# Patent

## Title
Fluid management system with pass-through fluid volume measurement

## Abstract

A fluid management system including a pass-through fluid volume measurement system to provide continuous measurement of fluid returned from a surgical site during transit to a waste collection system. The pass-through fluid volume measurement system eliminates the need to physically replace full fluid collection containers during the medical procedure with new, empty fluid collection containers.

## Background
RELATED APPLICATIONS
This application claims the benefit of U.S. Provisional Application No. 61/993,340, filed May 15, 2015, which is hereby fully incorporated herein by reference.


FIELD OF THE INVENTION
The present invention relates generally to fluid management systems used during surgical procedures to provide one or more functions associated with irrigation, distention, fluid warming, fluid deficit monitoring, suction, and the like, and more particularly relates to a method and apparatus for continuously measuring the volume of fluid being returned from the surgical site as it is being delivered to a waste collection system.
BACKGROUND OF THE INVENTION
A fluid management system (FMS) may be used in connection with a wide variety of medical procedures involving one or more fluid delivery functions including, but not limited to: fluid irrigation; distention of a body cavity; fluid warming; fluid deficit monitoring associated with delivery and return of fluid to/from a surgical site; and suction. The medical procedures may be associated with multiple surgical disciplines including, but not limited to: gynecologic, urologic, orthopedic, colorectal, and general surgical procedures.
During certain medical procedures, patient safety may require that the amount of fluid delivered to the surgical site and the amount of fluid returned from the surgical site be continuously monitored to determine the “fluid deficit.” Accordingly, a FMS may be configured to provide a fluid deficit monitoring function to accurately measure fluid inflow (to the surgical site) and outflow (from the surgical site), and to calculate a fluid deficit in order to monitor a patient's fluid absorption level during a medical procedure as excess fluid absorption can result in serious complications. Typically, fluid returning from the surgical site is collected in one or more fluid collection containers (e.g., canisters). The volume of fluid collected from the surgical site is typically determined by measuring weight. A fluid deficit is then calculated by comparing the volume of fluid delivered to the surgical site with the volume of fluid returned from the surgical site.
Canisters are frequently used as fluid collection containers. When a canister fills with fluid to a maximum capacity during a medical procedure, it becomes necessary to remove the full canister and replace it with a new, empty canister. There are several drawbacks to removing and replacing canisters during a medical procedure. In this regard, such activity can (i) disrupt the medical procedure by necessitating the suspension of suction used to remove fluid from the surgical site, and thereby cause a suspension of fluid deficit monitoring; (ii) cause inconvenience to medical personnel, especially in surgical procedures involving high fluid volumes, as medical personnel have to physically remove full canisters and replace them with new, empty canisters; (iii) potentially introduce errors into fluid deficit monitoring calculations due to disruption of the fluid management system during the canister replacement process (e.g., bumping or moving), which can adversely affect the ability of the fluid management system to accurately weigh the remaining and new canisters; (iv) potentially introduce errors into fluid deficit monitoring calculations due to leaks and spills caused by detaching tubing used to return fluid from the surgical site from full canisters and reattaching such lines to the new, empty canisters, and (v) increase the cost of a surgical procedure by requiring that a number of canisters be used during a surgical procedure which is commensurate with the amount of fluid used.
In view of the foregoing, there is a need for a fluid management system that incorporates a “pass-through” fluid volume measurement system that continuously measures the volume of fluid returning from a surgical site during transit to a waste collection system (e.g., a dedicated fluid collection system or a hospital's waste disposal system) and eliminates the need to replace full canisters with new, empty canisters during a medical procedure.
SUMMARY OF THE INVENTION
In accordance with the present invention, there is provided a fluid management system comprising: at least one fluid supply container for storing a fluid to be delivered to a surgical site; a pump for delivering the fluid from the at least one fluid supply container to the surgical site; and a pass-through fluid volume measurement system for determining the volume of fluid returned from the surgical site, said pass-through fluid volume measurement system comprising: a plurality of fluid collection containers, wherein each fluid collection container has (i) a suction input in fluid communication with a suction line for drawing a vacuum in the fluid collection container, (ii) a fluid input in fluid communication with a fluid return line for receiving fluid returning from the surgical site, and (iii) a fluid output in fluid communication with a fluid output line for evacuating the fluid collected in the fluid collection container to a waste collection system; one or more weight sensors for providing signals indicative of the sensed weight of the fluid collection containers; and a plurality of valves moveable between open and closed positions to control the flow of fluid through the suction line, the fluid return line and the fluid output line; a suction source for providing suction in the suction line to draw a vacuum in the fluid collection containers to thereby draw fluid from the surgical site into the fluid collection containers, and for providing suction in the fluid output line to draw fluid collected in the fluid collection containers into the waste collection system; and a control unit for receiving the signals from the one or more weight sensors to monitor a volume of fluid returned from the surgical site to the fluid collection containers, and moving the plurality of valves between the open and the closed positions to alternately fill one of the fluid collection containers while emptying another of the fluid collection containers.
In accordance with another aspect of the present invention, there is provided a fluid management system comprising: at least one fluid supply container for storing a fluid to be delivered to a surgical site; a pump for delivering the fluid from the at least one fluid supply container to the surgical site; and a pass-through fluid volume measurement system for determining the volume of fluid returned from the surgical site, said pass-through fluid volume measurement system comprising: a support member for supporting components of the pass-through fluid volume measurement system; a flow sensing device including: a disposable or single-use fluid measurement tube having an inlet port in fluid communication with a fluid return line for receiving fluid returning from the surgical site, and an outlet port in fluid communication with a fluid output line for receiving the fluid exiting the fluid measurement tube, at least one ultrasonic sensor for providing a signal indicative of the flow rate of fluid passing through the fluid measurement tube, and a clamping mechanism mounted to the support member, said clamping mechanism for temporarily mounting the fluid measurement tube in a proper orientation between the inlet and outlet ultrasonic sensors; a suction source for providing suction in the fluid return line and fluid output line to draw the fluid through the fluid measurement tube and subsequently into a waste collection system; and a control unit for receiving the signals from the inlet and outlet sensors to monitor a volume of fluid returned from the surgical site.
In accordance with still another aspect of the present invention, there is provided a method for continuously measuring a volume of fluid being returned from a surgical site as it is being delivered to a waste collection system, said method comprising: filling the first fluid collection container, by: opening a valve associated with a suction line in fluid communication with a first fluid collection container; opening a valve associated with a fluid return line in fluid communication with the first fluid collection container; closing a valve associated with a fluid output line in fluid communication with the first fluid collection container; closing a valve associated with a suction line in fluid communication with a second fluid collection container; and closing a valve associated with a fluid return line in fluid communication with the second fluid collection container; upon filling the first fluid collection container with fluid to a predetermined volume, emptying the first fluid collection container and filling the second fluid collection container, by closing the valve associated with a suction line in fluid communication with a first fluid collection container; closing the valve associated with a fluid return line in fluid communication with the first fluid collection container; opening the valve associated with a fluid output line in fluid communication with the first fluid collection container; opening the valve associated with a suction line in fluid communication with a second fluid collection container; opening the valve associated with a fluid return line in fluid communication with the second fluid collection container; and closing a valve associated with a fluid output line in fluid communication with the second fluid collection container; and alternately filling and emptying the first and second fluid collection containers until a medical procedure is completed.
In accordance with yet another aspect of the present invention, there is provided a method for continuously measuring a volume of fluid being returned from a surgical site as it is being delivered to a waste collection system, said method comprising the steps of: drawing fluid from the surgical site through a flow sensing device providing signals indicative of a fluid flow rate; monitoring the volume of fluid passing through the flow sensing device using the signals indicative of the fluid flow rate; and passing the fluid from the flow sensing device to the waste collection system until a medical procedure is completed.
An advantage of the present invention is the provision of a fluid management system that continuously measures the volume of fluid returning from a surgical site during transit to a waste collection system.
Another advantage of the present invention is the provision of a fluid management system that eliminates the need to replace full fluid collection containers with new, empty fluid collection containers during a medical procedure.
A still further advantage of the present invention is the provision of a fluid management system having a stand-alone pass-through fluid volume measurement system.
Yet another advantage of the present invention is the provision of a fluid management system capable of fluid delivery, suction, fluid removal/collection, fluid deficit monitoring, and fluid disposal.
These and other advantages will become apparent from the following description of illustrated embodiments taken together with the accompanying drawings and the appended claims



