Abstract:
Disclosed is an irrigation system. The irrigation system includes a manual pump. The manual pump can provide pressurized liquid through a tube at an outlet.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    This application is a continuation-in-part of U.S. patent application Ser. No. 14/928,066 filed on Oct. 30, 2015. The entire disclosure of the above application is incorporated herein by reference. 
     
    
     FIELD 
       [0002]    The subject disclosure relates to an irrigation system, and particularly relates to a manually powered irrigation system having a nozzle. 
       BACKGROUND 
       [0003]    This section provides background information related to the present disclosure which is not necessarily prior art. 
         [0004]    During selected procedures, it may be selected to provide a liquid to a specific location. Generally, fluid may be delivered through a tube that may be powered by a pump. Further, the tube may include suction portions to withdraw/remove material and/or irrigation liquid from a site. Selected systems include a Hydrodebrider® pressurized sinus irrigation system sold by Medtronic, Inc. and systems such as those disclosed in U.S. Patent Application Publication Nos. 2009/0270796 and 2011/0009699 and U.S. Pat. Nos. 8,790,301 and 8,206,349. Such systems are disclosed to include a vacuum source and a control to control a vacuum and irrigation. 
       SUMMARY 
       [0005]    This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features. 
         [0006]    According to various embodiments, a manual pump may be fitted with a valve system. The manual pump may include a syringe or other hand-held and/or operated pump mechanism. The valve system may allow for unidirectional or one-directional delivery of a fluid. 
         [0007]    The valve system may include two one-way valves to allow for filling of a syringe barrel during a first movement of a syringe piston and delivery of a liquid from the filled barrel during a second motion of the piston. The valve system, therefore, allows for generally continuous delivery of a fluid from a source to a selected area while connected to a source. 
         [0008]    Delivery of the fluid may be through a nozzle to provide a selected pressure of fluid to an irrigation site. Irrigation sites may include both living and non-living sites. Living tissue or anatomical sites may include body surfaces, such as nasal and sinus cavities. Non-living sites may include cleaning or preparing surgical equipment, implants, or work surfaces, such as degreasing. During irrigation, the pressure may assist in loosening or removing a selected material from a selected surface or breaking up large agglomerations of material into smaller portions for removal. 
         [0009]    Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. 
     
    
     
       DRAWINGS 
         [0010]    The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure. 
           [0011]      FIG. 1  is a plan view of an irrigation system, according to various embodiments; 
           [0012]      FIG. 2  is a detailed end view of an irrigation nozzle, according to various embodiments; 
           [0013]      FIG. 3  is a schematic environmental view of an irrigation site; and 
           [0014]      FIG. 4  is a plan view of an irrigation system, according to various embodiments; 
           [0015]      FIG. 5  is a detailed view of an irrigation tip assembly, according to various embodiments; 
           [0016]      FIG. 6  is a further detailed view of an irrigation tip assembly, according to various embodiments; and 
           [0017]      FIG. 7  is a plan view of an irrigation system, according to various embodiments. 
       
    
    
       [0018]    Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings. 
       DETAILED DESCRIPTION 
       [0019]    Example embodiments will now be described more fully with reference to the accompanying drawings. 
         [0020]    With initial reference to  FIG. 1 , an irrigation system  20  is illustrated. The irrigation system  20  is generally a manual irrigation system powered by a user that holds a syringe assembly  24  in one or more hands to operate the syringe assembly  24 . The syringe assembly  24  may include a piston head  26  interconnected with a piston rod  28 . The piston rod  28  may include various features such as a thumb hole or loop  30  to assist in operation of the syringe assembly  24  with one hand of a human user. 
         [0021]    The syringe assembly  24  may be a manual pump that may include various features such as further including finger or digit rings  42  to assist in manipulating the syringe assembly  24 , in addition to the thumb hole or loop  30 , again with one hand of a human user. Further, a connection portion  46  may include connection mechanisms such as a Luer-Lok® syringe connection, twist lock, press fit, or the like. Therefore, a mechanism may be interconnected with the syringe assembly  24  for use of the irrigation system  20 . 
