CLEANING DEVICES AND SYSTEMS FOR SURGICAL INSTRUMENTS, AND METHODS THEREOF

Embodiments described herein relate to systems, devices, and methods of cleaning endoscopes or other instruments during surgical procedures. In some embodiments, a system or device can include a trocar including a trocar shaft and a cap that collectively define fluid and/or electrical passages. In some embodiments, a system or device can include obturators with a wiping element and/or an absorbent element configured to remove debris and moisture from the interior walls of trocars. In some embodiments, a system or device can include a trocar with a liquid and gas interconnect device and venting systems for cleaning instruments disposed in the trocar channel.

TECHNICAL FIELD

Embodiments described herein relate to systems, devices, and methods for cleaning instruments, including trocars for cleaning endoscopes having fluid delivery and sensing functions, liquid and gas interconnections, and venting elements.

BACKGROUND

Use of small cameras in patient anatomy (e.g., body lumens or cavities) can aid in viewing interiors of the lumens while performing surgical procedures on or within the lumen or cavities. One common example of a camera is an endoscope. An endoscope is a medical device utilized for medical procedures requiring the visualization of internal organs in diagnostic or surgical settings generally referred to as a minimally invasive procedure. A physician may utilize an endoscope to make a diagnosis and/or to gain access to internal organs for treatment. The endoscope may be introduced into a patient's body via a natural orifice or through a small surgical incision.

Endoscopes and other cameras are used with an imaging system and an illumination system. The imaging system receives image data captured by the endoscope, and the illumination system can be used to provide light to assist in image capture. The three systems work together to give the physician clear views. During use, however, the tip of an endoscope or other camera may become obscured, e.g., due to smears, residue, debris, condensation, and/or other types of obstructing material. Therefore, there exists a need for an efficient way to clean the end of endoscopes and other cameras during a surgical operation.

SUMMARY

Embodiments described herein relate to a trocar designed to clean the end of an imaging device, such as, for example, an endoscope. In some embodiments, the trocar can be positioned in a body cavity (e.g., thoracic cavity, abdominal cavity). In laparoscopic surgery, for example, the trocar penetrates through the thickness of the abdominal or chest wall to provide access for various instruments to the interior of the body. The trocar is designed such that instruments can be inserted into the body interior without the significant loss of insufflation gases used to expand the body cavity. As such, the trocar is configured to create and maintain a working space for those instruments. In some embodiments, an endoscope can be placed through the trocar, and an imaging system receiving signals from the endoscope can display images of the body interior to guide the surgical procedure.

In some embodiments, the trocar can be configured to deliver quantities of liquid and/or gas to clean the end of the endoscope. In some embodiments, a connector or cable for delivering gas and/or liquid to a trocar can include components for coupling a liquid flow to a gas flow. In some embodiments, the connector can include a liquid/gas interconnect that combines a high-flow gas lumen to a small-bore diameter liquid lumen in a ‘T-shaped’ configuration with a single output. The pressurized gas that flows through the high-flow gas lumen can propel a small bolus of liquid solution and create a transient high-energy spray to wash an obscured end of an endoscope in a controlled sequence. One-way valves are fitted to the gas lumen and the liquid lumen to prevent cross-contamination between the gas and liquid lines during normal use of the system and failure conditions. The liquid lumen geometry can minimize trapped air, accommodate one-way valve compliance, and/or prevent the liquid solution from being drawn into the gas lumen. The gas lumen geometry can allow the system to be purged without impact on the liquid and can prevent regurgitation of the solution upstream into the gas line.

In some embodiments, the trocar can include one or more sensors. For example, the trocar can include a sensor for sensing the position of the distal end of an endoscope for cleaning. In some embodiments, the trocar can include elements for venting gases from within a body cavity. In some embodiments, a venting device can include a valve and/or a filter. In some embodiments, the venting device can be integrated into an insufflation line (e.g., using a stopcock).

In some embodiments, systems, devices, and methods described herein can include an obturator that can be used with the trocar for insertion of the trocar within a body cavity. The obturator can include a wiping clement and/or an absorbent element configured to remove debris and moisture from the interior walls of trocars. In some embodiments, the trocar and the obturator can have an asymmetrical shape, such that the obturator fits into the trocar in a specific manner such that the distal surfaces of the trocar and the obturator form continuous services for penetrating through body tissue. Methods for using cleaning systems can include delivery of liquid and/or gas for cleaning (e.g., timed to sensed position/orientation), for priming, and/or for fogging mitigation.

In some embodiments, an apparatus includes: a shaft defining a channel for receiving an instrument, the shaft having a distal end that is disposable within patient anatomy; an interconnector configured to couple to a liquid source and a gas source, the interconnector including a first valve configured to control delivery of the liquid and a second valve configured to control delivery of the gas, the interconnector configured to combine separate volumes of the liquid and the gas into a combined volume of the liquid and the gas; an ejection port disposed near a distal end of the shaft, the ejection port fluidically coupled to the interconnector and configured to eject the combined volume of the liquid and the gas into the channel in response to a distal end of the instrument being disposed near the ejection port; and a sensor disposed near the ejection port, the sensor configured to detect when the distal end of the instrument is disposed near the ejection port.

In some embodiments, an apparatus includes: a shaft defining a channel for receiving an instrument, the shaft having a distal end that is disposable within patient anatomy; a cap couplable to the shaft, the cap including a fluid port configured to couple to a liquid source and a gas source and an electrical port configured to couple to a controller; an ejection port disposed near a distal end of the shaft, the ejection port configured to eject a predetermined volume of liquid and gas into the channel in response to a distal end of the instrument being disposed near the ejection port; and a fluid passage defined by at least one of the shaft or the cap and extending along a longitudinal length of the shaft, the fluid passage configured to convey the predetermined volume of liquid from the fluid port to the ejection port; a sensor configured to detect when the distal end of the instrument is disposed near the ejection port; and an electrical line disposed in at least one of the shaft or the cap and extending along the longitudinal length of the shaft, the electrical line configured to couple the electrical port to the sensor.

In some embodiments, an apparatus includes: a shaft defining a channel for receiving an instrument, the shaft having a distal end that is disposable within patient anatomy; an ejection port disposed near a distal end of the shaft, the ejection port configured to eject a predetermined volume of liquid and gas into the channel in response to a distal end of the instrument being disposed near the ejection port; a sensor disposed near the ejection port, the sensor configured to detect when the distal end of the instrument is disposed near the ejection port; a vent fluidically coupled to the channel and configured to vent fluids from within the patient anatomy to an exterior of the patient anatomy; and a filter disposed along a pathway of the vent and being configured to filter the fluids being vented through the vent.

In some embodiments, an apparatus includes: a shaft defining a channel for receiving an instrument, the shaft having a distal end that is disposable within patient anatomy, the channel having an asymmetrical cross-section defined by a plurality of side walls where a first side wall of the plurality of side walls extends out further than one or more remaining side walls of the plurality of side walls; an ejection port disposed near a distal end of the shaft, the ejection port configured to eject a predetermined volume of liquid and gas into the channel in response to a distal end of the instrument being disposed near the ejection port, the ejection port being located in the channel on the first side wall; and a sensor disposed near the ejection port, the sensor configured to detect when the distal end of the instrument is disposed near the ejection port.

In some embodiments, a system includes: an elongate device having a distal end that is disposable within patient anatomy, the shaft including: a channel for receiving an instrument; an ejection port configured to eject a volume of liquid and gas into the channel in response to a distal end of the instrument being disposed near the ejection port; and a sensor configured to detect when the instrument is disposed near the ejection port; a controller operatively coupled to the elongate device, the controller configured to receive one or more signals from the sensors and to control delivery of the liquid and the gas to the elongate device; a connector including a plurality of lines configured to couple the elongate device to the controller, a liquid source, and a gas source; and at least one filter disposed along one or more of the plurality of lines, the at least one filter configured to filter at least one of the liquid or the gas prior to being delivered to the elongate device.

In some embodiments, a method includes: detecting that an imaging device has been retracted a predetermined distance into a channel of a trocar disposed within patient anatomy; in response to the detecting, activating a delivery of pressurized gas to propel and deliver a predetermined volume of liquid to the trocar; and delivering, via an ejection port disposed in the trocar, the predetermined volume of liquid into the channel of the trocar to clean a distal end of the imaging device.

In some embodiments, a method includes: detecting that an imaging device has been retracted a predetermined distance into a channel of a trocar disposed within patient anatomy; in response to the detecting, activating a delivery of pressurized gas through an interconnect configured to combine separate volumes of the gas and a liquid into a combined volume of gas and liquid; and delivering, via an ejection port, the combined volume of gas and liquid into the channel of the trocar to clean a distal end of the imaging device.

DETAILED DESCRIPTION

Embodiments described herein relate to systems, devices, and methods for cleaning imaging devices, such as, for example, endoscopes. Such systems, devices, and methods can be configured to clean the imaging devices while they are positioned within patient anatomy (e.g., a body lumen or cavity), e.g., when they are in use during a surgical procedure. In some embodiments, a cleaning system for cleaning an endoscope can be configured to use gas to propel small, controlled amounts of a liquid into a lumen of a trocar. In some embodiments, the gas can include carbon dioxide (CO2), nitrogen, argon, or any other suitable inert gas or combinations thereof. A liquid such as a wash solution is used to clean a distal end of the imaging devices. In some embodiments, an obturator can be shaped to fit in the trocar.

The obturator and/or the trocar can be shaped for insertion of the trocar into a body lumen or cavity. The shape of the obturator can be a function of the shape of the trocar lumen so that it can be inserted in a smooth manner and not have areas that grab tissues. If the trocar and the obturator have irregular shapes, this can ensure a glove-type fit between the two. The asymmetrical shape of the trocar lumen can also create a space between the wall of the trocar and the wall of the camera when a circular endoscope is placed inside the trocar. The asymmetrical shape of the trocar lumen can also prevent the trocar lumen from being blocked by the camera body. A space can always be present between the body of the camera and the walls of the trocar lumen, such that the outer surface of the camera is not able to rest on the wall of the trocar lumen. This ensures fluids are expelled and do not build up inside the trocar. This can help prevent fluid buildup inside the trocar. During surgery, debris and moisture can collect on interior walls of a trocar. The shape of the trocar lumen can affect whether tissues blood, or moisture can collect in the lumen during cleaning. This debris and moisture can originate from a body lumen or cavity, wherein the trocar is placed. Other sources of debris and moisture can include a wash solution that is ejected to clean an endoscopic camera during surgery. Insertion of an obturator with cleaning elements can clean the walls of the trocar. Cleaning elements can include wiping elements (e.g., squeegees) and/or absorbent elements (e.g., cloth).

Endoscopes can vary significantly. Some endoscopes use optical light, while others use infrared. Different endoscopes can also have different sizes and/or configurations. For example, some endoscopes can have a flat distal end, while other endoscopes can have angled or tapered distal ends. Systems and devices described herein can include sensors (e.g., light sensors) that can be configured to detect when an endoscope passes the sensor for a variety of different endoscopes. Once an endoscope is in a position to be cleaned, a bolus of wash solution is ejected onto the endoscope. After the ejection of the wash solution, a line containing the wash solution can be primed with fluid for a subsequent wash sequence. In some embodiments described herein, sensors on the trocar can detect illumination features at the end of the endoscope, thus identifying the precise position of the end of the endoscope, relative to the trocar shaft. The optical window of the endoscope that receives the image is nearly always in close proximity to the illumination features, and therefore, systems as described herein can detect the location of the optical end of the scope that has become soiled by surgical debris. Precisely positioned fluid and gas outlets on the inside of the trocar can then be actuated to provide a precise cleaning burst onto the tip of the endoscope, once the position of the endoscope has been detected by the optical sensors that locate the position of the illumination features.

In addition, some embodiments of cleaning systems described herein can include filters and/or vents on the trocar devices. In some embodiments, a filter can be used to filter liquids that are being delivered into the body cavity. In some embodiments, a vent can be used to vent excess gases and/or liquids from within a body lumen or cavity, e.g., to prevent overpressure. The vent can optionally include filters for filtering the vented gases and/or liquids, e.g., to reduce noxious and/or odorous fumes.

Examples of endoscope cleaning systems are described in U.S. Patent Publication No. 2019/0125176, filed Oct. 18, 2018, and titled, “Trocars,” U.S. Patent Publication No. 2021/0127963, filed Nov. 21, 2019, and titled “Intraoperative Endoscope Cleaning System,” and U.S. Patent Publication No. 2021/0127964, filed Nov. 21, 2019, and titled “Intraoperative Endoscope Cleaning System,” the disclosure of each of which is hereby incorporated by reference in its entirety. Systems, devices, and methods described herein improve on such cleaning systems, e.g., by improving delivery of liquid and/or gas into a trocar, adding components for coupling liquid and/or gas lines, and improving venting of excess gases within a body lumen or cavity via a trocar.