BRIEF DESCRIPTION OF THE DRAWINGS
The invention may take physical form in certain parts and arrangement of parts, embodiments of which will be described in detail in the specification and illustrated in the accompanying drawings which form a part hereof, and wherein:
FIG. 1 is a schematic diagram illustrating an FMS according to a first embodiment of the present invention, wherein the FMS includes a fluid management unit having a pass-through fluid volume measurement system and an integrated suction source for return of fluid from the surgical site and subsequent evacuation of the fluid returned from the surgical site to a waste collection system.
FIG. 2 is a schematic diagram illustrating an FMS according to a second embodiment of the present invention, wherein the FMS includes a fluid management unit having a pass-through fluid volume measurement system and an integrated suction source for return of fluid from the surgical site and subsequent evacuation of the fluid returned from the surgical site to a waste collection system.
FIG. 3 is a schematic diagram illustrating an FMS according to a third embodiment of the present invention, wherein the FMS includes a fluid management unit with a pass-through fluid volume measurement system, and an external suction source for return of fluid from the surgical site and subsequent evacuation of the fluid returned from the surgical site to a waste collection system.
FIG. 4 is a schematic diagram illustrating an FMS according to a fourth embodiment of the present invention, wherein the FMS includes a fluid management unit with a pass-through fluid volume measurement system and a suction source of a waste collection system, wherein the suction source of the waste collection system provides suction for both return of fluid from the surgical site and subsequent evacuation of the fluid returned from the surgical site to the waste collection system.
FIG. 5 is a schematic diagram illustrating a mechanical configuration of a pass-through fluid volume measurement system according an embodiment of the present invention.
FIG. 6 illustrates a tubing set used in connection with the FMS embodiment shown in FIG. 1.
FIG. 7 illustrates a tubing set used in connection with the FMS embodiment shown in FIG. 2.
FIG. 8 is a schematic diagram of a pass-through fluid volume measurement system according to a first alternative embodiment, wherein suction is provided by a suction source external to the measurement system.
FIG. 9 is a schematic diagram of the pass-through fluid volume measurement system according to a second alternative embodiment, wherein suction is provided by a suction source integrated in the pass-through fluid volume measurement system.
FIG. 10 is a schematic diagram of the pass-through fluid volume measurement system according to a third alternative embodiment, wherein suction is provided by a suction source integrated in the pass-through fluid volume measurement system.
FIG. 10A is a schematic diagram of the pass-through fluid volume measurement system shown in FIG. 10, as modified to include a single ultrasonic sensor for sensing fluid flow.
FIG. 11 illustrates a tubing set used in connection with the pass-through fluid volume measurement system shown in FIG. 8.
FIG. 12 illustrates a tubing set used in connection with the pass-through fluid volume measurement system shown in FIG. 9.
FIG. 13 illustrates a tubing set used in connection with the pass-through fluid volume measurement system shown in FIG. 10.