         [0022]    As is generally understood by one skilled in the art, the syringe assembly  24  may be operated to fill a syringe barrel  32  by moving the piston head  26  with the piston rod  28  generally in the direction of arrow  36  and may be emptied by moving the piston head  26  with the piston rod  28  generally in the direction of arrow  40 . It is understood, however, that the syringe assembly  24  may also have a self-return or self-priming system. Self-return systems may include a spring (not illustrated) to bias the piston head  26  away from the connection portion  46  generally in the direction of arrow  36 . The user, to express the material from the syringe, would overcome the biasing force of the spring to express the material and the biasing force would assist in moving or move the piston head away from the connection portion  46  to refill the syringe barrel. 
         [0023]    Connected with the syringe assembly  24  at the connection portion  46  may be a valve assembly  50 . The valve assembly  50  may include the dual check valve  80187  sold by Qosina, having a place of business at Ronkonkoma, N.Y. The valve assembly  50  may include various valve portions, including two one-way valves. The two one-way valves may include a one-way valve assembly  52 , which may be a first one-way valve assembly, that opens when negative pressure is formed within the valve assembly  50 . Negative pressure may be produced when the piston head  26  moves generally in the direction of arrow  36  to allow a flow of material through the one-way valve assembly  52  generally in the direction of arrow  54 . The material may flow generally in the direction of arrow  54  through a tubing  56 . The tubing  56  may be a flexible tubing to connect with a source container  58  holding or containing a volume or liquid, such as an irrigant liquid. 
         [0024]    The source container  58  may be a container, such as an IV bag or other appropriate volume of an irrigation fluid. The irrigation fluid may be a selected material such as saline. The irrigation fluid may further include various therapeutic reagents such as antibacterial, antimicrobial, anti-inflammatory, analgesic, hemostatic, and wound healing components. 
         [0025]    The tubing  56  may be connected with a connector  60  to a connection receptacle  62  of the irrigant volume container. The connector  60  and the connection receptacle  62  can be any appropriate connection members, as is generally understood in the art. The connection of the connector  60  with the connection receptacle  62  may generally be an open connection such that fluid will generally flow from the source container  58  through the tubing  56  once the connector  60  is connected with a connection receptacle  62 . The one-way valve assembly  52 , however, may control flow of the fluid from the source container  58  to the syringe assembly  24 , including within the syringe barrel  32 . 
         [0026]    Accordingly, as noted above, when the piston head  26  generally moves in the direction of arrow  36 , the irrigant is drawn from the source container  58  through the connection receptacle  62  and the connector  60  through the tubing  56  and generally in the direction of arrow  54 . The movement of the piston head  26  in the direction of arrow  36  may cause a negative pressure through the connection portion  46  to the valve assembly  50  to open the one-way valve assembly  52 . Therefore, the syringe barrel  32  fills with the irrigant fluid. 
         [0027]    Once a selected volume of the irrigant is positioned within the syringe barrel  32 , however, movement of the piston head  26  in the direction of arrow  36  may be ceased. The piston head  26  may then be moved in the direction of arrow  40  to move the piston head  26  generally towards the connection portion  46  to assist in removing or evacuating the irrigant material from the syringe barrel  32 . 
         [0028]    When the piston head  26  is moved generally in the direction of arrow  40 , the pressure at the valve assembly  50  may be increased. The increased pressure in the valve assembly  50  can close the one-way valve assembly  52  and open a one-way valve assembly  68 , which may be a second one-way valve assembly. The increased pressure at the one-way valve assembly  68  may cause the one-way valve assembly  68  to open to allow the irrigant to flow from the syringe barrel  32  through the valve assembly  50  and generally in the direction of arrow  70  through a tubing  72 . The tubing  72  may extend along a selected length and may bend according to a selected configuration. 
         [0029]    The tubing  72  may be formed of a material that may be rigid or bendable. In various embodiments, the tubing  72  may be bent for use and may maintain the selected bent configuration. Alternatively, or in addition thereto, the tubing  72  may only be flexible and a bendable support structure  74  may be positioned at at least a region of the tubing  72  to assist in supporting and holding the tubing  72  in a selected shape. According to various embodiments, the bendable support structure  74  may be a malleable tube, such as an aluminum tube, fixed within the tubing  72 . Various embodiments, may also include malleable wires embedded in a wall of the tubing  72 . Further, multiple tubes may be concentrically placed to support a bend. In still further various embodiments, a distal tube may be formed of a second material different from a proximal portion of the tubing  72  that may be malleable. It is understood, however, in various embodiments the tubing  72  may be a single type flexible non-malleable tubing. 