FIG.1is a block diagram of a system100for cleaning an endoscope or scope that can be disposed in a body lumen or cavity, according to an embodiment. As shown, the system100includes a fluid delivery system110fluidically coupled to a trocar130(or other elongate device) and a gas source160. The fluid delivery system110can optionally include an onboard power source112. Alternatively or additionally, the fluid delivery system110can optionally be coupled to an external power source150. The fluid delivery system110includes a pump mechanism116and a controller120. The fluid delivery system110can optionally a liquid reservoir114. Alternatively or additionally, the fluid delivery system110can optionally be coupled to an external liquid source170. Lines depicted inFIG.1connecting units can represent electrical, physical, and/or fluidic couplings.

The onboard power source112is an optional component integrated into the fluid delivery system110. The onboard power source112powers the pump mechanism116and/or the controller120. In some embodiments, the onboard power source can include a battery. In some embodiments, the onboard power source112can include a fuel cell. In some embodiments, the onboard power source can be integrated into the same structure as the liquid reservoir114, the pump mechanism116, and/or the controller120. For example, the onboard power source112, the liquid reservoir114, and the pump mechanism116can be disposed together in a housing (or one or more housing sections that couple together to form a housing).

Optionally, an external power source150can be coupled to the fluid delivery system110to deliver power to one or more components of the fluid delivery system110. In some embodiments, the external power source150can include a wall outlet. In some embodiments, the external power source150can include a battery or a battery pack physically separated from the fluid delivery system110. In some embodiments, the external power source150can power the pump mechanism116, the controller116, and/or the onboard power source112.

Alternatively or additionally, an external liquid source170can be used to supply liquid to the fluid delivery system110. The external liquid source170be separate from the fluid delivery system110but coupled to the fluid delivery system110, e.g., via a fluid line. In some embodiments, the external liquid source170can be a fluid bag or other type of fluid containing element. In some embodiments, the external liquid source170can be a water line or other fluid line within a building that can be coupled via a faucet or other connection to the fluid delivery system110. In some embodiments, the external liquid source170can be used to fill (e.g., pre-fill or re-fill) the liquid reservoir114. In some embodiments, the liquid delivered to the liquid reservoir can be the wash liquid or solution.

The pump mechanism116aids in delivering liquid (e.g., wash liquid or solution) to the trocar130. In some embodiments, the pump mechanism116can include or form part of a centrifugal pump, peristaltic pump, lobe pump, rotary gear pump, horizontal split case pump, air operated pump, diaphragm pump, magnetically driven pump, a mechanically driven pump, an electrically driven pump, or any other suitable pump apparatus or combinations thereof. In a specific embodiment, the pump mechanism116can include a plunger, platform, shaft, or other suitable component that can be actuated (e.g., via a pump actuator226) to compress a fluid line to deliver a liquid. For example, a pump mechanism116implemented as a plunger can be actuated to compress a flexible housing or tubing that contains a liquid. The compression of the flexible housing or tubing can cause the liquid within the flexible housing or tubing to be driven toward the trocar130, e.g., to fill the lines for a wash or cleaning sequence.

The controller120controls operation of the pump mechanism116. In some embodiments, the controller120can be in communication with or include a processor and/or a user interface. Operation of the pump mechanism116can be automatic or user-controlled. In some embodiments, the user via the user interface can set parameters for when to activate the pump mechanism116, e.g., to supply additional liquid for cleaning an endoscope. In some embodiments, the controller120can activate the pump mechanism116after each wash sequence to fill the liquid lines for a subsequent wash sequence. In some embodiments, the controller120can activate the pump mechanism116to fill the liquid lines in response to an indication that an endoscope has been positioned for cleaning (e.g., based on signals received by the controller120from one or more sensors). In some embodiments, the controller120can activate the pump mechanism116to fill the liquid lines in response to a detection of a drop in pressure or volume in the liquid lines (e.g., based on signals received by the controller120from one or more sensors).

The trocar130can be a surgical instrument that can be placed within a patient to provide access into a body lumen or cavity of the patient. In use, the trocar130is placed in the body lumen or cavity, e.g., with or without an obturator. The body lumen or cavity can include a thoracic cavity or an abdominal cavity. The trocar130includes a shaft or elongate structure that defines a channel or lumen within which an endoscope for viewing of the inside of the body lumen or cavity can be positioned. The trocar130includes one or more channels or lines in fluidic communication with the fluid delivery system110, e.g., for receiving gas and/or liquid from the fluid delivery system110. In some embodiments, the channels or lines can be primed after each deployment of wash solution (e.g., after each wash sequence). In some embodiments, the trocar130can be maintained in place by an anchor (not shown) placed on the outside of the patient's body. Further details of an example trocar are provided with reference toFIG.3below.

The gas source160is used to pressurize the liquid and deliver the liquid via the fluid delivery system110. In some embodiments, the gas source160can include a container (e.g., a tank) that houses a volume of pressurized gas. In some embodiments, the gas source160can deliver gas at a pressure of between about 20 psi and about 50 psi, including all values and sub-ranges therebetween. In some embodiments, the gas delivered by the gas source160can include air, CO2, nitrogen, argon, or any other inert gas or combinations thereof. The selected gas can be a gas that is commonly used in medical procedures and is safe for delivery into a body lumen or cavity.

FIG.2provides a more detailed view of the liquid and gas connections of a fluid delivery system210of a cleaning system for cleaning an endoscope disposed in a body lumen or cavity, according to an embodiment. The fluid delivery system210can be structurally and/or functionally similar to other fluid delivery systems described herein, including, for example, fluid delivery system110. As shown, the fluid delivery system210includes a controller220. The fluid delivery system219is fluidically coupled to the trocar230and an optional gas source260. The controller220includes a processor222, a gas control valve224, and a pump actuator226. A liquid reservoir214can be fluidically coupled to a liquid supply line272, with a pump mechanism216disposed along the coupling or line to control delivery of the liquid. In some embodiments, an optional heating element274can be coupled to the liquid reservoir214and/or the liquid supply line272, e.g., for heating the liquid. A gas source260can be fluidically coupled to a gas supply line262, with a gas control valve224disposed along the coupling or line to control delivery of the gas.

In some embodiments, an optional connector or cable240can house the gas supply line262, the liquid supply line272, and the electrical line282. In some embodiments, the connector240can include an outer cylindrical or tubular housing (e.g., a cable housing) that defines a lumen for containing the gas supply line262, the liquid supply line272, and the electrical line282. In some embodiments, the connector240can be composed of an insulative material, a rubber, a plastic, a polymer, or any combination thereof. The connector240can include a proximal connection or controller connection and a distal connection or trocar connection that each include connecting elements for coupling to the controller220and the trocar230, respectively. Further details of a connector are described with reference toFIGS.9C and9D.

In some embodiments, an optional filter264can be integrated into the gas supply line262. The filter264can be configured to filter the gas prior to delivery into a body lumen or cavity, e.g., to prevent contaminants, viruses, bacteria, etc. from entering the body lumen or cavity. In some embodiments, the filter264can be selected to provide filtering while also not disrupting the pressure behavior of the cleaning system. In particular, when pressure is switch on in the cleaning system (e.g., via opening of valve224), the pressure may cause a pressure spike that can beneficially produce a desirable spray of liquid within a channel of the trocar230. The presence of a filter264, however, may affect the behavior of the pressure of the pressurized gas.FIG.17shows the impact that different filters have on flow rates, according to embodiments. Five different types of filters were tested, including Qosina 11679 (Filter1), Pall Acrylic 6664197 (Filter2), Qosina 28204 (Filter3), Pall Posidyne GELELD96LL (Filter4), Sartorius 17805—Commercial Embodiment (Filter5). As shown, the filters are placed between a proximal connection and a distal connection of a connector. The flow rates at several locations along the gas line extending from a gas inlet (GAS IN) to a trocar are then measured. Specifically, the flow rates at each of points1,2,3, and4are measured. The resulting data showing the change in flow rates along the gas lines are depicted in plot1100. As shown, Filter5resulted in less disruption in flow rate along the gas line and therefore performed better than the other filters for the purposes of being used in the cleaning systems described herein. In some embodiments, the filter can be configured to filter the gas without changing a flow rate of the gas by more than about 10%, including any values or sub-ranges less than that. In some embodiments, a filter with a pore size of between about 0.1 and about 0.2 μm, including all values and sub-ranges therebetween, may be used. In some embodiments, the filter may be made from a polymer, ceramic, or glass material, including, for example, polycarbonate, polytetrafluoroethylene, acrylic, micro-glass, ceramic fiber, polypropylene, polyethersulfone, or combinations thereof.

While the filter264is described as being disposed in the gas supply line, it can be appreciated that one or more other filters can be used with the systems and devices described herein, including, for example, a filter disposed in the liquid supply line for filtering the liquid that is delivered to the trocar.

The processor222can be coupled to an electrical line282, e.g., for sending and/or receiving data from electrical elements disposed in the trocar. For example, the processor222via the electrical line282can be configured to receive data from one or more sensors disposed along a channel of the trocar, e.g., to detect when an endoscope is being retracted within the trocar for initiating a wash sequence. Optionally, the gas supply line262, the liquid supply line272, and the electrical line282can be contained within a connector240. The connector240can be a cable that houses each of the lines. In some embodiments, the liquid reservoir214, the pump mechanism216, the controller220, and the gas source260can be the same or substantially similar to the liquid reservoir114, the pump mechanism116, the controller120, and the gas source160, as described above with reference toFIG.1. Thus, certain aspects of the liquid reservoir214, the pump mechanism216, the controller220, and the gas source260are not described in greater detail herein.

The processor222is electrically connected to the trocar230via the electrical line282. In some embodiments, the processor222can communicate with sensor(s) (not shown) in the trocar230. The processor222can receive information from the sensor(s) and, based on that information, control the delivery of the gas and/or liquid, e.g., for initiating a wash sequence. For example, one or more sensors disposed in the trocar230can detect a position of the distal end of an endoscope positioned within the trocar. When the sensor(s) detect that the endoscope is retracted and/or positioned for cleaning, the sensor(s) can send that data to the processor222, which can activate the delivery of gas and/or liquid to clean the distal end of the endoscope. In some embodiments, the electrical line282can include conductive wiring. In some embodiments, the conductive wiring can be composed of copper, silver, brass, gold, titanium, stainless steel, carbon steel, or any combination thereof. In some embodiments, the electrical line282can be housed within the connector240and insulated from external elements.

The gas source260and the gas control valve224are fluidically coupled to the trocar via the gas supply line262. The gas control valve224controls delivery of gas into the trocar230. The gas control valve224can be controlled by the controller220(specifically, processor222) to deliver gas at desired times, e.g., when an endoscope is positioned for cleaning. In some embodiments, the gas supply line262can include flexible tubing. In some embodiments, the tubing can be composed of a polymer, polyvinylchloride (PVC), polyurethane, Tygon®, acrylic, or any other suitable material. In some embodiments, the gas supply line262can include a filter (e.g., filter264), e.g., for filtering the gas prior to delivery to the trocar.

The pump actuator226can actuate the pump mechanism216to deliver liquid to the trocar230via the liquid supply line272. The pump actuator226can include an electrical motor and/or other drive mechanisms for actuating the pump mechanism216. In some embodiments, the pump mechanism216can be a plunger, shaft, or other suitable structure that can be actuated to compress flexible tubing containing the liquid, e.g., to pump the liquid. In some embodiments, the pump actuator226can be powered by a battery, a wall outlet, or any other suitable power mechanism. In some embodiments, the liquid supply line272can include flexible tubing. In some embodiments, the tubing can be composed of a polymer, PVC, polyurethane, Tygon®, acrylic, or any other suitable material. Optionally, the heating element274can provide heat to the liquid reservoir214and/or the liquid supply line272. In some embodiments, the heating element274can be configured to heat the liquid to body temperature such that delivery of the liquid into the trocar does not cause fogging of the distal end of an endoscope, e.g., due to a temperature difference between the liquid and the gases within the body lumen or cavity. In some embodiments, the heating element274can provide heat to facilitate fluid flow of liquid through the liquid supply line272(e.g., by lowering the viscosity of the liquid).