DETAILED DESCRIPTION OF THE INVENTION
Referring now to the drawings wherein the showings are for the purposes of illustrating embodiments of the invention only and not for the purposes of limiting same, FIG. 1 shows a fluid management system (FMS) 10A according to a first embodiment of the present invention. FMS 10A is a multifunctional system that supplies fluid to a surgical site 200, removes fluid from surgical site 200, monitors a fluid deficit, and disposes of fluid returned from surgical site 200, as will be described in detail below. It should be appreciated that the term “surgical site” as used herein refers not only to the patient's body where a surgery is being performed, but also to the general region surrounding the patient.
FMS 10A is generally comprised of a fluid management unit 20A including a main unit 30, a pass-through fluid volume measurement system 60 and an integrated suction source 90. Fluid management unit 20A interfaces with a waste collection system 110, as will be described below. It should be appreciated that suction source 90 may alternatively be arranged as a component of measurement system 60.
As seen in FIG. 1, a fluid supply line 40 provides a fluid conduit between main unit 30 and surgical site 200, a fluid return line 43 provides a fluid conduit between measurement system 60 and surgical site 200, a suction line 33 provides a fluid conduit between suction source 90 and measurement system 60, a suction line 38 provides a fluid conduit between suction source 90 and waste collection system 110, and a fluid output line 53 provides a fluid conduit between measurement system 60 and waste collection system 110. Supply line 40, return line 43, suction line 33, suction line 38, and output line 53 may take the form of fluid conduits, such as conventional medical grade flexible plastic tubing.
Main unit 30 includes a control unit comprised of components such as a microprocessor or microcontroller, memory device(s), data storage device(s), output device(s) (e.g., LCD screen, touch screen, conventional display device, audio speaker, printer, and the like), and input device(s) (e.g., touch screen, keypad, keyboard, mouse, mechanical switching devices, and the like). Main unit 30 may also include one or more fluid container supports (such as hangers or hooks) for supporting one or more fluid supply containers (e.g., fluid bags) that store fluid that is to be delivered to a surgical site 200, weight sensors for detecting the weight of fluid in the fluid supply containers, and a pump for pressurizing fluid in the fluid supply containers and delivering the fluid to surgical site 200 via fluid supply line 40. For example, fluid supply line may be connected with a surgical instrument to facilitate a surgical procedure. It should be appreciated that gravity or other means of fluid pressurization may be substituted for the pump. Main unit 30 may also include numerous other components for regulating fluid flow, fluid pressure, fluid temperature (e.g., a fluid heating apparatus), and the like. The control unit controls the supply of fluid delivered to surgical site 200 via fluid supply line 40, monitors the volume of fluid supplied to surgical site 200 (via supply line 40), monitors the volume of fluid returned from surgical site 200 (via return line 43), and determines a fluid deficit. A detailed description of the components and operation of an exemplary fluid management unit, including fluid deficit monitoring, is provided in U.S. Pat. No. 8,444,592, issued May 21, 2013, which is fully incorporated herein by reference.
Pass-through fluid volume measurement system 60 determines the volume of fluid removed from surgical site 200 via fluid return line 43. According to the illustrated embodiment, measurement system 60 includes a first fluid collection container 64, a second fluid collection container 66, and first and second weight sensors 84, 86 respectively associated with fluid collection containers 64, 66. It is contemplated that fluid collection containers 64, 66 may take a variety of forms, including, but not limited to, disposable or re-usable rigid hard-shell canisters, rigid hard-shell canisters with disposable or reusable liners, disposable pouches or bags having a rigid skeleton, fluid containers supportable from mounting brackets or hooks.
The end of return line 43 located at surgical site 200 may include a plurality of input lines that are combined by a manifold. Each of these input lines may be located at different locations at surgical site 200. For example, the input lines may collect fluid from the patient, floor suctioning equipment, a fluid collection drape, and surgical instrument outflow ports.
In the embodiment shown in FIG. 1, the end of return line 43 fluidly connected with measurement system 60 includes a first branch 44 and a second branch 46 for fluid communication with fluid inputs (e.g., input tubes) of fluid collection containers 64 and 66, respectively. Branches 44 and 46 may be joined by a y-connector. Valves 44a, 46a respectively control fluid flow along first and second branches 44, 46 of return line 43. In one embodiment of the present invention, valves 44a, 46a take the form of pinch valves operable to open and close the fluid pathway through return line 43. Sections of tubing forming suction branches 44, 46 of return line 43 are respectively routed through the pinch valves that are controlled by the control unit of main unit 30. Furthermore, a one-way valve may be located within return line 43 to prevent backflow of fluid to surgical site 200.
Weight sensors 84, 86 may take the form of load cells that provide signals to main unit 30 indicative of the measured weight of fluid respectively collected in fluid collection containers 64, 66. The control unit of main unit 30 determines the volume of fluid collected in fluid collection containers 64, 66 from the measured weight.