         [0030]    The tubing  72  may be bent at a selected radius, such as near a tip  76  to assist in positioning the tip  76  at a selected location. For example, the tip  76  may be selected to be positioned in a sinus cavity, as discussed further herein, and forming a radius or angle near the tip  76  may assist in positioning the tip  76  within the selected sinus. The radius may be supported by the bendable support structure  74  that may be different than the material of the tubing  72 . 
         [0031]    With continued reference to  FIG. 1  and additional reference to  FIG. 2 , the tip  76  may be formed to cause a selected shape of a spray that exits the tubing  72  and the tip  76 . As illustrated in  FIG. 2 , a detailed view generally along or at the tip  76  of the tubing  72  is illustrated. The tip  76  may include a selectively shaped opening  80 . The opening  80  may include a slit that has a first surface  82  and a second surface  84 . The first and second surfaces  82 ,  84  may be angled relative to one another and may include an elongated configuration such that a fan-shaped spray emanates from the tip  76 . The opening  80  may also include sidewalls adjacent to the first and second surfaces  82 ,  84  to further direct the spray. The tip  76  may alternatively to the opening  80  and/or in additional to the opening  80  include one or more holes  85 . The holes  85  may be selectively shaped, such as circular, oval, discrete slits, etc. 
         [0032]    At the tip  76 , the first surface  82  may be angled relative to the second surface  84  to form a selected configuration of the spray, as noted above, which may be a fan shape. Further, due to the angle of the second surface  84 , the spray may be directional, such as spraying generally at the angle of the second surface  84  and away from an axis  88  through the tip  76 . This can allow the tip  76  to be rotated around the axis  88 , such as by rotating the syringe assembly  24 , to select a direction of the spray through the opening  80 . 
         [0033]    The tip  76 , as discussed above may include one or more holes  85 . If a single one of the holes  85  is included the single hole may direct a stream of the fluid. The single hole may be positioned at any appropriate location around or along the tip  76 . Alternatively, there may be many holes  85  positioned at selected locations on the tip  76 . For example, the holes  85  may be formed as a ring around an axis  88 . The ring of holes may be partial or complete to spray in a selected direction at the tip  76  relative to the axis  88 . 
         [0034]    Visualization of the location and/or direction of the spray may be made by direct endoscopic or direct visual inspection of the spray. Further, a navigational marker, such as a radiopaque indicator  90  may be included to indicate the location and/or direction of the spray from the opening  80 . For example, as illustrated in  FIG. 2 , a triangle or arrowhead may be the radiopaque indicator  90  that points towards the direction of the spray. Therefore, an imaging may be made to determine the location and/or direction of the spray from the tip  76 , such as through the opening  80  and/or the holes  85 . 
         [0035]    Further, a cross-sectional area or volume of the opening  80  relative to a cross-sectional area of an opening or lumen through the tubing  72  may be selected at an appropriate ratio of about 1:1 to about 1:10,000, including about 1:2 to about 1:100, including about 1:6. Further, more than one of the tips  76  may be provided on the tubing  72 . Multiple tips may provide for a spray being directed in a plurality of directions at once. Further, the tips  76  may be selectable or changeable during use. Different tips providing different rations may be used to provide different spray patterns and/or pressures. Accordingly, a kit may be provided that includes the irrigation system  20  with one or more tips  76 . The tips may be assembled during use. The kit may be provided in a container that allows sterilization of the kit prior to use. The ratio of the volume of the opening  80  relative to cross-sectional area of the lumen can allow for a selected pressure to be provided through the opening  80 . Providing a selected pressure, such as a pressure of about 1 pounds per square inch (PSI) to about 70 PSI may be provided. The selected PSI may assist in a procedure, such as debridement of a region. For example, debridement may include removing a biofilm, breaking an agglomeration, or otherwise providing pressure to an area to assist in removing one or more selected materials (e.g. debris, bacteria, irritant or allergen), or clearing a selected area. 
