Patent Description:
A surgical procedure, such as a minimally-invasive laparoscopic surgical procedure, may involve insufflation of a portion of the body with a gas. For example, in a laparoscopic procedure, an insufflation gas may be delivered to the peritoneal cavity of a patient to distend the abdomen, which may improve visual and physical access to internal organs in the abdomen. For example, distension of the patient's abdomen may provide sufficient operating space to enable adequate visualization of the structures and manipulation of instruments inside a patient.

It is important to maintain insufflation gas flow and pressure during a surgical procedure. For example, the interface between surgical equipment and an access orifice in the patient's body should be sealed to avoid or reduce leakage of insufflation gas, so that insufflation can be maintained. When a system has a leak, additional insufflation gas may be needed to maintain insufflation through the procedure (e.g., to make up for leaked insufflation gas).

In a minimally invasive surgical procedure, such as a laparoscopic procedure, one or more cannulas may be used to deliver surgical tools into a body cavity. A cannula seal is typically used to contain insufflation gas pressure within a body cavity, whether an instrument is inserted or not, to avoid or reduce leakage of insufflation gas through the cannula during the procedure. A source of insufflation gas may be coupled to a medical device, such as a cannula seal, to deliver insufflation pressure during a procedure.

<CIT> discloses a coupling system for connecting a tube set to a trocar that includes a multi-lumen trocar having a housing that includes a connector, wherein the connector has a plurality of coaxial flow passages defined therein by a plurality of concentric annular walls, a multi-lumen tube set including a plurality of tubes arranged in a parallel relationship, and a coupling including a generally cylindrical body having a first end portion configured to selectively mate with the coaxial flow passages of the connector of the trocar and a second end portion configured for attachment to the parallel tubes of the tube set.

<CIT> discloses a Luer lock connector for use in an insufflation system. The Luer lock connector includes: a body comprising a first end, a second end and an interior region; the interior region defining a gases flow passageway allowing insufflation gases to flow through the body from the first end to the second end; and the body being configured to be coupled to a tubing arrangement at the first end and to a patient interface at the second end; wherein, the second end is configured to be coupled to a patient interface fitting of the patient interface, the second end being further configured to seal around an outer surface of the patient interface fitting when the Luer lock connector is coupled to the patient interface; and wherein, the second end forms a seal with the outer surface of the patient interface fitting when the second end and the patient interface fitting are coupled.

<CIT> discloses a coupling system is disclosed for connecting a tube set to a trocar that includes a multi-lumen trocar having a housing that has a connector extending outwardly from the housing, the connector having a plurality of coaxial flow passages defined therein by a plurality of concentric annular walls, a multi-lumen tube set including a plurality of tubes arranged in a parallel relationship, a coupling including a generally cylindrical body having a first end portion adapted and configured to selectively mate with the coaxial flow passages of the connector of the trocar and a second end portion adapted and configured for attachment to the parallel tubes of the tube set, and a latch assembly operatively associated with the cylindrical body of the coupling for selectively engaging the connector of the trocar housing when the coupling mates with the connector.

The present invention provides a medical device as defined in the appended independent claim <NUM>.

Optional features are defined in the appended dependent claims.

An example medical device includes a device body and an insufflation fitting coupled to and extending from the device body. The insufflation fitting includes an annular high-flow fitting portion and an annular low-flow fitting portion extending away from the device body from the annular high-flow fitting portion. The annular high-flow fitting portion includes a first inner surface and a radially outward sealing surface generally reverse from the first inner surface. The annular low-flow fitting portion includes an inner sealing surface and a first radially outward surface generally reverse from the inner sealing surface. The first inner surface of the annular high-flow fitting portion and the inner sealing surface of the annular low-flow fitting portion define an insufflation gas flow passageway through the insufflation fitting.

A medical device fitting includes an annular high-flow fitting portion and an annular low-flow fitting portion extending away from the high-flow fitting portion. The annular high-flow fitting portion includes a first inner surface and a radially outward sealing surface generally reverse from the first inner surface. The low-flow fitting portion includes an inner sealing surface and a first radially outward surface generally reverse from the inner sealing surface. The first inner surface of the annular high-flow fitting portion and the inner sealing surface of the annular low-flow fitting portion define a fluid flow passageway. A high-flow connector surrounds the low-flow fitting portion and includes an inner female sealing surface in sealing engagement with the radially outward sealing surface of the annular high-flow fitting portion.

Another medical device fitting includes an annular high-flow fitting portion and an annular low-flow fitting portion extending away from the high-flow fitting portion. The annular high-flow fitting portion includes a first inner surface and a radially outward sealing surface generally reverse from the first inner surface. The low-flow fitting portion includes an inner sealing surface and a first radially outward surface generally reverse from the inner sealing surface. The first inner surface of the annular high-flow fitting portion and the inner sealing surface of the annular low-flow fitting portion define a fluid flow passageway.

A medical device includes a fluid connector including means for receiving a relatively low flow fluid connector and means for receiving a relatively high flow fluid connector. The means for receiving a relatively high fluid flow connector includes a male sealing surface coaxially aligned with the means for receiving a relatively low flow fluid connector.