Suction source 90 is fluidly connected with fluid collection containers 64, 66 (via suction line 33) and waste collection system 110 (via suction line 38). Waste collection system 110 is fluidly connected with fluid collection containers 64, 66 (via output line 53). Suction source 90 draws a vacuum in fluid collection containers 64, 66 (via suction line 33) to return fluid from surgical site 200 to fluid collection containers 64, 66 via return line 43. Suction source 90 also provides suction in suction line 38 and output line 53 to subsequently evacuate fluid collected in fluid collection container 64, 66 to waste collection system 110 via fluid output line 53. In the illustrated embodiment, suction source 90 takes the form of a vacuum pump.
Suction line 33 includes a first branch 34 and a second branch 36 for fluid communication with suction inputs (e.g., a suction tube) of fluid collection containers 64, 66, respectively. Branches 34 and 36 may be joined by a y-connector. Valves 34a, 36a respectively control suction along first and second branches 34, 36 of suction line 33. In one embodiment of the present invention, valves 34a, 36a may take the form of pinch valves operable to open and close the fluid pathway through suction line 33. Sections of tubing forming suction branches 34, 36 of suction line 33 are respectively routed through the pinch valves that are controlled by the control unit of main unit 30. Furthermore, a hydrophobic filter may be located within suction line 33 to prevent fluid from being sucked out of fluid collection containers 64, 66 through suction line 33. For example, hydrophobic filters may be located within branches 34 and 36 of suction line 33.
Output line 53 includes a first branch 54 and a second branch 56 for fluid communication with fluid outputs (e.g., a dip tube or bottom suction tube) of fluid collection containers 64, 66, respectively. Branches 54 and 56 may be joined by a y-connector. Valves 54a, 56a respectively control fluid flow along first and second branches 54, 56 of output line 53. In one embodiment of the present invention, valves 54a, 56a may take the form of pinch valves operable to open and close the fluid pathway through output line 53. Sections of tubing forming suction branches 54, 56 of suction line 53 are respectively routed through the pinch valves that are controlled by the control unit of main unit 30.
As indicated above, return line 43, suction line 33, and output line 53 take the form of fluid conduits, such as conventional medical grade flexible plastic tubing. In one embodiment of the present invention, the sections of tubing for branches 44, 46 (return line 43); branches 34, 36 (suction line 33); and branches 54, 56 (output line 53) may each include an integrated strain relief element that “snaps” into, or otherwise attaches to, a support structure (e.g., stand, mounting bracket, frame, etc.) of fluid management unit 20A. For example, the strain relief element may be mounted to a support stand 22, described below with reference to FIG. 5. It is also contemplated that the sections of tubing for branches 44, 46 (return line 43); branches 34, 36 (suction line 33); and branches 54, 56 (output line 53) that connect respectively with fluid input, suction input and fluid output of fluid collection containers 64, 66 have an accordion tubing component or section to allow for relaxed flexing and extension of the tubing. It should be appreciated that the strain relief element and accordion tubing section minimize forces applied to fluid collection containers 64, 66 as a result of “pushing and pulling” of the tubing. This minimizes disturbance to weight measurements made by weight sensors 84, 86, and thus provides for greater accuracy in fluid deficit monitoring.
FIG. 1 illustrates pass-through fluid volume measurement system 60 as a component of fluid management unit 20A. However, as will be described in detail below, the pass-through fluid volume measurement system of the present invention may alternatively be constructed as a stand-alone component that is separate from a fluid management unit. In this case, the strain relief element may attach to a support structure that independently supports pass-through fluid volume measurement system 60.
It is contemplated that waste collection system 110 may take a variety of different forms, including, but not limited to, a mobile fluid collection container or cart, a dedicated stand-alone fluid collection system with integrated suction, or a hospital's waste disposal system which may be accessible in the operating room.
In the illustrated embodiment, a combined tissue/air trap 132 (or individual tissue and air traps) is located within return line 43. A tissue trap (or other similar device) functions to collect tissue carried by fluid returning from surgical site 200 via return line 43 for subsequent analysis and/or to increase the accuracy of fluid deficit calculations. In the absence of a tissue trap, tissue returned from surgical site 200 can increase the weight of fluid collection canisters or interfere with fluid flow sensing measurements. Similarly, an air trap can increase the accuracy of fluid deficit calculations as air bubbles can interfere with fluid flow sensing measurements.
For enhanced safety, it is contemplated that measurement system 60 may also include one or more fluid level sensors for detecting the fluid level within fluid collection containers 64 and 66, and one or more leak sensors for detecting the presence of a leak in fluid collection containers 64, 66 or in a tubing connection associated therewith. A fluid level sensor determines, independently of the control unit of main unit 30, whether a fluid level has reached a predetermined fluid level within fluid collection containers 64, 66 and can close one or more of valves 44a, 46a, 34a, and 36a, if necessary. When a leak sensor detects the presence of a leak, the leak sensor transmits a signal to the control unit of main unit 30. In response to receipt of this signal, the control unit can take appropriate action, such as “closing” one or more of valves 44a, 46a, 34a, 36a and providing a visual and/or audible indicator to alert a user of a potential problem with measurement system 60.