         [0036]    With continuing reference to  FIGS. 1 and 2  and additional reference to  FIG. 3 , the irrigation system  20  may be used to debride or irrigate a selected nasal passage or sinus cavity. As is generally understood by one skilled in the art, a subject, such as a human subject  100 , may include or have a first nasal passage  110  or a second nasal passage  112 . Further, the human subject  100  may include one or more sinus cavities including schematically illustrated sinus cavities, including maxillary sinuses  114   a  and  114   b  and frontal sinuses  116   a  and  116   b.    
         [0037]    During a procedure, the tip  76  may be introduced through the first nasal passage  110  and moved into the maxillary sinus  114   a . The tip  76  may be carried on the tubing  72  and may be manipulated into position via holding and operating the syringe assembly  24 . During use, the user may then move the piston head  26  generally in the direction of arrow  36  to fill the syringe barrel  32  and then generally in the direction of arrow  40  to express the irrigation material through the tubing  72  and out of the tip  76 . 
         [0038]    When expressing the irrigation material out of the tubing  72  and tip  76 , a spray  120  may be formed as the irrigation fluid impinges upon an internal surface of the maxillary sinus  114   a . It is understood that the tip  76  may be moved through either or both of the first and second nasal passages  110 ,  112  into any of the selected sinus cavities, including either of the maxillary sinuses  114   a  or  114   b , or frontal sinuses  116   a  or  116   b  or other sinuses such as the sphenoid or ethmoid sinuses. Nevertheless, the user may operate the syringe assembly  24  to irrigate the sinus cavities and/or nasal passages. 
         [0039]    During operation, the user may continuously irrigate using a reciprocating action of the piston head  26 . By first moving the piston head  26  generally in the direction of arrow  36 , the syringe barrel  32  may be filled and then expressing material by moving the piston head  26  generally in the direction of arrow  40 . As noted herein, the repeated movement of the piston head  26  in the direction of the first arrow  36  then the second direction arrow  40  a continuous irrigation may be performed. 
         [0040]    The reciprocating motion of the piston head  26  may be manually operated by the user and may not cause a continuously steady stream (e.g. the continuous flow may be pulsatile) during the emptying of the source container  58 . However, due to the connection of the syringe assembly  24  to the source container  58  through the tubing  56  and the position of the valve assembly  50 , the source container  58  may be emptied or continuously used until debridement or irrigation is complete or the source container  58  is empty. Therefore, the user need not remove the syringe assembly  24  from the irrigation site to refill the syringe assembly  24  during an irrigation procedure, but may maintain the tip  76  at a selected irrigation position during an entire irrigation procedure while manually operating the syringe assembly  24  during the irrigation procedure. 
         [0041]    It is understood that the irrigation assembly, according to various embodiments, as discussed herein, may be use to irrigate selected surfaces or volumes.  FIG. 3  is merely exemplary of irrigating a surface or cavity within a human subject. It is understood, however, that other cavity within a subject may be irrigated. Further, devices, such as implants or treatment devices may have the irrigant applied to their surfaces before, during, or after positioning with in a subject. For example, an implant may have its surface irrigated after implantation to assist in removing an infection, etc. 
         [0042]    An irrigation system  220 , according to various embodiments, is illustrated in  FIG. 4 ,  FIG. 5 , and  FIG. 6 . The irrigation system  220  is a manual irrigation system that is configured to be powered by a user. For example, a user may apply manual pressure to operate the irrigation system  220 . Further, the irrigation system  220  may include components similar to the irrigation system  20 , discussed above. Identical components to the irrigation system  20  will be given the same reference numeral in the irrigation system  220  and not discussed in detail below. 
         [0043]    The irrigation system  220  may include a syringe system or assembly  224 . The syringe assembly  224  may be operated by one or more hands of a user as a manual pump to express or spray an irrigant from the syringe assembly  224 . The irrigant may be the same as that discussed above, and may be sprayed into various portions of the human subject  100 , as discussed above and illustrated in  FIG. 3 . It is understood, however, that the irrigation system  220  may be used to irrigate any selected volume and the irrigation of a human patient is not required. 