Each of these non-limiting examples can stand on its own or can be combined in various permutations or combinations with one or more of the other examples.

This Summary is intended to provide an overview of subject matter of the present patent application. The detailed description is included to provide further information about various aspects of the inventive subject matter.

As noted above, it is important to maintain insufflation gas flow and pressure during a surgical procedure. In some cases, however, it may also be important to not exceed a threshold flow parameter, such as flow rates, flow volumes, insufflation pressures, etc. As an example, it may be important to not exceed an insufflation pressure of <NUM> HG <NUM> (<NUM> PSI). At this maximum pressure (or below), however, it is still possible to vary the flow rate and/or volume, and it may be desirable to increase the flow rate and/or volume.

For example, a higher fluid flow rate/volume may be desirable or required in the event there is a leak in the system, or if there is another source of gas escape through the system. Higher flow may allow the system to keep up with need for flow to maintain sufficient insufflation. An example of a particular application may be in trans-anal procedures in the colon. Insufflation applications that involve smaller body cavities may be improved with higher flow, because it is generally easier to insufflate smaller body cavities with more flow. Additionally, if there's less volume in the cavity, a leak (or other gas escape) impacts the volume more quickly, and higher flow affords more time to respond to such situations and to thereby return to a proper or prescribed insufflation state as soon as possible.

One standard fitting that can be used in insufflation applications is the so-called Luer-type fitting ("Luer taper"). The Luer taper is a standardized system for certain fluid fittings used for making connections between a male-taper fitting and its mating female counterpart on medical and laboratory instruments. With standard Luer-type fittings (and other standard fittings), there's a limit to fluid flow through the fitting, which is dictated at least in part on the minimum diameter of the flow channel formed when the fittings are coupled together. In the Luer-type fitting this minimum diameter is typically the inner diameter of the tapered male Luer-type fitting.

Since Luer-type fittings are a standard in the medical device industry, current medical devices are typically designed to fit such standard fittings, including the so-called Luer-type fittings. This common design allows devices from different manufacturers (e.g., sources of insufflation gas, vacuum, or irrigation liquid, etc.; cannula seal connections, suction/irrigation instruments, etc.) to be coupled together. But since such standard fittings have fluid flow limits, a new fitting may advantageously be configured to adapt/couple to both a higher flow fitting and to a standardized low-flow Luer-type fitting for retrofit capability.

In one example in accordance with this disclosure, a medical device includes a device body and an insufflation fitting. The insufflation fitting is coupled to and extends from the device body. the insufflation fitting includes an annular low-flow fitting and an annular high-flow fitting. The annular low-flow fitting has a radially outward surface generally opposed to a first inner sealing surface. The inner sealing surface defines a flow passageway for insufflation gas. The annular high-flow fitting has a second inner sealing surface extending around and radially offset from the radially outward surface of the low-flow fitting.

In another example in accordance with this disclosure, a medical device includes a device body and an insufflation fitting. The insufflation fitting is coupled to and extends from the device body. The insufflation fitting includes an annular high-flow fitting portion and an annular low-flow fitting portion. The annular high-flow fitting portion has a radially outward sealing surface generally opposed to a first inner surface. The annular low-flow fitting portion extends away from the device body from the high-flow fitting portion. The low-flow fitting portion includes a first radially outward surface generally opposed to an inner sealing surface, the first inner surface and the inner sealing surface defining a flow passageway for insufflation gas.

<FIG> is a plan view depicting an example medical procedure environment that includes a multi-arm manipulating system <NUM> adjacent to a surgical table <NUM> that supports a patient <NUM>. A second manipulating system <NUM> may also be situated at the surgical table <NUM>. The manipulating systems <NUM>, <NUM> may be freestanding on a movable base, or they may be mounted to a table, floor, wall, or ceiling, or they may be supported on another piece of equipment in the clinical environment.

The manipulating system <NUM> or system <NUM> may be part of a larger system <NUM>, which may include other sub-systems, including, for example, fluoroscopy or other imaging equipment. One or both of the manipulating systems <NUM>, <NUM> may be operatively coupled to a user control system <NUM> or an auxiliary system <NUM>, or both. The user control system <NUM> may include one or more user input devices (e.g., controls) that may be configured to receive inputs from a user (e.g., clinician). The user control system <NUM> may also include or one or more user feedback devices (e.g., viewing system, or tactile or auditory feedback system) that may be configured to provide information to the user regarding the movement or position of an end effector, or an image of a surgical area. The auxiliary system <NUM> may, for example, include computer processing equipment (e.g., a processor circuit or graphics hardware), or communication equipment (e.g., wired or wireless communication circuits), or endoscopic camera control and image processing equipment.