The operation of FMS 10A will now be described in detail with reference to FIG. 1. At the beginning of a surgical procedure, fluid supply containers are mounted to main unit 30 and connected with fluid supply line 40 to supply fluid to surgical site 200. The volume of fluid supplied to surgical site 200 is monitored by main unit 30. In addition, two fluid collection containers 64, 66 are arranged to be independently weighed by respective weight sensors 84, 86. Respective strain relief elements are snapped into a support structure, and appropriate sections of tubing associated with branches 44, 46 (return line 43); branches 34, 36 (suction line 33); and branches 54, 56 (output line 53) are routed through corresponding valves 44a, 46a; 34a, 36a; and 54a, 56a, which take the form of pinch valves.
When a user initiates a procedure using main unit 30 that begins the flow of fluid to surgical site 200 via supply line 40, the control unit “zeroes” any previously stored weight values and begins recording the weight of each fluid collection container 64, 66 as indicated by respective weight sensors 84, 86. Then, valves 34a, 44a associated with the suction input and the fluid input of fluid collection container 64 are “opened” and valve 54a associated with the fluid output of fluid collection container 64 is “closed.” Furthermore, valves 36a and 46a associated with the suction input and fluid input of fluid collection container 66 are “closed.”
The control unit of main unit 30 monitors the volume of fluid supplied to the surgical site 200 and monitors the volume of fluid returned to fluid collection container 64 via signals received from weight sensor 84. When the fluid volume collected in fluid collection container 64 reaches a predetermined volume, the control unit “closes” valves 34a, 44a respectively associated with the suction input and the fluid input of fluid collection container 64, allows the weight sensor reading to stabilize, records the total weight of fluid collection container 64, and then “opens” valve 54a associated with the fluid output of fluid collection container 64 in order to empty fluid collection container 64 by evacuating the collected fluid to waste collection system 110. Simultaneously, the control unit “opens” valves 36a and 46a respectively associated with the suction input and the fluid input of fluid collection container 66, and “closes” valve 56a associated with the fluid output of fluid collection container 66 to begin filling fluid collection container 66 with the fluid returned from surgical site 200. In this manner, fluid collection from surgical site 200 and fluid deficit monitoring continues uninterrupted. The above-described “alternating” fill/empty process (i.e., alternating the filling and emptying of fluid collection containers 64 and 66), is repeated until the user ends the fluid collection procedure.
In accordance with the present invention, measurement system 60 is adapted to measure any amount of fluid returned from surgical site 200 during a medical procedure, without the burdensome and costly need to change fluid collection containers. Furthermore, the present invention allows fluid management unit 20A to continuously return fluid from surgical site 200, and thus allows uninterrupted determination of the fluid deficit which can be displayed to a user by visual and/or audible indicators (e.g., alarms) that may be appropriate based on the measured or calculated fluid deficit level.
FIGS. 2-4 illustrate fluid management systems according to alternative embodiments of the present invention. In these figures, components similar to those shown in FIG. 1 have been given the same reference numbers.
In the embodiment shown in FIG. 2, there is shown a FMS 10B having a fluid management unit 20B that includes an integrated suction source 95, which preferably takes the form of a pump. Suction source 95 provides suction in suction line 33 to return fluid from surgical site 200 to fluid collection containers 64, 66 and provides suction in output line 53 for evacuating fluid collected in fluid collection containers 64, 66 to waste collection system 110. It should be appreciated that suction source 95 may also be directly integrated into measurement system 60.
In the embodiment shown in FIG. 3, there is shown a FMS 10C having a fluid management unit 20C that does not include an integrated suction source and therefore fluid management unit 20C relies upon an external suction source 100 for suction. External suction source 100 may take the form of a conventional wall suction unit (e.g., vacuum pump) typically found in hospitals. External suction source 100 provides suction, via suction line 33, to return fluid from surgical site 200 to fluid collection containers 64, 66. External suction source 100 also provides suction via suction line 38b and output line 53 for evacuating fluid collected in fluid collection containers 64, 66 to waste collection system 110.
In the embodiment shown in FIG. 4, there is shown a FMS 10D having a fluid management unit 20D and a suction source 120 that is an integrated component of waste collection system 110. Suction source 120 may take the form of a conventional vacuum pump. Suction source 120 provides suction in fluid collection container 64, 66, via suction line 33, to draw fluid from surgical site 200 to fluid collection containers 64, 66. Suction source 120 also provides suction, via output line 53, for evacuating fluid collected in fluid collection containers 64, 66 to waste collection system 110.
It should be appreciated that the suction sources described herein (i.e., suctions source 90, 95, 100 and 120) may take a variety of forms including, but not limited to, a vacuum pump, a peristaltic pump, rotary vane pump, gerotor pump, piston pump, and the like.
In accordance with an embodiment of the present invention, fluid collection containers 64, 66 and all tubing associated suction line 33, return line 43 and output line 53 are components of a single-use/disposable tubing set. For example, FIG. 6 illustrates a tubing set used in connection with FMS 10A (FIG. 1) that includes tubing for return line 43 (including a plurality of input branches 42), tubing for suction line 33, tubing for output line 53, and fluid collection containers 64 and 66. A tissue/air trap 132 may also be located in the tubing of return line 43. The tubing set may also include additional tubing for suction line 38 between suction source 90 and waste collection system 110.