         [0044]    The syringe assembly  224  may be similar to the BD Cornwall™ disposable syringe system, sold by Becton, Dickinson &amp; Co., having a place of business in Franklin Lakes, N.J., USA. The syringe assembly  224  may include a syringe barrel  226  and a syringe plunger  228 . As discussed herein, the syringe barrel  226  may operate as a pump barrel having a volume and the syringe plunger  228  may be a plunger for a pump. Connecting the syringe barrel  226  and the syringe plunger  228  may be a spring member  232 . The spring member  232  may be held within a casing or handle  234 . The spring member  232  may be any appropriate biasing member or system to apply a bias force to the handle  234  and/or the syringe plunger  228 . 
         [0045]    The spring member  232  may be formed of a selected material, such as a metal or metal alloy, that causes it to be biased to an expanding or open position. Thus, the spring member  232  may be a biasing member that biases the handle  234  and/or the syringe plunger  228 . In biasing the syringe plunger  228 , the spring member  232  may bias and/or draw the syringe plunger  228  generally in the direction of arrow  236  to move a plunger head  238  in a first direction in the syringe barrel  226 . By moving the syringe plunger  228  in the direction of arrow  236 , a pressure in the syringe barrel  226  may be reduced so that it may be filled with a fluid from the source container  58 . The spring member  232 , therefore, biases the syringe assembly  224  to assist in filling the syringe barrel  226  and generally towards a full position. The handle  234  may further include a stopping or an arresting strap  240  that connects to a stop member or portion  242 . The stop member or portion  242  is configured to engage a fixed portion of the syringe barrel  226  or is fixed to the syringe barrel  226 . The arresting strap  240  engages the stop member or portion  242  to limit travel of the handle  234  when biased by the spring member  232 . 
         [0046]    The irrigant may be manually expressed from the syringe assembly  224  by the user grasping the handle  234  and squeezing or pressing a first handle member  234   a  towards the syringe barrel  226  and towards a second handle member  234   b  generally in the direction of arrow  250 , which may be opposite the direction of the arrow  236 . In squeezing the handle  234 , the user moves the syringe plunger  228  in a second direction in the syringe barrel  226 , and generally in the direction of arrow  250 . This forces a fluid out of the syringe barrel  226  and through the valve assembly  50 , connected to the syringe barrel  226 . The expressed material is directed, by the valve assembly  50 , through the tubing  72 . 
         [0047]    Once a selected material has been expressed or emptied from the syringe barrel  226 , the user may release or stop squeezing the handle  234 . Once the handle  234  is released, the spring member  232  in applying the biasing force, will cause the handle  234 , connected to the syringe plunger  228 , to generally move in the direction of arrow  236 . The spring member  232  may be configured and manufactured to overcome any force applied by the first handle member and the second handle member  234   a ,  234   b , alone, and friction of the syringe plunger  228  within the syringe barrel  226 . In this manner, the syringe barrel  226  may be refilled with an irrigant from the source container  58  as the spring member  232  biases the handle  234  in the direction of arrow  236  to move the syringe plunger  228  in the direction of arrow  236 . The spring member  232 , therefore, may also make continuous or extended irrigation easier and less stressful to a user. The biasing spring may provide all of the force necessary to refill the syringe barrel  226 . Thus, the user may only need to provide the force to express material from the irrigation system  220 . As noted herein, expressing material may be performed by the user squeezing the handle  234 . 
         [0048]    The source container or source container  58  may be connected with the syringe barrel  226  via or with tubing, such as flexible tubing  56 . The source container  58  may hold any selected irrigation fluid, such as those discussed above including sterile saline or other materials that may include therapeutic agents such as antimicrobials, antibacterials, or the like. Further, the source container  58  may be any appropriate container, such as an IV bag. 