FIG.3is a diagram of a trocar330, according to an embodiment. As shown, the trocar330includes a trocar hub331and a trocar shaft332. A trocar channel333extends through the trocar shaft332. One or more sensors334, an electronic port335, one or more ejection ports336, and/or a liquid/gas interconnect or interconnector337are integrated into or disposed in the trocar shaft332. A vent338, optionally including a filter338aand a valve338b,can also be integrated into or disposed in the trocar shaft332. An electrical line382can be coupled to the electronic port335, while a gas line362and a liquid line372can be coupled to the liquid/gas interconnect337. In some embodiments, the gas line362, the liquid line372, and the electrical line382can be the same or substantially similar to the gas supply line262, the liquid supply line272, and the electrical line282, as described above with reference toFIG.2. Thus, certain aspects of the gas line362, the liquid line372, and the electrical line382are not described in greater detail herein.

The trocar hub331is an enlarged portion of the trocar330for housing one or more components of the trocar330. The trocar hub331provides a handle for placement of the trocar330. The trocar shaft332is an elongated portion of the trocar330and is connected to the trocar hub331. In use, the trocar hub331can be positioned outside of a patient's body while the trocar shaft332(or a substantial majority of the trocar shaft332) is positioned within the patient's body.

The trocar hub331and the trocar shaft332can collectively define a trocar channel333for receiving an instrument, e.g., an endoscope, an obturator, etc. In some embodiments, the trocar channel333can have a diameter of between about 1 mm (3 French) and about 10 mm (30 French), including all sub-ranges and values therebetween. For example, the trocar channel333can have a diameter of about 10 French or slightly larger than 10 French such that the trocar channel333is configured to receive an instrument (e.g., endoscope) having up to a 10 French diameter. In use, the trocar330can be positioned within a patient such that the channel333extends into a body lumen or cavity. The channel can therefore provide access to a body lumen or cavity, e.g., for positioning one or more instruments within the body lumen or cavity. The trocar330can be positioned through an incision in the patient's body. In some embodiments, an obturator (e.g., obturator590) can be positioned within the trocar channel333while the trocar is being positioned within the body and then removed after the distal end of the trocar has been positioned within the body lumen or cavity. Other instruments (e.g., endoscopes) can then be positioned within the trocar channel333after the obturator has been removed. Further details of an obturator are described with reference toFIG.5.

The trocar330can form a part of a cleaning system for an endoscope, e.g., such as the system described above with reference toFIG.1. As such, the trocar330can include components that can facilitate a cleaning or wash sequence associated with an endoscope. In particular, the trocar330an include one or more ports (e.g., electronic port335, ejection port(s)336, liquid/gas port(s)) and/or one or more sensor(s)334.

In some embodiments, the trocar330can optionally include a liquid/gas interconnect337. The liquid/gas interconnect337can be configured to combine a liquid stream and a gas stream into one output stream, as further described with reference toFIG.14. The liquid/gas interconnect337receives a feed from the gas line362and the liquid line372. The liquid/gas interconnect337can include a collection of valves and tubes for controlling the delivery of fluid (e.g., gas and/or liquid). In some embodiments, the liquid/gas interconnect337can be integrated into or disposed in a connector that coupled to the trocar330(e.g., a trocar connection or distal connection of connector240) instead of being integrated into or disposed in the trocar330. In such embodiments, the output stream from the liquid/gas interconnect337can be coupled to a liquid/gas port integrated into or disposed in the trocar shaft332. Further details of such a configuration are described with reference toFIGS.10A-10D.

The sensor(s)334can detect whether a device (e.g., an obturator, a scope) is in the trocar channel333and/or a position and/or orientation of the device within the trocar channel333. The sensor(s)334can trigger liquid and/or gas deployment via the ejection port(s)336upon detecting that the device is in a position and/or orientation for cleaning. For example, when a device is retracted into the trocar channel333such that at least one sensor334detects the device, the sensor(s)334can trigger liquid and/or gas deployment. The sensor(s)334can be coupled to a controller (e.g., controller220) via electronic port335and electrical line382. As such, the sensor(s)334can send signals to the controller for detecting a position and/or orientation of the device. In response to detecting that the device is in a position and/or orientation for cleaning, the controller can trigger delivery of the liquid and/or gas via one or more ejection port(s)336into the trocar channel333. In some embodiments, the trocar330can include 1, 2, 3, 4, 5, 6, 7, 9, 10, or at least about 10 sensors334. For example, in some embodiments, the trocar330can include a single sensor334that can be configured to detect when an instrument (e.g., an endoscope) is close to the sensor (e.g., based on light detected by the sensor being above a predetermined threshold), and in response to detecting the light, the liquid and/or gas delivery can be triggered (e.g., via a controller). In some embodiments, the trocar330can include a first sensor that detects when an instrument (e.g., endoscope) is first inserted into the trocar channel333and a second sensor that detects when the instrument, having been previously inserted into the trocar channel333, is being retracted for cleaning. In such embodiments, the first sensor, upon detecting that the instrument is being inserted into the trocar channel333, can send a signal to a controller to not initiate a wash sequence as the instrument passes by the second sensor. Then with subsequent detection of the instrument by the second sensor (e.g., in response to a retraction of the instrument), the second sensor can send a signal to the controller to initiate the wash sequence. The sensor(s)331can include one or more light sensors, photoelectric sensors, pressure sensors, infrared sensors, force sensors, position sensors, piezoelectric sensors, mechanical sensors, etc.

The electronic port335can couple the sensor(s)334to the electrical line382and other electronic components of a cleaning system (e.g., controller220). In some embodiments, the electronic port335is configured to provide power to the sensor(s)334. In some embodiments, the electronic port335is configured to send to and/or receive data from the sensor(s)334.

The ejection port(s)336eject a gas and/or liquid (e.g., a wash solution) into the trocar channel333, e.g., to wash a device such as, for example, an endoscope positioned in the trocar channel. In some embodiments, the ejection port(s)336can be angled retrograde or back towards a proximal end of the trocar330such that the ejection port(s)336eject the gas and/or liquid in a proximal direction, e.g., toward a distal end of an instrument. In some embodiments, the trocar330can include a single ejection port that is configured to generate a spray, e.g., for cleaning a distal end of an endoscope. In some embodiments, the trocar330can include a plurality of ejection ports for generating sprays. In some embodiments, the plurality of ejection portions can be set at different angles and/or orientations to cover a larger region within the trocar channel333.

In use, a high-pressure source of gas can be used to deliver a set volume of liquid (e.g., wash solution) into the trocar channel333. The high-pressure source of gas and the liquid can be coupled via the gas line362and the liquid line372, respectively, to the liquid/gas interconnect337. The liquid/gas interconnect337can combine the high-pressure gas with the liquid, and with each wash sequence, allow the high-pressure gas to draw and eject a set volume of liquid into the trocar channel333. In some embodiments, the high-pressure gas can be delivered at pressures of at least about 20 psi to at least about 50 psi, including all sub-ranges and values therebetween. For example, in an embodiment, the high-pressure gas can be delivered at a pressure of at least about 30 psi, at least about 35 psi, or at least about 40 psi. Each wash sequence can last about 100 to about 500 ms, including all sub-ranges and values therebetween. For example, in an embodiment, the wash sequence can be at least about 100 ms to about 300 ms, including 200 ms.

The liquid being delivered by the ejection port(s)336can include water, a saline solution, a buffered solution, or a bio-compatible surfactant. For example, the liquid or wash solution can include a mixture of water and a surfactant. The mixture can include at least about 10% surfactant, about 15% surfactant, about 20% surfactant, about 25% surfactant, about 30% surfactant, about 35% surfactant, about 40% surfactant, or higher amounts of surfactant to water. In use with cleaning an endoscope, the distal end of the endoscope can be coated with a surfactant solution before being inserted into the trocar channel333. The wash solution with a percentage of surfactant can then be used to wash the distal end of the endoscope, e.g., in one or more wash sequences when the endoscope is retracted. The presence of the surfactant in the wash solution can build a hydrophobic layer on the distal end of the endoscope, which can reduce fogging, water build-up, and other types of build-up on the distal end of the endoscope.

The vent338is fluidically coupled to the trocar channel333. The vent338can be configured to allow for release for gases built up during surgery. In some embodiments, the vent338can be a passive vent, e.g., an opening that can allow gases to exit the body lumen or cavity via the trocar channel333and vent338. Alternatively, the vent338can be coupled to a vacuum source or other active component that can be used to regulate pressure within the body lumen or cavity. As shown, the vent338can optionally include a filter338aand a valve338b.The filter338acan capture filter the gases exiting the body lumen or cavity and reduce smell or other compounds being carried by the existing gases. The filter338acan be configured to vent gases and/or liquids, including, for example, water vapors, as well as gases and smoke created during tissue cutting and/or coagulation using electrosurgical devices (e.g., radiofrequency (RF) and/or ultrasonic cutting tools). The valve338bcan be opened or closed to permit or block gas flow through the vent338. In some embodiments, the valve338bcan be controlled manually. For example, a physician can open or close the valve338bvia a switch, button, etc. to allow for venting. In some embodiments, the valve338bcan be configured to automatically open, e.g., when the pressure within the body lumen or cavity is above a predefined pressure. The valve338bcan also be configured to prevent backflow, e.g., flow of air or other gases within an external environment around the trocar into the trocar lumen333and/or body lumen or cavity.

FIG.4depicts an example trocar430, where the trocar430includes a main shaft432and a cap480, according to an embodiment. As shown, the trocar shaft432can include a trocar channel433extending therethrough, a sensor434, and an ejection port436. The cap480can be formed separately from the trocar shaft432but be coupled to the trocar shaft432. The cap480can include an electronic port435and a liquid/gas interconnect437. In some embodiments, the trocar430, the trocar shaft432, the trocar channel433, the sensor434, and the ejection port436can be the same or substantially similar to the trocar330, the trocar shaft332, the trocar channel333, the sensor(s)334, and the ejection port336, as described above with reference toFIG.3. Thus, certain aspects of the trocar430, the trocar shaft432, the trocar channel433, the sensor434, and the ejection port436are not described in greater detail herein.

As noted, the cap480can be coupleable to the trocar shaft432. In some embodiments, when the cap480is coupled to the trocar shaft432, the cap480and the trocar shaft432can collectively form a passage for directing liquid and/or gas from the liquid/gas interconnect437to the ejection port(s)436and/or a passage for housing an electrical connection between the electronic port435and the sensor(s)434. As such, each of the trocar shaft432and the cap480can include grooves or ridges that define such passages. Alternatively, in some embodiments, the cap480can define one or more portions of a passage for directing liquid and/or gas from the liquid/gas interconnect437to the ejection port(s)436and/or a passage for housing an electrical connection between the electronic port435and the sensor(s)434, while the trocar shaft432can define other portions of such passages. In such cases, when the cap480and the trocar shaft432are coupled together, the respective portions of the passages defined by the cap480and the trocar shaft432can join together. Still alternatively, in some embodiments, the cap alone can define (or substantially define) a passage for directing liquid and/or gas from the liquid/gas interconnect437to the ejection port(s)436and/or a passage for housing an electrical connection between the electronic port435and the sensor(s)434. Still alternatively, in some embodiments, the trocar shaft432can define a passage for directing liquid and/or gas from the liquid/gas interconnect437to the ejection port(s)436and/or a passage for housing an electrical connection between the electronic port435and the sensor(s)434.

In some embodiments, the cap480can fit into the trocar shaft432via an interlocking mechanism. For example, the cap480can including coupling elements that snap into place on the trocar shaft432. In some embodiments, the cap480can be coupled to the trocar shaft432via a mechanical, magnetic, adhesive, etc. manner. In some embodiments, the cap480can fit into grooves on the trocar shaft432. In some embodiments, the cap480can be formed separately from the shaft432but be permanently coupled to the shaft432to form a unitary piece. In some embodiments, the cap480can be coupled to and decoupled from the shaft432. In some embodiments, the electronic port435and the liquid/gas interconnect437can be integrated into the cap480. The liquid/gas interconnect437can be fluidically connected to ejection port(s)436in the trocar shaft432when the cap480and the trocar shaft432and coupled together. The electronic port435can include a mating surface for an electrical plug or other connection. In some embodiments, the electronic port435and the sensor(s)434can be communicatively coupled to one another via a flat or flexible circuit board. The flexible circuit board can be disposed in a passage defined by one or both of the cap480or trocar shaft432, as described above.