FIG. 7 illustrates a tubing set used in connection with FMS 10B (FIG. 2) that includes tubing for return line 43 (including a plurality of input branches 42), tubing for suction line 33, tubing for output line 53, and fluid collection containers 64 and 66. A tissue/air trap 132 may also be located in the tubing of return line 43. It should be appreciated that in this embodiment, the tubing for output line 53 is arranged through suction source 95.
Tubing sets similar to those illustrated in FIGS. 6 and 7 are used for the embodiments of FMS 10C and 10D respectively shown in FIGS. 3 and 4.
Referring now to FIG. 5, there is shown a schematic diagram illustrating a mechanical embodiment of measurement system 60. Main unit 30, suction source 90 and measurement system 60 are mounted to portable support stand 22 having a pole 23 and a base 24 with wheels. In an alternative embodiment, main unit 30, suction source 90 and measurement system 60 may be mounted to a fixed support structure, such as a wall. Support members 74 and 76 (e.g., platform plates) respectively support fluid collection containers 64, 66. Weight sensor 84, 86 are mechanically connected with support members 74, 76. In the illustrated embodiment, fluid collection containers 64, 66 are each independently weighed by respective weight sensors 84, 86. Weight sensors 84, 86 provide signals to main unit 30 indicative of the respective measured weight of fluid collected in fluid collection containers 64, 66. Control unit of main unit 30 determines the volume of fluid collected in fluid collection containers 64, 66 from the measured weight.
It is contemplated that the pass-through fluid volume measurement system of the present invention may take alternative forms. Referring now to FIG. 8, there is shown a pass-through fluid volume measurement system according to a first alternative embodiment. Measurement system 260 replaces the weight sensors and fluid collection containers of measurement system 60 with a fluid flow sensing device. In the illustrated embodiment, measurement system 260 is comprised of a fluid flow measurement tube 262 having an inlet port 264 at one end and an outlet port 266 at the opposite end, inlet and outlet ultrasonic sensors 274 and 276 (e.g., an ultrasonic transceiver, ultrasonic transmitter, or ultrasonic receiver) which are fixed or permanent components of measurement system 260, and a clamping mechanism 280 for temporarily mounting or attaching measurement tube 262 in a proper orientation between inlet and outlet ultrasonic sensors 274, 276. For example, clamping mechanism 280 may engage and capture measurement tube 262 with clamp or grip members (e.g., C-clamps). It is contemplated that clamping mechanism 280 may also include components that cause members supporting sensors 274, 276 to rotate, pivot, or move in order to properly position, orient or align sensors 274, 276 relative to measurement tube 262 to measure fluid volume in measurement tube 262. For example, installing a measurement tube 262 into engagement with clamping mechanism 280 may cause a spring-loaded sensor support member to press and hold sensors 274, 276 against the ends of measurement tube 262 in proper alignment. Sensors 274 and 276 are used to determine the flow rate of fluid passing through measurement tube 262. Sensors 274 and 276 provide signals, indicative of flow rate of fluid passing through measurement tube 262, to the control unit of main unit 30 (of a fluid management unit), which in turn determines the volume of fluid flowing through measurement tube 262. In the illustrated embodiment, measurement tube 262 is part of the single-use or disposable tubing set. Measurement tube 262 may also be a re-usable fluid tube that can be re-sterilized. Furthermore, sensors 274, 276 and clamping mechanism 280 may be permanently mounted to a support member (not shown) that supports components of measurement system 260. For example, such support member may take the form of a wall, cart, or stand.
It also contemplated that measurement system 260 may also include one or more temperature sensors 290 for sensing the temperature of the fluid in measurement tube 262. Temperature sensor 290 is properly oriented to measure the temperature of the fluid when measurement tube 262 is received into clamping mechanism 280. Temperature sensor 290 provides fluid temperature information to the control unit of main unit 30, which uses the temperature information to more accurately determine the fluid flow rate through measurement tube 262.
Furthermore, measurement system 260 may also include an accumulator in addition to combined tissue/air trap 132. The accumulator conditions the fluid prior to entering measurement tube 262 by absorbing surges or pulsations in the fluid flow.
Ultrasonic flowmeters use sound waves to determine the velocity of a fluid flowing in a pipe or tube. At “no flow” conditions, the frequencies of an ultrasonic wave transmitted into the tube and its reflections from the fluid are the same. Under flowing conditions, the frequency of the reflected wave is different due to the Doppler effect. When the fluid moves faster, the frequency shift increases linearly. Signals from the transmitted wave and its reflections are processed to determine the flow rate. A “transit time” ultrasonic flowmeter sends and receives ultrasonic waves between transducers in both the upstream and downstream directions in the tube. At “no flow” conditions, it takes the same time to travel upstream and downstream between the two transducers. Under flowing conditions, the upstream wave will travel slower and take more time than the (faster) downstream wave. When the fluid moves faster, the difference between the upstream and downstream times increases. Upstream and downstream times are processed to determine the flow rate.
For the embodiment of measurement system 260 shown in FIG. 8, an external suction source 100 or a suction source 120 internal to a waste collection system 110A provides the suction to draw fluid from surgical site 200 through return line 43, measurement tube 262, and output line 53 to the waste collection system.
In FIG. 9 a pass-through fluid volume measurement system 260A includes an integrated suction source 95 to provide suction for drawing fluid from surgical site 200 through return line 43, measurement tube 262, and output line 53 to waste collection system 110. Suction source 95 takes the form of a pump, wherein suction line 53 extends through suction source 95.