         [0049]    The source container  58  may be connected with the tubing  56  using the connector  60  at the connection receptacle  62  with the source container  58 . The tubing  56  and connector  60  and connection receptacle  62  may be substantially similar to that discussed above. Further, as material exits the source container  58  it may flow in through the tubing generally in the direction of the arrow  54  through the valve assembly  50 . The valve assembly  50  may be similar or identical to the valve assembly discussed above including the check valve  80187  sold by Qosina. The valve assembly  50  may include two one-way valves, as discussed above. Accordingly, the valve assembly  50  may allow material only to flow from the source container  58  into the syringe barrel  226  and not from the syringe barrel  226  into the source container  58 . Further, the valve assembly  50  may allow material to be expressed only from the syringe barrel  226  through the irrigation tubing  72  while not allowing material to move through the valve assembly  50  from the irrigation tubing  72  either into the syringe barrel  226  or into the source container tubing  56 . Therefore, the valve assembly  50  allows material to be drawn from the source container  58  into the syringe barrel  226  and then expressed and irrigated through the irrigation tubing  72  generally in the direction of arrow  70 . The valve assembly  50 , however, will generally not allow flow in the directions opposite of arrows  54  and  70 . 
         [0050]    The valve assembly  50  allows the irrigation system  220  to be used to draw an irrigation material from the source container  58  into the syringe barrel  226  and then express the irrigation material from the syringe barrel  226  through the tubing  72 , in a manner similar to that discussed above. The irrigation system  220  may be operated by the user squeezing the handle  234  to empty the syringe barrel  226  (at least a selected amount). The spring member  232  may then bias the syringe plunger  228  out of the syringe barrel  226  generally in direction of arrow  236  to refill the syringe barrel  226  from the source container  58 . This operation allows for substantially continuous irrigation by reciprocating the syringe plunger  228  in the syringe barrel  226 . The user squeezes the handle  234  to express material and then releases the handle  234  to allow the spring member  232  to move the syringe plunger  228  to refill the syringe barrel  226  for the user to then express more fluid, if selected. 
         [0051]    The tubing  72  may be connected to a terminal irrigation assembly or tip assembly  300 . The terminal irrigation assembly  300 , as illustrated in  FIG. 4 ,  FIG. 5 , and  FIG. 6 , may include a vacuum tube connection region  302  that may include a connection member  304  having a proximal male connector  306  and a distal male connector  308 . The proximal male connector  306  may be received within a female connector  309  of a vacuum source tube  311 . The distal male connector  308  may be received within a proximal connection portion  312  of an irrigation tip holder  320 . It is understood, however, that the irrigation tip holder  320  need not be included as a separate or separable member. 
         [0052]    The vacuum source tube  311  may be connected to a vacuum source  321 . The vacuum source may be any appropriate source, such as a PM61 Power Vac Aspirator, sold by Precision Medical, Inc., having a place of business in Northampton, Pa. The vacuum source may also be a non-portable system such as a constant suction system, such as one generally available in hospitals as a central suction system. 
         [0053]    If selected, the irrigation tip holder  320  may include an external wall  322  that defines an internal cannula  324 . The suction may be drawn through the internal cannula  324  and the suction or vacuum source tube  311 . The irrigation tip holder  320  may be formed from a syringe barrel such as a syringe Luer-Lok® hypodermic syringe sold by Becton, Dickinson and Company Corporation, having a place of business in Franklin Lakes, N.J. The syringe barrel may have the vacuum tube connection region  302  positioned within a proximal end  326  of the syringe barrel that defines the proximal connection portion  312 . As discussed herein, therefore, suction may be drawn through the irrigation tip holder  320  at a selected time. The irrigation tip holder  320  may further include a Luer-Lok® hypodermic syringe with a partial or half-twist connection at a distal end connector  330 . A Y-connector or Y-connection portion  340  may connect with the distal end connector  330 . As noted above, the irrigation tip holder  320  need not be included and the vacuum source tube  311  may be connected directly to the Y-connector  340 . 
         [0054]    The Y-connector  340 , as discussed further herein, may communicate with or have an irrigation tip tube  350  passed through at least a portion of the Y-connector  340 , including an “Y”-arm or extension  354  extending from a central member  356  of the Y-connector  340 . The central member  356  may define a first, main, or central cannula  358  and the Y-arm or extension  354  may also define a second, auxiliary, or extension cannula  360 . The central cannula  358  may intersect with the extension cannula  360  and be in fluid communication. The Y-connector  340  may be connected at the distal end connector  330  to the irrigation tip holder  320 . As discussed herein, suction may draw material through the central cannula  358  and the internal cannula  324  through the vacuum source tube  311 . 