FIGS.6A-6Bshow cross-sectional views of a trocar shaft632, according to an embodiment.FIG.6Ashows a trocar shaft632with a trocar channel633having a circular cross section, whileFIGS.6Bshows a trocar shaft632′ with a trocar channel633′ with a non-circular cross-section. The trocar channel633′ can be referred to as having an asymmetrical cross-section. In particular, the asymmetrical cross-section can be formed of a plurality of side walls or portions with a side wall or portion that extends further out radially than one or more other side walls or portions. An electrical line (e.g., a printed circuit board (PCB))628and a liquid and/or gas lumen604can be disposed adjacent to the trocar channels633,633′. The asymmetrical shape of the trocar channel633,633′ can create a space or provide a gap between the wall of the trocar channel633,633′ and the wall of the camera when a circular endoscope is placed inside the trocar630. This design can prevent the trocar channel633,633′ from being blocked by a body of the camera, such that a space is always present between the body of the camera and the walls of the trocar channel633,633′, such that the outer surface of the camera is not able to rest on the wall of the trocar channel633,633′. This can help prevent fluid buildup inside the trocar630.

In some embodiments, the electrical line628can supply power to one or more electrical components (e.g., sensors) disposed within the trocar shafts632,632′. In some embodiments, the electrical line628can receive data from and/or send data to one or more electrical components (e.g., sensors) disposed within the trocar shafts632,632′. The liquid and/or gas lumen604can deliver a liquid (e.g., wash solution) or a gas to an ejection port (not shown) at a distal end of the trocar630.

The trocar channel633′ can be asymmetrical such that additional clearance can be provided between an exit of an ejection port and the surface of an endoscope.FIG.7provides a more detailed breakdown of the cross section of an asymmetrical trocar channel733′, according to an embodiment. As shown, the trocar channel733′ results from the combination of a first circular cross-section having a first radius R1and a first center C1and a second circular cross-section having a second radius R2and a second center C2. In some embodiments, the first circular cross-section can be the cross-section that receives a portion of an endoscope. In other words, an endoscope that is positioned within the trocar channel633′ can be configured to sit within the first circular cross-section with radius R1. The first radius R1can be greater than the second radius R2.

In some embodiments, the first radius R1can be about 1.1 to about 1.5 times the second radius R2, including all values and sub-ranges therebetween. In some embodiments, the first radius R1can be between about 0.5 mm to about 10 mm, including all values and sub-ranges therebetween. In some embodiments, the first cross-section can have a radius R1that allows it to receive endoscopes of up to about 10 French (3.33 mm) or up to about 30 French (10 mm), including all values therebetween. For example, the first cross-section can have a diameter (i.e., two times the radius R1) that is slightly larger than the largest sized endoscope that the trocar channel633′ is designed to receive. In some embodiments, the second radius R2can be between about 0.1 mm to about 5 mm, including all values and sub-ranges therebetween.

In some embodiments, the second center C2can be offset from the first center C1by at least about 0.5 mm, at least about 1 mm, at least about 2 mm, at least about 3 mm, at least about 4 mm, or at least about 5 mm. In some embodiments, the second center C2can be offset from the first center C1by between about 0.5 mm and about 10 mm, including all values and sub-ranges therebetween. In some embodiments, the second center C2can be offset from the first center C1by a value of less than a radius R1of the first cross-section. In other words, the first and second circular cross-sections can be designed to overlap, thereby forming the combined asymmetrical cross-section.

As shown, the second circle extends beyond the outer circumference of the first circle by a clearance distance CD. In some embodiments, the clearance distance CD can be at least about 0.1, at least about 0.5, at least about 1 mm, at least about 2 mm, at least about 3 mm, at least about 4 mm, at least about 5 mm, at least about 6 mm, at least about 7 mm, at least about 8 mm, at least about 9 mm, or at least about 10 mm. In some embodiments, the clearance distance CD can be no more than about 10 mm, no more than about 9 mm, no more than about 8 mm, no more than about 7 mm, no more than about 6 mm, no more than about 5 mm, no more than about 4 mm, no more than about 3 mm, no more than about 2 mm, or no more than about 1 mm. Combinations of the above-referenced values of the clearance distance CD are also possible (e.g., at least about 1 mm and no more than about 10 mm or at least about 1 mm and no more than about 2 mm), inclusive of all values and ranges therebetween.

The clearance distance CD can represent the distance between an exit of an ejection port (e.g., ejection port336,446) and an endoscope positioned within the trocar channel633′. In use, an endoscope can be positioned within the first circular cross-section with the radius R1, and an ejection port can be disposed along the second cross-section with the radius R2. In some embodiments, the ejection port can be disposed in the second cross-section at the furthest point (or near furthest point) away from the first cross-section. For example, as shown inFIG.6B, a liquid and/or gas channel604that is coupled to an ejection port can be disposed near a point in the cross-section that is furthest from the first cross-section. In some embodiments, the ejection port can be disposed at other points along the perimeter of the section cross-section. When a volume of liquid and/or gas is ejected via the ejection port, that volume can spread out or diffuse within the clearance distance CD before contacting the endoscope. As such, a trocar channel with an asymmetrical cross-section can be configured to allow for greater distribution of liquid and/or gas, which can enable greater contact between a liquid spray and the distal end of an endoscope. Additionally, the trocar channel with the asymmetrical cross-section can prevent closure or blocking of the ejection port by an endoscope (e.g., in the case of a tight fit between the endoscope and the walls of the trocar channel). The trocar channel with the asymmetrical cross-section can also prevent or reduce fluid buildup inside the trocar.

FIG.5is a diagram of an obturator590, according to an embodiment. As shown, the obturator590includes an obturator hub592, an obturator shaft594, an optional obturator channel593extending the length of the obturator590, an absorbent element596, and a wiping element598. As shown, the obturator590can be inserted into the trocar channel533. In some embodiments, the trocar channel533can be the same or substantially similar to the trocar channel333, as described above with reference toFIG.3. Thus, certain aspects of the trocar channel533are not described in greater detail herein.

The obturator shaft594has sharp edges to facilitate initial placement of a trocar into the body lumen or cavity. For example, the distal end of the obturator shaft594can form a sharp, penetrating tip with a distal end of a trocar, and the penetrating tip can be used to cut through tissue while the trocar and obturator590are inserted through the tissue into the body lumen or cavity. In some embodiments, an imaging device such as an endoscope can be placed in the obturator channel593during placement of the obturator590in the body lumen or cavity. In such embodiments, the imaging device can be positioned within the obturator channel593and used to capture image data of the patient anatomy as the obturator590is inserted into the body lumen or cavity. In some embodiments, the obturator590can be composed of a polymer, polyethylene, polypropylene, PVC, polycarbonate, polystyrene, or any other suitable material.

The obturator hub592can optionally include a wiping element598and an absorbent element596. In some embodiments, the wiping element598and/or the absorbent element596can be configured to clean an endoscope, e.g., when the endoscope is removed from a patient. For example, the wiping clement594and/or absorbent element596can be used to wipe the end of an endoscope, e.g., to remove debris or other deposits on the end of the endoscope. In some embodiments, the wiping element598and/or the absorbent element596can be configured to clean the trocar channel533and/or other parts of the trocar530. For example, the wiping element598can contact a wall of the trocar channel533to remove moisture and debris from the wall. The wiping element598can also be configured to clean seal in the trocar530. In some embodiments, the wiping element598can be implemented as an annular wiper blade that can encircle a perimeter of the obturator shaft594. For example, the wiping element598can include a squeegee, a rubber stopper, an O-ring, or any other suitable device. When the obturator hub592is disposed within the trocar channel533, the wiping element598can be configured to create a seal with the inner surface of the trocar channel533. In some embodiments, the wiping element594can be directionally orientated such that insertion of the obturator590into the trocar channel533does not cause wiping but proximal retraction of the obturator590from the trocar channel533causes wiping or scraping of the sides of the trocar channel533. In some embodiments, the wiping element594can be formed of a flexible material, while in other embodiments, the wiping element594can include portions that are formed of rigid material and/or portions that are formed of flexible material.

The absorbent element596can be configured to absorb debris and/or moisture from the interior sides of the trocar channel533and/or other parts of the trocar530(e.g., seals). The debris and/or moisture absorbed can include debris and/or moisture dislodged or captured by the wiping element598. In some embodiments, the absorbent element596can include cloth, cotton, sponge, calcium chloride, silica gel, activated carbon, sodium polyacrylate, rayon, or any other suitable material or combinations thereof. In some embodiments, the absorbent element596can encircle the entire perimeter of the obturator590. Alternatively, the absorbent element can be disposed at discrete locations along a perimeter of the obturator590. In some embodiments, the absorbent element596can have a thickness of between about 0.5 mm and about 10 mm, including all values and sub-ranges therebetween.

FIG.14is a diagram of a liquid/gas interconnect, according to an embodiment. The liquid/gas interconnect1437can be structurally and/or functionally similar to other liquid/gas interconnects described herein, including, for example, liquid/gas interconnect337. As shown, gas flow1466enters through a gas line1462and a valve1464and liquid flow1476enters through a liquid line1472and a valve1474. The gas flow1466and the liquid flow1476merge and exit as a liquid/gas output1483. The gas line1462and the liquid line1472can be structurally and/or functionally similar to other gas lines and liquid lines described herein, respectively, including, for example, gas line262and liquid line272.

As described above, a cleaning system as described herein can be configured to use a pressurized gas (e.g., carbon dioxide) to propel a set volume of liquid into a trocar channel, e.g., to deliver it as a high-energy spray that can wash a distal end of an endoscope. The liquid/gas interconnect1437, similar to other liquid/gas interconnects described herein, can be configured to combine the set volume of liquid with the pressurized gas to enable the delivery of the gas/liquid spray.

As depicted inFIG.14, the gas flow1466designates a flow path of gas through the interconnect1437. A valve1464regulates the flow of gas therethrough. In some embodiments, the valve1464can be controlled manually (e.g., the user can control when the valve1464is open and how much the valve1464is open). Alternatively, the valve1464can be configured to open automatically, e.g., when the pressure of the gas on the proximal side of the valve1464(i.e., the side of the valve1464coupled to the gas line1462) exceeds a threshold value. In some embodiments, the threshold pressure to open the valve1464can be at least about 20 psi to at least about 50 psi, including all sub-ranges and values therebetween. For example, the threshold pressure to open the valve1464can be at least about 30 psi, at least about 35 psi, or at least about 40 psi. In some embodiments, the gas delivered by the gas source can include CO2, nitrogen, argon, or any other inert gas or combinations thereof. In some embodiments, the valve1464can be a check valve. In some embodiments, the valve1464can prevent backflow of liquid into the gas line1462.

As depicted inFIG.14, the liquid flow1476designates a flow path of liquid (e.g., wash solution) through the liquid/gas interconnect1437. The valve1474regulates the flow of wash solution therethrough. The valve1474can be configured to prevent backflow of the liquid. The diameter of the liquid line1472(e.g., DI as shown inFIG.15) can be sized to prevent bubble formation. In particular, the valve1474can prevent backflow of the liquid and the size of the liquid line1474can hold the liquid in place until the gas passes through the valve1474to draw out the liquid. In some embodiments, the valve1474can be controlled manually. In some embodiments, the valve1474can be configured to automatically open. For example, the opening and closing of the valve1474can be triggered when the pressure of the liquid on the proximal side of the valve1474(i.e., the side of the valve1474coupled to the liquid line1472) exceeds a threshold value. In some embodiments, the threshold pressure to open the valve1474can be lower than the threshold valve to open the valve1464and/or valve1484. As such, liquid can be delivered via the liquid line1472into an internal volume of the liquid/gas interconnect1437without leaking into the gas line and/or out through the output of the liquid/gas interconnect1437. In use, liquid from a liquid supply (e.g., external liquid source170, liquid reservoir114) coupled to the liquid line1472can be delivered into an internal volume defined by various lumens of the liquid/gas interconnect1437. The liquid that is delivered can have a set volume, e.g., for use in a wash sequence. The delivery of the liquid into the liquid/gas interconnect1437can be controlled by a controller (e.g., controller220), as described above with reference toFIG.2. For example, the controller can include a pump actuator (e.g., pump actuator226) that is coupled to a pump mechanism216, which can be used to pump a set volume of liquid into the liquid/gas interconnect1437in preparation for each wash sequence. In some embodiments, the controller can be configured to pump the set volume of liquid into the liquid/gas interconnect1437after each wash sequence in preparation for a subsequent wash sequence. In some embodiments, the controller can be configured to pump the set volume of liquid into the liquid/gas interconnect1437in response to a trigger event (e.g., the detection of an endoscope being withdrawn by a physician, which can be detected, for example, by a sensor). The process of delivering each set volume of liquid into the liquid/gas interconnect1437can be referred to as priming. In some embodiments, the valve1474can be a check valve. In some embodiments, the valve1474can prevent backflow of liquid and/or gas into the liquid line1472.