In FIG. 10 a pass-through fluid volume measurement system 260B also includes an integrated suction source 95 to provide suction for drawing fluid from surgical site 200 through return line 43, measurement tube 262, and output line 53 to waste collection system 110. Suction source takes the form of a pump, wherein return line 43 extends through suction source 95.
It is contemplated in another alternative embodiment that the two ultrasonic sensors 274, 276 may be arranged in positions relative to measurement tube 262 that differ from the positions as depicted in the illustrated figures. For example, ultrasonic sensors 274, 276 may be located at the top and bottom portions of measurement tube 262. Furthermore, it is also contemplated that the measurement system may be configured with only a single ultrasonic sensor (e.g., an ultrasonic transceiver) for determining the volume of fluid flowing through measurement tube 262. For example, FIG. 10A illustrates a measurement system 260C that is a modified version of measurement system 260B (FIG. 10), wherein a single ultrasonic sensor 278 is substituted for sensors 274, 276. Single ultrasonic sensor 278 may take the form of a sensor or transducer that measures the deviation of the angle of reflected ultrasound to determine fluid flow rate.
In accordance with an embodiment of the present invention, measurement tube 262, return line 43 and output line 53 are components of a single-use/disposable tubing set. For example, FIG. 11 illustrates a tubing set used in connection with measurement system 260 (FIG. 8) that includes tubing for return line 43 (including a plurality of input branches 42) and tubing for output line 53. A tissue/air trap 132 may also be located in the tubing of return line 43. The tubing set may also include additional tubing for suction line 38 between external suction source 100 and waste collection system 110. It should be appreciated that in the embodiment illustrated in FIG. 11, that waste collection system 110 and external suction source 100 can be replaced with waste collection system 110A having an internal suction source 120. In this embodiment, tubing for suction line 38 is omitted.
FIG. 12 illustrates a tubing set used in connection with measurement system 260A (FIG. 9) that includes tubing for return line 43 (including a plurality of input branches 42) and tubing for output line 53. A tissue/air trap 132 may also be located in the tubing of return line 43. It should be appreciated that in this embodiment, the tubing for output line 53 is arranged through suction source 95 that takes the form of a pump.
FIG. 13 illustrates a tubing set used in connection with measurement system 260B (FIG. 10) that includes tubing for return line 43 (including a plurality of input branches 42) and tubing for output line 53. A tissue/air trap 132 may also be located in the tubing of return line 43. It should be appreciated that in this embodiment, the tubing for return line 43 is arranged through suction source 95.
It should be appreciated that according to an alternative embodiment of the present invention, measurement systems 60 and 260 (including alternative embodiments 260A and 260B) may be configured as stand-alone devices that are physically separated from the fluid management unit. In this alternative embodiment, measurement systems 60, 260 may include their own control unit (independent of the control unit of main unit 30) having a microprocessor/microcontroller, display unit, and input unit. According to this embodiment, the control unit of the measurement system may perform some of the functions (described above) that are carried out by the control unit of main unit 30. Furthermore, measurement systems 60, 260 may also include a wireless or wired communications interface for communicating with main unit 30 of the fluid management unit via a wireless or wired communications medium. As a stand-alone device, measurement systems 60, 260 may be mounted to a portable support structure (e.g., a cart or mobile stand) or fixed support structure (e.g., a wall). Furthermore, the strain relief element discussed above may attach to the support structure that independently supports stand-alone measurement systems 60, 260.
It is contemplated that a variety of modifications and alterations may be made to the illustrated embodiments of the present invention without departing from the spirit and scope of the present invention. For example, the number of fluid collection containers and weight sensors may be greater than the number of fluid collection containers shown in the embodiments described above. In one alternative embodiment, a single weight sensor may be used to sense the weight of multiple fluid collection containers. Moreover, it is contemplated that other suitable means may be substituted for the weight sensors to detect the volume of fluid in the fluid collection containers (e.g., means for counting pump rotations or height of water column as determined through optical sensing). In addition, other types of tube constricting devices may be substituted for the above-described valves, including manually-controllable devices.
It is further contemplated that the accuracy of fluid deficit calculations may be improved by using an opacity meter to provide information indicative of the composition of the fluid returned from the surgical site. In this regard, the opacity meter provides a signal to the control unit of main unit 30 that can be used to ascertain or estimate the percentage of blood that comprises the fluid returned from the surgical site. For example, an opacity meter could be used to sense the opacity of the fluid flowing through return line 43, collected in fluid collection containers 64, 66, flowing through measurement tube 262, or flowing through output line 53.
Other modifications and alterations will occur to others upon their reading and understanding of the specification. It is intended that all such modifications and alterations be included insofar as they come within the scope of the invention as claimed or the equivalents thereof.

