of the surgical scope150with a burst of carbon dioxide from nozzle114of the surgical scope cleaner100to remove the saline from the lens156. Each of the liquid spray and the burst of gas can be provided for pre-determined periods of time that may be the same length or different lengths. The respective periods of liquid spray and burst of gas can overlap such that liquid and gas is provided simultaneously for at least a portion of the time.

In some embodiments, the cleaning sequence described above can be performed in response to a user command. For example, a user may see blurring on one or more endoscopic images or video displayed on the display in the operating room indicating smudging and/or fogging of the lens of the scope and may issue a command to commence the scope cleaning sequence. The command may be provided, for example, via a button press on the endoscopic camera, such as endoscopic camera746ofFIG.7. The button press can be communicated via communication line744to a camera controller, such as camera controller810ofFIG.8B. The camera controller can be communicatively connected to a fluid management apparatus. For example, with reference toFIG.3, the camera controller can be a component of external system334or communicatively connected to external system334, which is communicatively connected to fluid management apparatus300. Based on the user's command, the external system334can send a command to the apparatus300to perform the cleaning sequence. The user could also push a button he/she temporarily attaches to the scope, the camera head, or that comes integrated into the proximal end of the scope cleaning sheath with an electrical wire running to the insufflator via the connector and said button/switch would be integrated into the tube set.

In some embodiments, an image analysis and control system, such as various embodiments of external system334, includes image processing that analyzes one or more images or one or more video frames generated by the endoscopic imager to detect scope smudging and/or fogging. Once the scope smudging and/or fogging has been detected, the control system may send a control command to the fluid management apparatus300to perform a cleaning sequence. Accordingly, in some embodiments, the control system includes one or more processors and memory storing one or more programs for performing a method to automatically detect deposits on a lens of a surgical scope and send a command to a connected apparatus to initiate a cleaning sequence for the surgical scope. An exemplary method performed by a control system, according to various embodiments, is method1200ofFIG.12. At step1202of method1200, the control system receives one or more images of a surgical field from an endoscopic imager that is communicatively connected to the control system. The endoscopic imager includes an endoscopic camera connected to a scope, such as surgical scope150, that is inserted in the surgical cavity. The scope may be received in a scope cleaner, such as surgical scope cleaner100, or may have integrated cleaning functionality, such as scope1100ofFIGS.11A-E. At step1204, the control system automatically detects a deposit on a lens of the surgical scope by analyzing the one or more images. Any suitable image processing algorithm or combination of algorithms may be used to detect deposits. At step1206, the control system sends a command to a communicatively connected fluid management apparatus to provide one or more fluids to the surgical field for cleaning the surgical scope. In some embodiments, the command may be sent automatically in response to detecting deposits. According to various embodiments, in response in response to receiving the command from the control system, the fluid management apparatus supplies a liquid flow and/or a gas flow from the apparatus to the surgical scope cleaner or surgical scope with integrated cleaning for cleaning a lens of the surgical scope during a surgical procedure. In some embodiments, the liquid flow is supplied first for a first period and the gas flow is supplied for a second period that is at least partially subsequent to the first period.

In some embodiments, the image analysis and control system may provide a notification to the user, such as on a display in the operating room, that smudging and/or fogging has been detected. The image analysis and control system may wait for a confirmation from the user to initiate the cleaning sequence. The user may confirm that the cleaning sequence may be performed via any suitable user input, such as a voice command, a button press on the camera head, or a button press on a user interface of the image analysis and control system. In response to receiving the user command, the image analysis and control system may send an initiate cleaning sequence command to the fluid management apparatus, which may respond by controlling the cleaning sequence.

The fluid cleaning apparatus may control a cleaning sequence by actuating the actuator to provide flow of the liquid to the scope cleaner. For example, the controller328of apparatus300may send a command to actuator316to cause the flow device318to permit the flow of liquid received from the reservoir318. With reference toFIGS.4C and4D, this may include controlling the solenoid448so that the plunger446moves the lever442to cause the valve438to move to the open position. In some embodiments, the cleaning sequence includes spraying the lens with liquid for a first predetermined period. Once this period has elapsed, the actuator may be controlled to stop the flow of liquid. For example, the plunger446may be retracted and the valve438may return to a closed position due to the force of the spring444.

The fluid cleaning apparatus may continue the cleaning sequence by opening a valve for pressurized gas to flow to the surgical scope cleaner. For example, with reference toFIG.3, the controller328may control the valve314to open, allowing pressurized gas from gas supply inlet306to flow (as regulated by, for example, regulator312or regulator315) to the scope cleaner. The gas may be provided for a second predefined period of time. The burst of gas may be provided while the liquid is being provided or may be provided entirely after the liquid is provided.