The gas flow1466and the liquid flow1476can merge at a ‘T’ intersection. In use, liquid can be delivered via liquid line1472into the liquid/gas interconnect1437and held within the liquid/gas interconnect1437(e.g., in a space defined between valves1464,1474,1484). When a wash sequence is triggered, e.g., due to a retraction of an endoscope, the gas line462can deliver a high-pressure gas into the liquid/gas interconnect1437, which can force open valves1464,1484and propel a predetermined volume or bolus of liquid out of the liquid/gas interconnect1437. This liquid/gas output1483can then be delivered into a liquid/gas port of a trocar (e.g., trocar330) and into the trocar channel (e.g., trocar channel333) to wash an instrument (e.g., endoscope) disposed within the trocar channel. In some embodiments, each predetermined bolus of liquid can include at least about 1 μL, at least about 2 μL, at least about 3 μL, at least about 4 μL, at least about 5 μL, at least about 6 μL, at least about 7 μL, at least about 8 μL, at least about 9 μL, at least about 10 μL, at least about 11 μL, at least about 12 μL, at least about 13 μL, at least about 14 μL, at least about 15 μL, at least about 16 μL, at least about 17 μL, at least about 18 μL, or at least about 19 μL of liquid. In some embodiments, each bolus of liquid can include no more than about 20 μL, no more than about 19 μL, no more than about 18 μL, no more than about 17 μL, no more than about 16 μL, no more than about 15 μL, no more than about 14 μL, no more than about 13 μL, no more than about 12 μL, no more than about 11 μL, no more than about 10 μL, no more than about 9 μL, no more than about 8 μL, no more than about 7 μL, no more than about 6 μL, no more than about 5 μL, no more than about 4 μL, no more than about 3 μL, or no more than about 2 μL. Combinations of the above-referenced volumes for each bolus of liquid are also possible (e.g., at least about 1 μL and no more than about 20 μL or at least about 5 μL and no more than about 15 μL), inclusive of all values and ranges therebetween. In some embodiments, each bolus can include about 1 μL, about 2 μL, about 3 μL, about 4 μL, about 5 μL, about 6 μL, about 7 μL, about 8 μL, about 9 μL, about 10 μL, about 11 μL, about 12 μL, about 13 μL, about 14 μL, about 15 μL, about 16 μL, about 17 μL, about 18 μL, about 19 μL, or about 20 μL of liquid.

The bolus of liquid can be delivered over a time period of about 100 ms, about 110 ms, about 120 ms, about 130 ms, about 140 ms, about 150 ms, about 160 ms, about 170 ms, about 180 ms, about 190 ms, about 200 ms, about 210 ms, about 220 ms, about 230 ms, about 240 ms, about 250 ms, about 260 ms, about 270 ms, about 280 ms, about 290 ms, or about 300 ms, inclusive of all values and ranges therebetween. In some embodiments, an optional valve1484can be disposed downstream from the ‘T’ connection point between the gas and liquid flow paths. The valve1484can be configured to allow a bolus of liquid therethrough when a threshold pressure is reached. In some embodiments, the valve1484can be a check valve. As such, the valve1484can be configured to allow the liquid/gas output1483to be delivered into a trocar while preventing backflow of any liquid or gas that may remain within a trocar after a was sequence. In some embodiments, the valve1484can be structurally and/or functionally similar to the valve1464. In some embodiments, the liquid/gas interconnect1437may not include a valve1484. In such embodiments, the Venturi effect from the diameter of the gas line1462relative to the diameter of the liquid line1472can hold the liquid in place until a blast of gas draws the liquid out of the liquid line1472and pushes the liquid out of the liquid/gas output1483.

The passages or lumens for the flow of gas (e.g., gas flow1466) and the flow of liquid (e.g., liquid flow1476) can be configured to have dimensions and/or geometry that facilitates flow in a preferential direction (e.g., toward a trocar) while preventing or reducing the likelihood of flow in the opposite direction (e.g., away from a trocar). An example of such dimensions and/or geometry is described with reference to the interconnect depicted inFIG.15.FIG.15is a detailed diagram of a liquid/gas interconnect1537, according to an embodiment. As shown, the liquid/gas interconnect1537includes a gas line1562, a valve1564, a liquid line1572, a valve1574, and a liquid/gas output1583. In some embodiments, the gas line1562, the valve1564, the liquid line1572, the valve1574, and the liquid/gas output1583can be the same or substantially similar to the gas line162, the valve1464, the liquid line1472, the valve1474, and the liquid/gas output1483, as described above with reference toFIG.14. Thus, certain aspects of the gas line1562, the valve1564, the liquid line1572, the valve1574, and the liquid/gas output1583are not described in greater detail herein.

As shown, the gas line1562and the liquid line1572form an intersection angle A1. In some embodiments, the intersection angle A1, can be about 60 degrees, about 65 degrees, about 70 degrees, about 75 degrees, about 80 degrees, about 85 degrees, about 90 degrees, about 95 degrees, about 100 degrees, about 105 degrees, about 110 degrees, about 115 degrees, or about 120 degrees, inclusive of all values and ranges therebetween. Desirably, the gas line1562and the liquid line1572can merge at a ‘T’ intersection or connection, i.e., where the intersection angle Al is about 90 degrees. A ‘T’ connection can optimize the Venturi effect on the flow of liquid as it merges with the flow of gas.

In some embodiments, the liquid/gas output1583can couple to a port (e.g., a liquid/gas port of a trocar) that is fluidically coupled to an ejection port of a trocar. As such, the combined stream of gas and liquid can be ejected from the ejection port and into a trocar channel, e.g., to clean an endoscope positioned within the channel. In some embodiments, the liquid/gas output1583can be threaded, e.g., to facilitate coupling to a valve, port, or other structure.

As noted above, the diameters, lengths, and/or other geometry of the lumens or passages within the liquid/gas interconnect1537can be selected to allow a predetermined volume of fluid to be delivered to the trocar during each wash sequence. For example, the inner diameter D1of the section of the liquid line1572adjacent to the liquid/gas intersection, the inner diameter D2of the gas line before and after the liquid/gas intersection, the length L1of the section of the liquid line1572adjacent to the liquid/gas intersection, and/or the distance L2from the liquid/gas intersection and the valve1564can be selected to facilitate capture of a set volume of liquid from the liquid line during each timed release of the gas through the gas line1562. As described above, gas can be delivered via gas line1562for a predetermined period of time, during which a predetermined volume of liquid is captured by the gas and propelled by the gas into the trocar lumen. After the wash sequence, the predetermined volume of liquid can then be re-filled into the liquid/gas interconnect1537, e.g., during a priming sequence. As described above, the predetermined volume of liquid delivered during each wash sequence can be less than about 5 μL.

In some embodiments, D1can be about 0.5 mm to about 1 mm, inclusive of all values and ranges therebetween. In some embodiments, D2can be about 1 mm to about 2 mm, inclusive of all values and ranges therebetween. The ratio between D2and D1can be tuned to create a desired Venturi effect. For example, the ratio of D2to D1can be between about 1.5 and about 5, including, for example, about 2 and any other values of subranges therebetween. By having the liquid line have a smaller diameter than the gas line, liquid within the liquid line is less likely to leak into the gas line and gas within the gas line is less likely to enter the liquid line and form undesirable bubbles. When pressurized gas is released and travels through the gas line, it can pull the liquid within the liquid line out through the outlet of the interconnect.

As described with reference toFIG.15, the valves1564,1574can be selected to allow for flow of liquid and/or gas above certain pressures. The interconnect1537can define larger spaces for receiving the valves1564,1574, and then have those spaces taper down to the suitable dimensions of the lumens for enabling the precise delivery of the liquid during a wash sequence. The tapering of the gas line1562and/or the liquid line1572enables appropriate space to be provided for receiving the valves1544,1574while still maintaining the appropriate diameters of the liquid and gas lines where the liquid and gas lines meet.

FIGS.12A-12Cshow a trocar1230as part of a cleaning system1200when used with an endoscope1203, according to embodiments. As shown, the trocar1230can be disposed within a body cavity that lies below a layer of tissue. The trocar1230includes a trocar hub1231, a trocar shaft1232, and a trocar channel1233. The endoscope1203is coupled to an imaging system1295. A fluid delivery system1210, a gas source1260, and an optional external liquid source1270are coupled to the trocar1230. As depicted inFIG.12B, an external circuit1228extends along the trocar1230. The external circuit1228is electronically coupled to sensors1234a,1234b,1234c(collectively referred to as sensors1234). The trocar1230can also include a lumen1204that terminates at an orifice or ejection port1236, e.g., where a liquid or wash solution can be ejected to wash the distal end of the endoscope1203positioned within the trocar channel. In some embodiments, the fluid delivery system1210, the trocar1230, the gas source1260, and the external liquid source1270can be the same or substantially similar to the fluid delivery system110, the trocar130, the gas source160, and the external liquid source170, as described above with reference toFIG.1. In some embodiments, the trocar hub1231and the trocar shaft1232can be the same or substantially similar to the trocar hub331and the trocar shaft332, as described above with reference toFIG.3. Thus, certain aspects of the fluid delivery system1210, the trocar1230, the trocar hub1231, the trocar shaft1232, the gas source1260, and the external liquid source1270are not described in greater detail herein.

The imaging system1295can be any suitable imaging system that can be used with endoscopes or other imaging devices as described herein. In some embodiments, the imaging system1295can include processing circuitry, memory, and a user interface, e.g., for processing image data captured by the endoscope1203and displaying image data to a user (e.g., via the user interface). The endoscope1203can include a shaft with a lens and/or illumination system, e.g., for capturing image data within a body lumen or cavity. In some embodiments, the endoscope1203can include any of the features described in U.S. Patent Publication No. 2021/0127963.

As an illustrative example, the sensors1234may be configured to detect a position and/or orientation of the endoscope1203. For example, sensor1234amay be configured as a “scope present” sensor, and be configured to detect when the endoscope1203has been positioned within the trocar channel. Sensor1234bmay be configured as a “prime” sensor, and be configured to detect when the endoscope1203is being retracted within the trocar channel and therefore being positioned for a wash sequence. Detection of the endoscope1203may trigger a priming of the wash solution channel, e.g., such that the predetermined volume of liquid is positioned for ejection into the trocar channel. Sensor1234cmay be configured as a “wash” sensor, and be configured to detect when the endoscope1203has been positioned for cleaning or washing. For example, sensor1234cmay be configured to detect when the distal end of the endoscope1203is near the ejection port1236(e.g., slightly proximal of the ejection port1236) such that a liquid/gas spray is delivered into the trocar channel to clean the distal end of the endoscope1203. The electrical circuit1228may comprise a circuit board such as a flexible circuit board. Other circuits and electrical pathways may be used.

Alternatively, in some embodiments, fewer number of sensors may be used. For example, in some embodiments, the sensors1234may not include a prime sensor. In particular, a first sensor, e.g., sensor1234c,can be disposed near the ejection port1236and be configured to send a signal to a controller (e.g., controller220) when the distal end of the endoscope1203is near the ejection port1236and positioned for cleaning. Optionally, a second sensor, e.g., sensor1234a,can also be disposed along the trocar channel at a position that is proximal of the first sensor. The second sensor can be configured to detect when the endoscope1203is initially being inserted into the trocar channel, and to send a signal to the controller to not initiate a wash sequence during the initial insertion of the endoscope1203. The controller may be configured to trigger priming of the liquid line automatically after each wash sequence, thereby not requiring a separate prime sensor.

Still alternatively, in some embodiments, a greater number of sensors may be used. For example, additional sensors can be used to detect an orientation of the endoscope1203, e.g., for when the endoscope1203has an angled distal end, as depicted inFIGS.12B and12C. With an angled distal end, the endoscope1203may need to be positioned such that the angled surface of the endoscope1203faces the ejection port1236, e.g., for cleaning of the angled surface. Therefore, the endoscope1203may be rotated by a physician such that it is positioned to face the ejection port1236. While the orientation of an angled endoscope is described herein, it can be appreciated that the orientation of the angled endoscope may not affect the cleaning of the endoscope. For example, sufficient pressures of liquid/gas spray may enable cleaning of the angled surface of the endoscope even when the angled surface of the endoscope does not face the ejection portion1236. For example, pressures of between about 20 psi and about 50 psi (including all values and sub-ranges therebetween) may be used to cause sufficient spraying of the liquid/gas into the trocar channel to clean the surface of any type of endoscope, including, for example, flat and angled endoscopes.