## Claims

1. A fluid management system comprising:
at least one fluid supply container for storing a fluid to be delivered to a surgical site;
a fluid pressurization device for delivering the fluid from the at least one fluid supply container to the surgical site; and
a pass-through fluid volume measurement system for determining the volume of fluid returned from the surgical site, said pass-through fluid volume measurement system comprising:
a support member for supporting components of the pass-through fluid volume measurement system;
a flow sensing device including:
a disposable or single-use fluid measurement tube having an inlet port in fluid communication with a fluid return line for receiving fluid returning from the surgical site, and an outlet port in fluid communication with a fluid output line for receiving the fluid exiting the fluid measurement tube,
at least one ultrasonic sensor for providing a signal indicative of the flow rate of fluid passing through the fluid measurement tube, and
a clamping mechanism mounted to the support member, said clamping mechanism for temporarily mounting the fluid measurement tube in a proper orientation in relation to the at least one ultrasonic sensor;


a suction source for providing suction in the fluid return line and fluid output line to draw the fluid through the fluid measurement tube and subsequently into a waste collection system; and
a control unit for receiving the signals from the at least one ultrasonic sensor to monitor a volume of fluid returned from the surgical site.

2. The fluid management system of claim 1, wherein said suction source is a component of said fluid volume measurement system.

3. The fluid management system of claim 1, wherein said control unit is a component of said fluid volume measurement system.

4. The fluid management system of claim 1, wherein said fluid measurement tube is re-usable.

5. The fluid management system of claim 1, wherein said pass-through fluid volume measurement system further comprises a temperature sensor for sensing fluid temperature of the fluid in the fluid measurement tube.

6. The fluid management system of claim 1, wherein the system includes a tubing set comprised of:
the flow sensing device;
a first tubing portion providing the fluid input line connected to the inlet port of the flow sensing device; and
a second tubing portion providing the fluid output line connected to the output port of the flow sensing device.

7. The fluid management system of claim 1, wherein said flow sensing device includes a first ultrasonic sensor associated with the inlet port, said first ultrasonic sensor mounted to the support member, and a second ultrasonic sensor associated with the outlet port, said second ultrasonic sensor mounted to the support member, wherein the first and second ultrasonic sensors provide signals indicative of the flow rate of fluid passing through the fluid measurement tube.