         [0055]    The Y-connector  340  connects at a connection region  352  with one or more sheaths that are sheather so the sip tube  350 . The tip tube  350  may be sheathed or covered in one or more fixed shape sheaths or sleeves. The sheaths may include a 70° curved sheath  370 , a 120° curved sheath  372 , and a 13° curved sheath  374 . It is understood, however, that more sheaths may be provided and that sheaths of other curvatures may be provided. Each of the sheaths  370 ,  372 ,  374  may be passed over the tip tube  350 . The tip tube  350  may be flexible enough that it will obtain or be held in the shape of the sheath  370 ,  372 ,  374  when placed inside of the sheath  370 ,  372 ,  374 . Each of the sheaths  370 ,  372 ,  374  may be selectively and/or separately connected to the connection region  352 . Each of the sheaths may include an outer diameter of about 1 millimeter (mm) to about 10 mm, including about 1 mm to about 6 mm, and further including about 3 mm to about 5 mm. 
         [0056]    The tip  76  may extend from the tip tube  350 . In various embodiments, the tip  76  may be formed separate from the tip tube  350  and inserted into and connected to the tip tube  350 . In various embodiments, the tip  76  may be formed at a distal end of the tip tube  350 . The tip tube  350  extends from the tip  76  through a portion of the Y-connector  340  at the connection region  352  and into the extension cannula  360  of the Y-arm or extension  354 . The tip tube  350  further extends through an extension arm connector  380  and a directional control system that may include a direction control member (e.g. a grip or handle)  382  to a tip tube connector  400 . The tip tube connector  400  may connect with a female connector  310  of the tubing  72 . When connected, as material is expressed from the syringe barrel  226 , the material may travel past the valve assembly  50  (in the general direction of arrow  70 ) through the tubing  72  and through the tip tube  350  and the tip  76  to a selected location, such as within a sinus passage as discussed above. Therefore, material may be irrigated through the tip  76  of the irrigation tip tube  350  from the syringe barrel  226 . 
         [0057]    The tip tube  350  may be fixedly connected to the direction control member  382  which may rotate within the extension arm connector  380 . As the direction control member  382  rotates, such as around an axis  410  in the direction of double headed arrow  412 , the tip tube  350  may also rotate causing the tip  76  to also rotate. As the tip  76  rotates it may be rotated around an axis  420  that may be defined by the tip tube  350  and the selected sheath positioned over the tip tube  350 , such as the sheath  370  as illustrated in  FIGS. 5 and 6 . 
         [0058]    As discussed above, the tip  76  may include the opening  80  that forms a fan or other selected shape of the spray of the material being expressed through the tip or from the tip  76 . In rotating the direction control member  382  around the axis  410 , which in turn rotates the tip  76  around the axis  420 , generally in direction of the double headed arrow  424 , allows the fan or other shaped spray to also be rotated around the axis  420 . Therefore, if a substantially flat fan is expressed from the tip  76  and the fan rotates around the axis  420 , the fan may cover a surface generally defining a circle or disc shape around the axis  420 . 
         [0059]    Further, the sheath  370  (as may all of the sheaths  370 ,  372 ,  374 ) may include an opening or passage between an internal wall  430  and an outer wall  434  of the tip tube  350 . The sheath  370 , in forming the passage, will allow the suction or vacuum formed from the vacuum source  321  to be drawn through the sheath  370  and, in turn, through the central cannula  358  of the Y-connector  340  and the internal cannula  324  of the irrigation tip holder  320  and then through the vacuum source tube  311 . The suction may be passed the tip  76  and though the selected sheath  370 ,  372 ,  374 , generally in the direction of arrow  450 . 
         [0060]    As discussed above, the vacuum source  321  may be a constant vacuum source providing a constant vacuum and suction through the terminal irrigation assembly  300 . Thus, suction may always be provided at or near the tip  76  through the sheath, such as the sheath  370 , even during expressing or irrigation of a selected area. In providing constant suction or vacuum, the irrigation material may not build up at a selected location and removed or debrided material may be withdrawn once it is loosened from a selected surface. Therefore, the terminal irrigation assembly  300  may provide both a suction and irrigation at or near the tip  76  of the terminal irrigation assembly  300 . 