As described above, the operation of the cleaning system may comprise priming of the system with a fixed or predetermined quantity of solution (e.g., about 1 μl to about 20 μl). In some embodiments, the priming can occur when a prime sensor detects the presence of the endoscope1203within the trocar channel. Alternatively, the priming can occur after delivery of liquid/gas during a wash sequence, e.g., in anticipation of a subsequent wash sequence. When the wash sequence is triggered, e.g., via sensor1234C, pressurized gas may be activated for a fixed time period (e.g., about 100 ms to about 500 ms, including intervening end points such as about 200 ms and the like). The gas may serve one or more purposes, for example, as a propellant to atomize the solution into a high-energy spray as it exits the orifice (e.g., which may last about 100 ms to about 500 ms, including intervening endpoints) and/or as a drying system to remove excess solution from the distal end of the endoscope1203(e.g., which may last about 100 ms to about 500 ms, including intervening endpoints). In the latter case, the pressurized gas may be delivered alone without liquid. Other sequences may be used.

As shown, the orifice or ejection port1236is angled in a proximal direction at an orifice angle OA. In some embodiments, the distal surface of the endoscope1203can also angled, e.g., at an endoscope angle EA. As described above, when the endoscope1203has an angled distal end, it can be desirable to orient the endoscope such that the angled surface of the endoscope1203faces the ejection port1236. This configuration allows for a substantial amount of the surface of the endoscope1203to be contacted by the wash solution or liquid spray exiting the ejection port1236. In some embodiments, the orifice angle OA can be between about 5 degrees to about 90 degrees, inclusive of all values and sub-ranges therebetween.

In some embodiments, cleaning systems as described herein can be used to clean multiple different kinds and/or sizes of endoscopes. For example, a trocar (e.g., trocar330,1230) can have a trocar channel that is designed to receive endoscopes having an outer diameter of up to a predetermined value (e.g., up to about 10 mm). Endoscopes then having diameters that fit within the trocar channel can be cleaned using the systems and methods described herein, regardless of the size and/or configuration of the endoscopes. For example, a trocar channel large enough to receive a 10 mm endoscope can be configured to clean any endoscope that is smaller than or equal to 10 mm, including for example, a 5 mm or an 8 mm endoscope. The cleaning systems can also be designed to clean endoscopes having different distal tip configurations, including, for example, different angles, curvature, etc. In particular, the cleaning system can be designed to clean endoscopes have different angles, including, for example, 0, 30, or 45 degree angled lenses. To achieve this, the cleaning systems described herein can be configured to deliver a spray of liquid and/or gas at predetermined pressures above a threshold value that allows for sufficient cleaning of any shape or configuration of endoscope. In some embodiments, this threshold value can be between at least about 20 psi and about 50 psi, including, for example, at least about 35 psi.

FIGS.8A-8Oare illustrations of a trocar830and an obturator890of a cleaning system, and various components thereof, according to embodiments. As shown, the trocar830includes a gas/liquid port803, grooves814,816, an ejection port815, openings or transparent sections817, a PCB828, a trocar hub831, a trocar shaft832, a trocar channel833, sensor(s)834, an electronic port835, a vent838, a trocar cover840, a cover hole841, a stopcock switch845, a cap880, cap grooves885,886, electronic port opening882, and liquid/gas port883. As shown, the obturator890includes an obturator hub892, an obturator channel893, an obturator cap895, and an obturator cap hole897. In some embodiments, the trocar830, the trocar hub831, the trocar shaft832, the trocar channel833, the sensor(s)834, the electronic port835, and the vent838can be the same or substantially similar to the trocar330, the trocar hub331, the trocar shaft332, the trocar channel333, the sensor(s)334, the electronic port335, and the vent338as described above with reference toFIG.3. In some embodiments, the obturator890, the obturator hub892, and the obturator channel893, can be the same or substantially similar to the obturator590, the obturator hub592, and the obturator channel593, as described above with reference toFIG.5. Thus, certain aspects of the trocar830, the trocar hub831, the trocar shaft832, the trocar channel833, the sensors834, the electronic port835, the obturator890, the obturator hub892, and the obturator channel893are not described in greater detail herein.

FIG.8Ashows a side-by-side view of the trocar830and the obturator890.FIG.8Bshows an exploded view of the trocar830.FIG.8Cshows a side view of the trocar830with a circular section indicating the perspective ofFIG.8L.FIG.8Dshows an overhead view of a trocar shaft832.FIGS.8E and8Fshow a front and back view of the cap880.FIG.8Gshows a top view of the trocar cover840, whileFIG.8Hshows a front view of the trocar cover840.FIG.8Ishows a side view of the obturator890, whileFIG.8Jshows a top view of the obturator890.FIG.8Kshows an auxiliary view of the obturator cap895.FIG.8Lshows a detailed view of the bottom of the trocar830.FIG.8Mshows a cross-sectional view of a trocar channel833.FIG.8Nshows a bottom of the obturator890inserted into the trocar830.FIG.8Oshows a detailed view of the trocar hub831with the obturator890disposed therein.

As shown, the PCB828can function as an electrical line that connects the sensor(s)834to the electronic port835. In some embodiments, the sensor(s)834and the electronic port835can be disposed on the PCB828. The electronic port835can be configured to be disposed within the electronic port opening882, such that an electrical connection can be established between the electronic port835and an external electrical line (e.g., electrical line282) via the electronic port opening882. As described with reference toFIG.10C, a trocar connection of a connector can be configured to couple to the trocar and, when coupled, an external electrical line housed within the connector can be configured to couple to the electronic port835. The PCB828can be disposed within a passage that is collectively defined by the groove886of the cap and the groove816of the trocar shaft. In particular, the cap880can be configured to couple to the trocar shaft832, as shown inFIG.8A. The cap880can sit within a groove881defined along a side of the trocar shaft832, and when coupled together, the groove886of the cap and the groove816of the trocar shaft can come together to form a passage for housing the PCB828. This passage can be configured to maintain the PCB828in place, while also providing protection for PCB828, e.g., by sealing PCB828within the passage such that fluids within the trocar channel and/or external to the trocar do not contact the PC828.

As noted, one or more sensors834can be disposed on the PCB828toward a bottom or distal end of the PCB828. InFIG.8B, two sensors834are disposed at the distal end of the PCB828, but it can be appreciated that a single sensor or more than two sensors can be disposed on the PCB828. In an embodiment, the sensor(s)834can be light sensors. The light sensors can be disposed behind transparent portions817(or within openings817) disposed along the groove816of the trocar. As such, the light sensors can be configured to detect when there is light within the trocar channel, e.g., as an indication of when a distal end of an endoscope may be near the sensors. In particular, when the trocar830is used for cleaning an endoscope, the endoscope can be disposed within the trocar channel of the trocar830, and one or more light sensors can be disposed at a location near an ejection port815of the trocar830. In particular, at least one light source can be disposed at the same point along the longitudinal length of the trocar as the ejection port815. The distal end of the endoscope can emit a light, e.g., for providing illumination within a body cavity for capturing image data. When the endoscope is withdrawn or retracted within the trocar channel, e.g., to initiate a wash sequence, the light emitted by the endoscope may be detected by the light sensor(s). In some embodiments, the light sensor(s) can be configured to detect when a level of light within the trocar channel is greater than a predetermined threshold or has changed by a predetermined amount or percentage. In response to there being sufficient light (e.g., the level of light being above the threshold), which can be indicative of the position of the distal end of the endoscope being in close proximity to the ejection port, the cleaning system (e.g., via a controller such as, for example, controller120,220) can cause a volume of liquid and/or gas to be ejected from the ejection port815to clean the distal end of the endoscope. In some embodiments, the light sensor(s) can provide sensor data indicative of the level of light within the trocar channel, and a controller (e.g., controller120,220) of the cleaning system can be configured to determine when that level of light is above a threshold for ejecting the liquid volume. Alternatively, the light sensor(s) can be triggered to send a signal to a controller of the cleaning system when the level of light within the trocar channel is above a threshold. While this example cleaning operation is provided herein with reference to light sensors, it can be appreciated that other types of sensor(s) can also be used with the trocar cleaning systems as described herein, including, for example, pressure sensors, motion sensors, etc.

As depicted in the detailed view ofFIG.8L, at least one sensor834is configured to be disposed adjacent to the ejection port815. By having at least one sensor834be close to the ejection port, the sensor834can provide a more accurate approximation of when the distal end of an endoscope may be in proximity to the ejection port815. In some embodiments, the ejection port815can be angled retrograde, e.g., as depicted inFIG.12C, and in such cases, the liquid volume can be set to be ejected when the distal end of the endoscope is proximal of the ejection port. Such positioning can enable the spray pattern as shown inFIG.12C.

As further depicted inFIG.8L, the ejection port815can be disposed at a distal end of a groove814that is defined along the trocar shaft or body. The groove814together with a groove885defined in the cap880can be configured to define a passage for delivering liquid and/or gas to the ejection port815. In particular, the cap880as shown inFIGS.8E and8Fdefines two grooves. The first groove886for mating with the groove816to form the passage for housing the PCB828, as described above. And a second groove885for mating with groove814to form a passage for delivering liquid and/or gas to the ejection port815. When the cap880is coupled to the trocar shaft, the grooves885,814can combine together to form the passage for delivering liquid and/or gas to the ejection port815. Alternatively, in some embodiments, the cap880alone or the trocar shaft832alone can define the passage for delivering liquid and/or gas to the ejection port815. The cap can include a liquid/gas port883that can be configured to connect to an output of a liquid/gas interconnect (e.g., the liquid/gas interconnect, as described above with reference toFIG.3) for receiving volumes of liquid and/or gas. In some embodiments, the ejection port can have a diameter of between about 0.01 inches and about 0.5 inches, including all values and sub-ranges therebetween, including, for example, about 0.05 inches. In some embodiments, the ejection port815can be angled retrograde, e.g., similar to the ejection port1236described with reference toFIG.12C. In some embodiments, the ejection port836can be angled from a longitudinal axis of the passage or grooves885,814by between about 10 degrees and about 90degrees, including all values and sub-ranges therebetween (e.g., about 45 degrees, or between about 30 degrees and about 60 degrees). In some embodiments, the ejection port836can also be angled laterally (e.g., within a lateral plane of the trocar830) or rotated off center from longitudinal plan of the passage or grooves885,814. For example, the ejection port836can be angled outward toward a side of the trocar channel by about 1 degree to about 20 degrees, including all values and sub-ranges therebetween (e.g., about 7.5 degrees rotated off center, or between about 5 degrees and about 10 degrees rotated off center). Alternatively, the ejection port836can be angled inward toward a centerline of the trocar channel by about 1 degree to about 20 degrees, including all values and sub-ranges therebetween.

As depicted inFIG.8N, the passages for housing the PCB828and delivering fluid and/or gas can be disposed along a side S4of the trocar shaft832that extends more distally than other sides of the trocar shaft832. In particular, the ejection port815can be disposed along the more distally extending side S4at a location that is distal to the distal end of the opposite side S3. As such, volumes of liquid and/or gas (e.g., liquid sprays) that are ejected by the ejection port815can spray generally toward a space that is not bounded on the opposite side by a wall of the trocar channel833. Such positioning of the ejection port815can minimize or reduce entrapment or buildup of moisture within the trocar channel, thereby reducing the risk of fogging or condensation forming on the distal end of an endoscope during cleaning.

As noted above, the cap880can fit into the groove881on the trocar body or shaft832. In some embodiments, the cap880can snap into place on the trocar shaft832. In some embodiments, the cap880can be coupled to the trocar shaft832via an adhesive, a magnetic coupling, and/or a magnetic coupling.

The trocar830can include a stopcock switch845that can be rotated to open and close a vent838. In some embodiments, the stopcock switch845can also be rotated between a first position for venting and a second position for insufflation. Further details of such a stopcock switch845are described with reference toFIGS.9A-9C.

In some embodiments, the trocar shaft832and at least a portion of the trocar hub831can be formed as a unitary component, e.g., molded as a single piece. In some embodiments, the trocar hub831and the trocar shaft832can be transparent or semi-transparent or translucent. In some embodiments, the trocar hub831and trocar shaft832can be composed of a polymer, PVC, polypropylene, polyethylene, polycarbonate, or any other suitable material or combinations thereof. The trocar hub831can include a removable or attachable cover840. The trocar cover840can attach to the trocar hub831via an interlocking mechanism, snap mechanism, or other mechanical coupling (e.g., fasteners, clips, etc.) Alternatively or additionally, the trocar cover840can attach to the trocar hub831via adhesive, magnetic coupling, etc. The trocar cover840includes the cover hole841, e.g., for insertion of the obturator890and/or an endoscope.