According to some embodiments, surgical scope cleaning is built into the surgical scope itself by building at least one fluid channel and at least one fluid outlet into the scope shaft. This can be particularly advantageous for small surgical scopes, such as sinuscopes, for which a separate cleaning sheath may be prohibitively large for inserting into narrow passageways, such as in the sinuses. Thus, according to various embodiments, the scope and cleaning sheath functions are combined into a single solution—a scope having integrated cleaning capability. By combining these two conventionally separate functions, the overall size of the scope with cleaning capability can be minimized and a much smaller cross-sectional area can be achieved than a separate scope and sheath solution. According to various embodiments, integration of the cleaning solution into the scope has other advantages, including reducing the amount of reflections and other visual impairments (obstruction of view, etc.) that are introduced by a separate sheath and maintaining the working length of the scope, which would otherwise be shortened by a sheath.

A scope with integrated cleaning, according to various embodiments, can be particularly suitable for functional endoscopic sinus surgery (FESS) and Transnasal Skull Base surgeries for which the cross-sectional size of the inserted device is a major design limiter due to the limited size of the operating space. According to various embodiments, by integrating the cleaning channel into the scope, the size of the combined solution can be as small as an elliptical cross section with a height of 4.6 mm and width of 4.0 mm (which is the size of a conventional sinuscope) while maintaining a cleaning channel cross-section that is sufficiently large for use with pumps and tubing that are conventionally used in the operating room.

FIGS.11A-Eillustrate a scope having integrated cleaning functionality, according to some embodiments. Looking first atFIG.11A, scope1100includes a shaft1102that extends distally from a main body and is configured for insertion into a surgical cavity during use. The shaft1102includes at least one fluid channel (described further below) that directs fluid to at least one fluid outlet1114at the distal end1116of the shaft1102. The at least one fluid outlet1114is configured to direct fluid onto an optical component1112(such as a window or lens) located at the distal end1116of the shaft.

The main body1104includes an eyepiece1106located at a proximal end1118of the scope1100. The eyepiece1106can be configured for connecting the scope1100to an imager. The main body includes a light port1108, which can be configured as a light cable connector for connecting to a light cable that provides illumination to the scope1100. The main body1104also includes at least one fluid port1110for connecting to at least one fluid supply and/or exhaust supply system for supplying fluid and/or exhaust to the scope1100. The at least one fluid port1110can be configured for a liquid, such as saline, or for a gas, such as carbon dioxide (as used herein, the term “fluid” encompasses liquids and gases). In some embodiments, the main body1104includes a single fluid port1110. In some embodiments, the main body1104includes multiple fluid ports1110, such as a liquid port and a gas port. In some embodiments, a fluid port1110can be used to supply both a liquid and a gas, either sequentially (such as via upstream valving) or simultaneously (such as to increase the pressure of supplied liquid.) In some embodiments, fluid flows both into and out of the port1110, such as due to a peristaltic operation of a fluid supply system. The at least one fluid port1110can be configured for connecting to conventional tubing used for supplying fluids to the surgical field.

FIG.11Billustrates a perspective view of a cross-section (taken on line A-A ofFIG.11A) of a portion of the shaft1102of scope1100. The shaft1102includes at least one fluid channel1120for fluid to flow between the at least one fluid port1110in the main body1104and the at least one fluid outlet1114at the distal end1116of the shaft1102. The at least one fluid channel1120is located between a first wall portion1122that corresponds to the outer tubular wall of a conventional scope shaft (see tube152of scope150ofFIGS.1A-1Bfor an example of an example of an outer tubular wall of a conventional scope configuration) and a second wall portion1130that extends at least partially around the first wall portion1122.

According to various embodiments, the second wall portion1130extends only partially around the first wall portion1122such that the external surface of the shaft1102is formed by the second wall portion1130and the portion of the first wall portion1122that is not surrounded by the second wall portion1130. With the second wall portion1130extending only partially around the first wall portion122, the outer surface of the shaft1102is non-cylindrical. The increase in size needed to accommodate the at least one fluid channel1120is concentrated in a width1134of the shaft1102in the direction of the major axis, with the increase in width1132in the direction of the minor axis being less or none at all relative to the shaft of a conventional endoscope of the same size. In some embodiments, the first wall portion1122is cylindrical and the width1132of the shaft1102in the direction of the minor axis is equal to the diameter of the first wall portion1122, such that there is no increase in width of the shaft1102along the minor axis relative to a conventional scope shaft of the same size. For example, the width1132along the minor axis for an endoscope1100sized to correspond to a conventional 4 mm scope may be 4 mm.

According to various embodiments, the first wall portion1122and second wall portion1130are integrated into a unitary piece, which can be formed in any suitable fashion, such as via welding the second wall portion1130to the first wall portion1122, extrusion, and/or machining. In some embodiments, multiple fluid channels are provided between the first wall portion1122and the second wall portion1130, such as configured like the two conduits118and120shown inFIG.1D.