         [0061]    Accordingly, the irrigation system  220  may be operated to irrigate at the tip  76  and vacuum or suction material near the tip  76  through the sheath  370  (or other appropriate sheath  370 ,  372 ,  374 ) connected to the connection region  352 . A user may irrigate an area, such sinus or other selected volume, and material once expressed from the tip  76  and/or debrided from a surface may be removed with the suction. 
         [0062]    It is understood that the irrigation system  220  may be operated in performing a procedure on a human, such as for irrigation of the nasal passage or sinus cavity. It is further understood, however, that irrigation system  220  may be used in a non-human subject for irrigating, providing a selected material (e.g., a lubricant) or cleaning a selected volume of any appropriate object. For example, the irrigation system  220  may be used to provide a selected liquid to a machine system for a selected purpose, including those expressed above. 
         [0063]    In addition, the user may remove the syringe assembly  224  from the Y-connector  340  and place a cap or other member  391  in its place. The cap  391  may be tethered to the Y-connector  340  or otherwise obtained to block the irrigation passage of the Y-connector  340 . When blocked, the vacuum source  321  would provide the only flow through the Y-connector  340  and the system may operate in a suction only mode. Thus, the irrigation system  220  may be blocked to allow only suction, for various purposes. 
         [0064]    According to various embodiments an irrigation system  220 ′, as illustrated in  FIG. 7 , may be altered relative to the irrigation system  220  illustrated in  FIG. 4  above. The irrigation system  220 ′ illustrated in  FIG. 7  may include the syringe assembly  224  connected to the Y-connector  340  without the tubing  72  between the syringe assembly  224  and the Y-connector  340 . The syringe assembly  224  may be connected to the Y-connector  340  through the female connector  310  and the direction control member  382 . Therefore, the direction control member  382  may be still operated to change direction of the tip  76  by moving the tip tube connector  400 , as discussed above. 
         [0065]    Further, as illustrated in  FIG. 7 , the irrigation system  220 ′ may have the syringe assembly  224  connected to the central member  356  rather than to the Y-arm or extension  354  as illustrated in  FIGS. 4, 5, and 6 . It is understood that this is not required, but that the Y-connector  340  may be connected in either manner for the irrigation system  220 , illustrated in  FIG. 4 , or the irrigation system  220 ′, illustrated in  FIG. 7 . In the irrigation system  220 ′, however, the cannula  358  through the central member  356  is not operated as the suction cannula, but is the irrigation cannula. Further, the extension cannula  360  in the Y-arm or extension  354  is not the irrigation cannula, but is the suction cannula. Therefore, the cannula in either the central member  356  or the Y-arm or extension  354  is determined by which portion to which it is connected. 
         [0066]    In this manner, the irrigation system  220 ′ may be operated with a substantially single hand (as illustrated in  FIG. 7 ) of the user or operator without requiring the user to hold the syringe assembly  224  in one hand and the terminal irrigation assembly  300  in a separate hand. The user, therefore, may be able to move the tip  76  with the sheath  370  by moving the syringe assembly  224  rigidly connected to the sheath  370  through the Y-connector  340 . The user may further be able to operate or rotate the tip tube connector  400  with the direction control member  382 , as discussed above. Nevertheless, the syringe assembly  224  may be rigidly connected to the terminal irrigation assembly  300  to assist in efficiently operating the irrigation system  220 ′ without the need for the separate tubing  72 . The irrigation system  220 ′, however, may operate substantially similar to the irrigation system  220  as described above without the tubing  72 . That is, upon squeezing the handle  234 , the syringe plunger  228  may move in the direction of arrow  250  to move the irrigation fluid generally in direction of arrow  70  through the terminal irrigation assembly  300  and the tip  76  to irrigate a selected location. 
         [0067]    Example embodiments are provided so that this disclosure will be thorough, and will fully convey the scope to those who are skilled in the art. Numerous specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to those skilled in the art that specific details need not be employed, that example embodiments may be embodied in many different forms and that neither should be construed to limit the scope of the disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail. 
         [0068]    The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.