The obturator890can fit into the trocar channel833, e.g., to facilitate initial insertion of the trocar830into a body lumen or cavity. As shown inFIG.8A, the obturator890includes a pointed distal end for piercing through body tissue.FIG.8Ndepicts the distal end of the obturator890when it is fully inserted into the trocar channel833. In such position, the obturator890can follow a profile of the trocar830at the distal end of the trocar830. As shown, the obturator890can have a first angled surface S1and a second angled surface S2. The first angled surface S1and the second angled surface S2can continue the respective angled surfaces of the trocar830and provide a continuous surface for penetrating through tissue. While not depicted inFIGS.8A-8O, in some embodiments, the obturator890can include a wiping element and/or an absorbent element for cleaning the trocar channel833and/or an endoscope. As shown, the obturator890includes the obturator cap895, which includes the hole897that can be used to receive an instrument (e.g., an endoscope). In some embodiments, a first endoscope having a smaller profile can be inserted within the obturator890during insertion of the trocar830into the body lumen or cavity, and then the obturator890and the first endoscope can be removed to allow for insertion of a second endoscope with a larger profile into the trocar channel. As shown inFIG.8M, the trocar channel833can have an asymmetrical cross-section, similar to that described with reference toFIGS.6B and7. The asymmetrical cross-section of the trocar channel833can have a first lateral dimension L1and a second lateral dimension L2, e.g., resulting from the overlap of two circular cross-sections. In some embodiments, the first lateral dimension L1can be at least about 1 mm, at least about 2 mm, at least about 3 mm, at least about 4 mm, at least about 5 mm, at least about 6 mm, at least about 7 mm, at least about 8 mm, at least about 9 mm, at least about 10 mm, at least about 15 mm, or at least about 20 mm. In some embodiments, the first lateral dimension L1can be no more than about 20 mm, no more than about 15 mm, no more than about 10 mm, no more than about 9 mm, no more than about 8 mm, no more than about 7 mm, no more than about 6 mm, no more than about 5 mm, no more than about 4 mm, or no more than about 3 mm. Combinations of the above-referenced values of the outer diameter L1are also possible (e.g., at least about 2 mm and no more than about 20 mm or at least about 5 mm and no more than about 10 mm), inclusive of all values and ranges therebetween. The second lateral dimension L2can be greater than the first lateral dimension L1. In particular, the second lateral dimension L2can be at least about 1% to at least about 10% greater than the first lateral dimension L1, including all values and sub-ranges therebetween.

As described above with reference toFIGS.6B and7, the asymmetrical cross-section of the trocar channel833can be formed from two overlapping circular cross-sections. In use, an endoscope can be inserted through the larger of the two circular cross-sections and be held within that cross-section given its size and the small dimension smaller circular cross-section. The ejection port815can be disposed along perimeter of the smaller circular cross-section (seeFIG.8M) such that the ejection port815is spaced by a distance from the endoscope. Such positioning of the ejection port815can enable a larger spray to develop when liquid is ejected from the ejection port815and/or prevent closure or blocking of the ejection port815by the endoscope (e.g., in the case of a tight fit between the endoscope and the walls of the trocar channel833).

The travel of liquid and/or gas from a liquid/gas interconnect through the trocar shaft832to the ejection port815can be frictionless or substantially frictionless. In particular, the trocar830(including trocar shaft832and cap880) can be designed to provide a pathway for fluid flow that transitions from larger lumens down to a ultra-small ejection port in a frictionless manner, e.g., without sharp transitions (e.g., sharp turns or curves) and without sudden changes in passage diameter. Such can help prevent or reduce liquid trapping and/or bubble formation.

FIGS.9A-9Cshow an example stopcock switch945with first and second passages945a,945b,according to an embodiment. In some embodiments, the stopcock switch945can be the same or substantially similar to the stopcock switch845described above with reference to the trocar830. Thus, certain aspects of the stopcock switch945are not described in greater detail herein. The stopcock switch945can be integrated into a vent (not shown) and can be used to switch between coupling a first passage945aor a second passage945bto a vent hole of a trocar. The first passage945acan be used for a first function (e.g., passive venting), while the second passage945bcan be used for a second function (e.g., insufflation). For example, when the stopcock switch945is in a first position, the first passage945acan align with a vent hole or channel of a trocar, thereby allowing for passive venting. In some embodiments, the vent hole of the trocar can have a diameter of between about 1.0 mm and 3.0 mm, including for example, about 1.9 mm and other values and sub-ranges therebetween. In some embodiments, the diameter of the first passage945acan be between about 1.0 mm and about 3.0 mm, including, for example, about 2.5 mm and other values and sub-ranges therebetween. When the vent hole of the trocar and the first passage945aare aligned, they can collectively create a vent path that has a diameter equal to the lesser of the diameters of the vent hole of the trocar and the first passage945a.For example, when a 2.5 mm inner diameter first passage945ais aligned with a 1.9 mm inner diameter vent hole of a trocar, a 1.9 mm inner diameter vent path can be formed. The size of the vent path can be indicative of the venting rate, and adjustments to either the trocar vent hole or the first passage945acan be made to provide for smaller and/or faster venting. In some embodiments, the first passage945aand the second passage945bcan have the same diameter, while in other embodiments, the first passage945aand the second passage945bcan have different diameters.

FIGS.10A-10Dare illustrations of various components of a wash or cleaning system, according to an embodiment. As shown, the system includes a trocar1030, a connector1078including a controller connection1084(or proximal connection) and a trocar connection1079(or distal connection), a liquid/gas interconnect1037disposed in the trocar connection1079, and a controller1075. The trocar1030includes a gas/liquid port1005, trocar hub1031, a trocar shaft1032, an electric port1035, a vent1038, and a stopcock switch1045. The controller1075can be coupled to an electric wire1076and a gas line1077. In some embodiments, the cleaning system depicted inFIGS.10A-10Dcan be structurally and/or functionally similar to the cleaning systems described in other embodiments, and can include like components as those systems. For example, the connector1078, the trocar1030, the trocar hub1031, the trocar shaft1032, the liquid/gas interconnect1037, and the controller1075can be the same or substantially similar to the connector240, the trocar330, the trocar hub331, the trocar shaft332, the liquid/gas interconnect337, and the controller120,220, respectively, as described above with reference toFIGS.1-3. In some embodiments, an obturator1090can be coupled to the trocar1030, e.g., for facilitating placement of the trocar1030within the body lumen or cavity. The obturator1090can be the same or substantially similar to the obturator590, as described above with reference toFIG.5. Thus, certain aspects of the connector1078, the trocar1030, the trocar hub1031, the trocar shaft1032, the liquid/gas interconnect1037, the obturator1090, and the controller1075are not described in greater detail herein.FIG.10Ashows the trocar1030, whileFIG.10Bshows a detailed view of the trocar hub1031with the obturator1090disposed therein.FIG.10Cshows a coupling between the trocar1030and the trocar connection1079.FIG.10Dshows a coupling between the controller1075and the controller connection1084.

The controller1075can be operatively coupled to the trocar1030, e.g., via connector1078, and can control delivery of liquid and/or gas to the trocar1030. The controller1075includes an outlet for connection to the controller connection1084of the connector1078, which then connects to the trocar1030. The controller1075is configured to receive power via the electrical wire1076and gas via the gas line1077. In some embodiments, the gas line1077can be configured to deliver pressurized gas including CO2, nitrogen, argon, or any other inert gas or combinations thereof.

The connector1078can include flexible tubing or insulation that houses an electrical line, a gas line, and/or a fluid line, as described with reference toFIG.2. The connector1078includes the controller connection1084and the trocar connection1079. The liquid/gas interconnect1037can be integrated into the trocar connection1079. The trocar connection1079can be configured to couple to the trocar1030, as shown inFIG.10C. When the trocar connection1079and the trocar1030are coupled, an output of the liquid/gas interconnect1037can be coupled to a liquid/gas port disposed in the trocar and an electrical connector disposed within the trocar connection1079can be coupled to an electrical port1035in the trocar. As such, when the trocar connection1079is coupled to the trocar1030, the connector1078can be configured to provide electrical and fluid communication between the trocar1030and the controller1075. The controller connection1084can be configured to be coupled to the controller1075. As shown inFIG.10D, the controller connection1084can be received within a receptacle or opening within the controller1075. In some embodiments, the controller connection1084can include an onboard liquid reservoir, e.g., liquid reservoir214, that can be pumped (e.g., via a pump mechanism216and/or pump actuator226disposed within the controller220) to deliver liquid to the liquid/gas interconnect1037for subsequent delivery into the trocar channel. Alternatively, the controller connection1084can include a port for coupling to a liquid reservoir disposed within the controller1075and/or coupled to the controller1075, e.g., for receiving liquid for delivery to the liquid/gas interconnection1037. The controller connection1084can also include a port for coupling to the gas source via gas line1077and a port or connector for coupling to the power source via power line1076. The connector1078, by having each of the electrical, gas, and liquid connections and lines, provides an efficient mechanism for coupling these lines between the controller1075and the trocar1030. The connector1078can also be designed to house and protect the lines during operation, e.g., to reduce wear and/or tangling of the lines.

Additionally, the trocar1030can include a vent1038and a stopcock switch1045. In some embodiments, the stopcock switch1045can be rotated to open and close the vent1038. For example, the stopcock switch1045can be configured to rotate to close or open a passage through the vent1038. In some embodiments, the stopcock switch1045can include multiple passages with different diameters, e.g., for different uses. For example, the stopcock switch1045can include a first passage with a first diameter for venting and a second passage with a second diameter for insufflation or venting at a different rate than the first passage. The stopcock switch1045can then be rotated to selectively position the passages for operation.

FIG.11shows an obturator1190with an absorbent element1196fitting into a trocar1130. Upon insertion of the obturator into the trocar, the absorbent element1196can aid in cleaning the interior walls of a trocar channel1133. In some embodiments, the absorbent element1196can include cloth, cotton, sponge, calcium chloride, silica gel, activated carbon, sodium polyacrylate, rayon, or any other suitable material or combinations thereof. As depicted inFIG.11, the absorbent element1196can encircle the entire perimeter of the obturator1190and extend continuously for a set distance along a longitudinal axis of the obturator1190. In some alternative embodiments, the absorbent element can be disposed on only a portion of the perimeter of the obturator1190and/or extend longitudinally at discrete points along the obturator1190. In some embodiments, the trocar1130and the trocar channel1133can be the same or substantially similar to the trocar330and the trocar channel333, as described above with reference toFIG.3. In some embodiments, the obturator1190and the absorbent element1196can be the same or substantially similar to the obturator590and the absorbent element596, as described above with reference toFIG.5.

FIGS.16A-16Dshow a trocar1630with venting and a filtration system, according to an embodiment. As shown, the trocar1630includes a trocar shaft1632and a vent1638. The vent1638includes a filter1638A, a valve1638B, and a filter cover1638C. In some embodiments, the trocar1630can be the same or substantially similar to other trocars described herein, including the trocar330as described above with reference toFIG.3and the trocar830as described above with reference toFIGS.8A-80, and can include components that are structurally and/or functionally similar to those trocars. Thus, certain aspects of the trocar1630are not described in greater detail herein.

As described above, the vent1638is configured to vent gases from within the body lumen or cavity to an outside of the body lumen or cavity, e.g., to prevent pressure buildup within the body lumen or cavity. In some embodiments, the vent1638can be positioned such that the vented gases are directed away from electrical and/or fluid connections (e.g., directed away from a trocar connection of a connector such as, for example, connector240) to prevent excessive humidity near electrical connections. In some embodiments, the vent1638can be configured to have standard size and/or geometry, e.g., to allow for the use of off-the-shelf filters with the vent. In some embodiments, the vent1638(or a port of the vent1638) can be coupled to an active evacuation system (e.g., a smoke or gas evacuation system, such as, for example, an aspiration or suction system) to allow for active removal of gases from the body lumen or cavity. In some embodiments, the size of the vent1638can be modified for different surgery or patient types, e.g., to provide for different rates of venting and/or to facilitate maintaining a certain pressure within the body lumen or cavity. In some embodiments, the vent1638can vent gas from the abdominal cavity. In some embodiments, the vent1638can vent gas from the thoracic cavity when operating on the lungs. In some embodiments, the minimum diameter of the vent1638can be between about 1.0 mm and about 3.0 mm, including all values and sub-ranges therebetween. For example, in an embodiment, the minimum diameter of the vent1638can be at least about 1.6 mm, about 1.9 mm, about 2.1 mm, about 2.2 mm, or about 2.4 mm. Larger diameter vents can be associated with larger flow rates and venting.