The shaft1102includes an inner tube1124that is located radially inwardly of the first wall portion1122and defines with the first wall portion1122a channel1126for locating fiber optics that carry light from a light cable connected to the light port1108. The inner tube1124defines an optical channel1128for directing light from a scene and can house one or more optical components (not shown).

FIGS.11C and11Dare perspective and cross-sectional views, respectively, of a distal portion of the shaft1102, according to various embodiments. At least one fluid outlet1114is provided at the distal end1116of the shaft1102and is configured for directing fluid from the at least one fluid channel1120onto an optical component1112located at the distal end of the1116of the shaft1102. The at least one fluid outlet1114is configured to turn the fluid flow so that it impinges on the optical component1112to wash and/or blow deposits from the optical component1112. In some embodiments, the at least one fluid outlet1114is formed by rolling a distal end of the second wall portion1130inwardly. In some embodiments, a separate fluid outlet1114is joined to the distal end of the second wall portion1130. In some embodiments, the at least one fluid outlet is rigidly disposed on the shaft1102to ensure that the at least one fluid outlet does not obscure the field of view of the endoscope1100. The at least one fluid outlet can be configured to minimize reflections, such as by being provided with a non-reflective coating or formed of a non-reflective material.

In some embodiments, a fluid outlet can be provided for each of multiple fluid conduits. For example, multiple fluid outlets could be configured as in nozzle head110ofFIG.1C, which includes two nozzles112,114. In some embodiments, a single fluid outlet can be provided for multiple fluid conduits. The single fluid outlet can be configured for providing fluids from the multiple conduits sequentially—such as a liquid spray followed by a gas blow—and/or for providing a mixture of the fluids from the multiple conduits.

FIG.11Eis a cross section of a proximal portion of the shaft1102and a portion of the main body1104, according to some embodiments. The at least one fluid port1110communicates with the at least one fluid channel1120of the shaft1102via a fluid passageway1136in the main body1104. In some embodiments, the fluid passageway1136is defined by a gap between the first wall portion1122and an opening in the main body1104formed for receiving the first wall portion112.

The second wall portion1130can be sealed to the main body1104to prevent fluid leakage, such as by welding the second wall portion1130to the main body1104. In some embodiments, the second wall portion1130terminates at the main body1104.

According to some embodiments, the first wall portion1122extends into the main body1104and terminates within the main body1104. Fiber optics1138from the light port1108extend into the channel1126. The inner tube1124may extend toward the proximal end of the main body1104, terminating at the eyepiece1106.

According to various embodiments, to prevent fluid leakage into the optical portion of the main body1104, a seal1140is positioned in the main body1104for sealing between the main body1104and the outer surface of the first wall portion1122at a location that is between the fluid port1110and the light port1108. The seal1140can prevent fluid from flowing proximally into the light port portion of the main body1104.

Endoscope1100can be used according to any of the methods described above, including method900ofFIG.9and method1000ofFIG.10, except that the fluid flow and nozzles are provided directly on the endoscope1100rather than as part of a sheath. For example, according to various embodiments, one or more tubes of one or more fluid supply systems, such as apparatus300for managing fluid flow into and out of a surgical field ofFIG.3, fluid supply apparatus400ofFIGS.4A and4B, fluid supply apparatus500ofFIGS.5A-5B, or fluid supply apparatus600ofFIG.6, are connected to the one or more fluid ports1110of the endoscope1100. This may be done, for example, using tube set700ofFIG.7. The endoscope1100is then inserted into the patient's body. Due to the smaller size of the shaft1102of the endoscope1100relative to a cleaning sheath for the same relative size scope, smaller spaces and/or a smaller incision (for a smaller trocar) can be achieved. The endoscope1100can be used in a conventional manner and when deposits form on the optical component1112, one or more fluids can be directed to the optical component1112to remove the deposits. The triggering of the fluid flow can be achieved in any suitable manner, including according to any of the methods described herein for sheath-based cleaning.

According to some embodiments, the endoscope1100is configured as a sinuscope and has a single fluid port1110, single fluid channel1120, and single fluid outlet1114. The endoscope1100is attached to commercially available sinuscope cleaning pump(s) via tubing connected to the fluid port1110. When the pump is activated, fluid (such as saline) flows into the fluid port1110, flows through the fluid channel1120, and flows onto the optical component1112of the endoscope1100to wash deposits (such as smudging or fogging) from the optical component1112. During a reverse cycle of the pump(s), fluid can be drawn back into the fluid channel1120via the fluid outlet1114(which then functions as a fluid inlet) to remove fluid from the optical component1112of the endoscope1100. According to various embodiments, the cross-sectional area of the fluid channel1120is optimized to prevent the development of back-pressure in the tubing while also allowing for appropriate velocity and direction of the fluid at the distal end1116of the endoscope1100.