The vent1638can include a filter1638A along the evacuation path. The filter1638A can capture particles within the vented gases, e.g., to reduce smells, contaminants, etc. within the vented gases. In some embodiments, the filter can include polyester, activated carbon, stainless steel, fiberglass, knitted mesh, polyethylene, foam, air filter, ceramic, polypropylene, or any other suitable material or combinations thereof. In some embodiments, the filter1638A can be used with a filter cover1638C. In some embodiments, the filter cover1638C can prevent ejection of debris not captured by the filter1638A. In some embodiments, the filter cover1638C can attenuate noise. In some embodiments, the filter cover1638C can prevent external debris (e.g., blood or other bodily fluid on physician's gloves) from contacting the filter1638A. The vent1638can also include a valve1638B (e.g., a butterfly valve or other suitable valve) along the evacuation path. The valve1638B can be configured to allow for flow or venting when the pressure inside the trocar1630reaches a threshold value. The threshold value can be set to facilitate maintaining a certain level of pressure within the body lumen or cavity but to allow venting when such intraluminal pressure reaches higher levels. In some embodiments, the threshold pressure can be between about 5 mm Hg and about 100 mm Hg, including all values and sub-ranges therebetween. For example, the threshold valve can be set to 20 mm Hg, above which the valve1638B would open and allow for venting.

FIGS.13A-13Billustrate methods associated with operating cleaning systems, according to various embodiments.FIG.13Ashows a method1300of setting up a cleaning system as described herein. As shown, the method1300includes positioning a controller (e.g., controller120) near a surgical table at1302. The method1300optionally includes prefilling a liquid reservoir (e.g., liquid reservoir214) at1304. The method1300further includes connecting lines and/or a tubing set to the controller at1306, inserting a trocar (e.g., trocar330) with an obturator (e.g., obturator590) into a patient at1308, removing the obturator at1310, connecting lines (e.g., electric wire1076) and/or a tubing set (e.g., gas line1077) from the controller to the trocar at1312, and inserting an imaging device (e.g., endoscope1203) into a trocar at1314.

In greater detail, at1302, the controller is positioned near a surgical table. The controller, as described with reference toFIGS.1and2, can control operation of the endoscope cleaning system. At1304, a liquid reservoir, e.g., disposed within a controller connection of a connector (e.g. connector240), can be pre-filled with a liquid. In some embodiments, the liquid reservoir can be filled with wash solution. In some embodiments, the wash solution can include a saline solution, a buffered solution, a bio-compatible surfactant, and/or any of the wash solutions described in U.S. Patent Publication No. 2021/0127963, incorporated above by reference.

At1306, lines and/or a connector (e.g., a tubing set) are connected to the controller. For example, a controller connection of a connector including a liquid line, a gas line, and/or an electrical line can be coupled to the controller. The connector can have a second end (e.g., a trocar connection) that can coupled to a trocar, and therefore provide fluidic coupling and electrical communication between the controller and the trocar. The controller can also be fluidically coupled to a pressurized gas supply, e.g., via tubing. In some embodiments, the gas can include air, CO2, nitrogen, argon, or any other inert gas or combinations thereof. In some embodiments, the controller can also be fluidically coupled to an external liquid reservoir or liquid source (e.g., external liquid source170). Alternatively, in some embodiments, the connector may include an onboard reservoir (e.g., reservoir114,214) and therefore a separate coupling to an external liquid reservoir may not be required.

At1308, the trocar and obturator are inserted into the patient. When being inserted into the patient, the obturator may include an endoscope that is positioned within the obturator channel (e.g., obturator channel593). The obturator can include a sharp, penetrating tip that can cut through tissue to form a passage into the body lumen or cavity. An insufflation line can also be coupled to the trocar or obturator, whereby a gas can be pumped into the body lumen or cavity once the trocar has been placed within the body lumen or cavity. At1310, after the trocar has been positioned within the body lumen or cavity, the obturator and insufflation line are removed from the trocar.

At1312, the lines and/or the connector (e.g., a tubing set) are connected to the trocar. For example, a trocar connection of the connector can be coupled to a port disposed on the trocar. The trocar connection can include an electrical connection and a gas and/or liquid connection (e.g., an output of a liquid/gas interconnect), which can mate with an electrical port and a gas/liquid port disposed in the trocar, respectively. Once the connector and the trocar are coupled, the liquid reservoir and the gas source can be fluidically coupled to the trocar, such that the wash solution can be ejected from the trocar (e.g., via an ejection port). At1314, the imaging device (e.g., an endoscope) is inserted into the trocar channel. The imaging device can then be positioned within the trocar for the duration of a surgical procedure.

The details of operating a cleaning system, e.g., once a trocar of the cleaning system has been positioned within the body cavity and an imaging device (e.g., endoscope) has been positioned within the trocar channel, are now described with reference toFIG.13B.FIG.13Bdepicts a method1350for washing the imaging device. At1352, image data feed from the imaging device can optionally be monitored for fouling. At1354, it can be determined whether the imaging device requires cleaning. If not, the imaging device continues to be monitored at1352. If yes, a user (e.g., surgeon or medical assistant) can optionally be alerted to wash the imaging device at1356. In some embodiments, a compute device (e.g., a compute device that is part of an imaging system such as, for example, imaging system1295and/or a compute device associated with the cleaning system such as, for example, the controller) can automatically detect fouling of the imaging device based on the image feed and trigger an alert or a wash sequence. The method1350further includes detecting that the trocar has been retracted a predetermined distance within the trocar lumen at1358and the initiation of a wash sequence at1360. The method1350optionally includes a drying and/or de-fogging sequence at1362. The method1350further includes priming the liquid and gas lines for the next wash sequence at1364.

In greater detail, at1352, the image data feed from the imaging device is monitored and a determination is made as to whether the image device requires cleaning, at1354. In some embodiments, the determination of whether the image device requires cleaning can be made by the user. In some embodiments, the determination can be made automatically by a compute device (e.g., a controller such as, for example, controller120,220and/or a processor associated with an imaging system). For example, light capture by the image device can be monitored and if the capture does not exceed a predetermined threshold, an alert can be generated and/or wash sequence initiated.

At1356, the user may be alerted to wash the imaging device. At1358, the controller of the cleaning system can detect that the imaging device has been retracted a predetermined distance within the trocar lumen, e.g., by a user after being alerted to wash the imaging device. Once the imaging device has been retracted by the predetermined distance, the wash sequence ensues at1360. The detecting can be done using a sensor (e.g., sensor(s)334) that is configured to monitor an amount of light within the trocar channel. The sensor can be configured to send a signal to the controller in response to detecting an amount of light that is greater than a predefined threshold. Alternatively, the sensor can be configured to send a stream of data to the controller, and the controller can be configured to determine when the sensor data is indicative of light being greater than a predefined threshold. The predefined threshold can be selected to capture when the imaging device is sufficiently close to an ejection port of the trocar (e.g., ejection port336) to deliver a liquid and/or gas spray. For example, the predefined threshold of light can be representative of when the imaging device and therefore its illumination is sufficiently close to the sensor, which can be positioned next to the ejection port.

At1360, the wash sequence ensues. The wash sequence includes ejecting a spray of liquid to clean the distal end of the imaging device. In some embodiments, the wash sequence can include ejecting a preset or predetermined volume of liquid into the trocar lumen. In some embodiments, the liquid can include the wash solution. Once the wash sequence is complete, an optional drying/de-fogging sequence can ensue at1362. In some embodiments, the drying/defogging sequence can include ejecting gas into the trocar lumen without liquid. The gas can aid in drying liquid droplets off the imaging device. The gas can be free or substantially free of moisture content. In some embodiments, the ejection of gas can automatically following the ejection of a preset volume or bolus of liquid, e.g., because the pressurized gas is used to carry and push the liquid out of the ejection port first before ejecting out of the ejection port. At1364, the liquid line can be primed for the next wash sequence. In other words, the liquid line is filled with wash solution.

FIG.18illustrates a method1800associated with the operation of cleaning systems as described herein, according to various embodiments.

As described above, a trocar (e.g., trocar330) can be positioned within a body lumen or cavity, e.g., with or without using an obturator (e.g., obturator590). An imaging device such as an endoscope (e.g., endoscope1203) can then be positioned within the trocar channel (e.g., trocar channel333) for visualizing the inside of the body cavity. At1802, the method1800includes detecting that the imaging device has been retracted a predetermined distance within the trocar channel. The detecting can be done using a sensor (e.g., sensor(s)334) that is configured to monitor an amount of light within the trocar channel. The sensor can be configured to send a signal to a controller (e.g., controller220) in response to detecting an amount of light that is greater than a predefined threshold. Alternatively, the sensor can be configured to send a stream of data to the controller, and the controller can be configured to determine when the sensor data is indicative of light being greater than a predefined threshold. The predefined threshold can be selected to capture when the imaging device is sufficiently close to an ejection port of the trocar (e.g., ejection port336) to deliver a liquid and/or gas spray. For example, the predefined threshold of light can be representative of when the imaging device and therefore its illumination is sufficiently close to the sensor, which can be positioned next to the ejection port.

Once the imaging device has been retracted by the predetermined distance, the delivery of the pressurized gas can be activated, at1804. Optionally, the pressurized gas being delivered can be filtered using a filter (e.g., filter264).

The wash sequence ensues, at1808. The wash sequence includes ejecting a spray of liquid to clean the distal end of the imaging device. In some embodiments, the wash sequence can include ejecting a preset or predetermined volume of liquid into the trocar lumen. In some embodiments, the liquid can include the wash solution. Once the wash sequence is complete, an optional drying/de-fogging sequence can ensue, at1810. In some embodiments, the drying/defogging sequence can include ejecting additional gas into the trocar lumen without liquid. The gas can aid in drying liquid droplets off the imaging device. The gas can be free or substantially free of moisture content.

Optionally, at1812, gases within the body lumen or cavity can be vented out of the body lumen or cavity, e.g., via a vent (e.g., vent338). At1814, the liquid line can be primed for the next wash sequence. In other words, the liquid line is filled with wash solution.

In addition, the disclosure may include other innovations not presently described. Applicant reserves all rights in such innovations, including the right to embodiment such innovations, file additional applications, continuations, continuations-in-part, divisionals, and/or the like thereof. As such, it should be understood that advantages, embodiments, examples, functional, features, logical, operational, organizational, structural, topological, and/or other aspects of the disclosure are not to be considered limitations on the disclosure as defined by the embodiments or limitations on equivalents to the embodiments. Depending on the particular desires and/or characteristics of an individual and/or enterprise user, database configuration and/or relational model, data type, data transmission and/or network framework, syntax structure, and/or the like, various embodiments of the technology disclosed herein may be implemented in a manner that enables a great deal of flexibility and customization as described herein.

The term “substantially” when used in connection with “cylindrical,” “linear,” and/or other geometric relationships is intended to convey that the structure so defined is nominally cylindrical, linear or the like. As one example, a portion of a support member that is described as being “substantially linear” is intended to convey that, although linearity of the portion is desirable, some non-linearity can occur in a “substantially linear” portion. Such non-linearity can result from manufacturing tolerances, or other practical considerations (such as, for example, the pressure or force applied to the support member). Thus, a geometric construction modified by the term “substantially” includes such geometric properties within a tolerance of plus or minus 5% of the stated geometric construction. For example, a “substantially linear” portion is a portion that defines an axis or center line that is within plus or minus 5% of being linear.

As used herein, the term “set” and “plurality” can refer to multiple features or a singular feature with multiple parts. For example, when referring to a set of devices, the set of devices can be considered as one device with multiple portions, or the set of devices can be considered as multiple, distinct devices. Thus, a set of portions or a plurality of portions may include multiple portions that are either continuous or discontinuous from each other. A plurality of particles or a plurality of materials can also be fabricated from multiple items that are produced separately and are later joined together (e.g., via mixing, an adhesive, or any suitable method).

While specific embodiments of the present disclosure have been outlined above, many alternatives, modifications, and variations will be apparent to those skilled in the art. Accordingly, the embodiments set forth herein are intended to be illustrative, not limiting. Various changes may be made without departing from the spirit and scope of the disclosure. Where methods and steps described above indicate certain events occurring in a certain order, those of ordinary skill in the art having the benefit of this disclosure would recognize that the ordering of certain steps may be modified and such modification are in accordance with the variations of the invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. The embodiments have been particularly shown and described, but it will be understood that various changes in form and details may be made.