<FIG> depicts example manipulating system <NUM>. The example manipulating system <NUM> includes a base <NUM>, a support tower <NUM>, and one or more manipulator arms <NUM>, <NUM>, <NUM>, <NUM>, which may be mounted on the support tower <NUM>. An instrument <NUM> (shown in more detail in <FIG>) is mounted to an instrument mount <NUM> on one of the manipulator arms <NUM>-<NUM>. The instrument mount <NUM> includes, as an example, an instrument carriage <NUM>, which is mounted to a spar <NUM>, which may be a telescoping or non-telescoping spar. A cannula <NUM> may be mounted to a cannula mount <NUM>, and the instrument <NUM> may be inserted through a cannula seal in the cannula <NUM>, and into the patient <NUM> (<FIG>) for use in a therapeutic or diagnostic surgical procedure. Through movement of the manipulator arms <NUM>-<NUM>, the translation and orientation of the instrument <NUM> may be controlled in multiple mechanical degrees of freedom, e.g. lateral, horizontal, vertical, angular movements in one, two, or three planes. The system <NUM> may include one or more light features <NUM>, <NUM>, <NUM>, <NUM>, <NUM>, <NUM> at one or more of a variety of locations on the manipulator arms <NUM>-<NUM> (i.e., at joints between arm links, as shown).

Cannula <NUM> may be inserted into the patient <NUM>, and a surgical instrument seal assembly (not shown) is inserted into the cannula. The instrument seal prevents insufflation gas from escaping through the open cannula when no instrument is inserted in the cannula, and it also prevents insufflation gas from escaping between the instrument shaft and the cannula inner wall when an instrument is inserted in the cannula.

<FIG> depicts example user control system <NUM>. The user control system <NUM> includes hand controls <NUM>, <NUM> and foot pedal controls <NUM>, <NUM>, <NUM>. The hand controls <NUM>, <NUM> and foot pedal controls <NUM>, <NUM>, <NUM> are used to control equipment at one or more of the manipulating systems <NUM>, <NUM>. For example, an operator may manipulate portions of a distal end of an instrument <NUM> by using the instrument controls. The controls may include haptic feedback features so that a surgeon may interpret physical information at the instrument <NUM>, such as resistance or vibration, through the controls. The user control system <NUM> may also include a viewing system <NUM> that displays video or other images of a surgical site.

<FIG> depicts an example auxiliary system <NUM>. The example auxiliary system <NUM> optionally includes telesurgical system functions that are not incorporated into other system units, such as computer processing system <NUM> for processing teleoperation controls, facilitating communication between the user control system and the manipulating system, or a remote site, endoscopic camera control and illumination, electrosurgical generation and control, etc. The auxiliary system <NUM> may also include a display <NUM>, which shows images that the user (e.g., a clinician) is seeing on the user control system <NUM>, a video feed from a camera in the patient <NUM>, or other information. In an example configuration, signals input at a user control system <NUM> may be transmitted to the processing system <NUM> on the auxiliary system <NUM>, which interprets the inputs and generate commands that are transmitted to the manipulating system <NUM> to cause manipulation of an instrument <NUM> or portions of a manipulator arm <NUM>. The processing system <NUM> is shown on a cart for exemplary purposes, but it may also be arranged in various configurations, e.g., it may be integrated as part of the user control system <NUM>, the manipulating system <NUM>, <NUM>, or both, or divided between the user control system <NUM> and manipulating system <NUM>, <NUM>. The equipment may also be provided as software, hardware, or both, on an installed or remote system.

<FIG> depicts example instrument <NUM>. The instrument <NUM> includes a proximal portion <NUM>, which is configured to couple to an instrument mount on a manipulator arm. The instrument <NUM> also includes a distal portion <NUM> and an instrument shaft <NUM> between the proximal portion <NUM> and the distal portion <NUM>. The distal portion <NUM> shown is a stapler, and in other instruments it may be a cautery tool, cutter, camera, or other medically relevant end effector. The instrument <NUM> may be teleoperatively controlled via command signals received from a control computer, such as a user control system <NUM> or auxiliary system <NUM> to conduct a surgical procedure. Inputs may be received from a user (e.g., clinician), and the instrument <NUM> may be controlled based on the user inputs.

In an example, instrument <NUM> is inserted into the patient <NUM> via cannula <NUM>, which also contains a surgical instrument seal assembly as described above. In such a procedure, it may be important to provide and maintain insufflation of a body cavity of the patient <NUM>.

<FIG> is a perspective view depicting example surgical instrument seal assembly <NUM>. <FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. Referring to <FIG> and <FIG>, instrument seal assembly <NUM> includes device body <NUM>, insufflation fitting <NUM>, and valve <NUM>. Valve <NUM> is fluidically connected to the fluid passageway of insufflation fitting <NUM> and configured to control the flow of insufflation gas into device body <NUM>. Valve <NUM> can be a variety of different valves, including a stopcock valve as depicted in the example of <FIG> and <FIG>.

Insufflation fitting <NUM> extends from device body <NUM>, and a flow passage is defined through fitting <NUM> and into device body <NUM>. Insufflation fitting <NUM> includes high-flow fitting <NUM> and low-flow fitting <NUM>. In this disclosure, high-flow is a rate and/or volume of flow that is higher relative to low-flow. In the case of insufflation fitting <NUM> and other such fittings in accordance with this disclosure, for a constant fluid pressure high-flow fitting <NUM> provides or enables a higher rate and/or volume of flow of fluid than low-flow fitting <NUM>. In some examples, high-flow fitting <NUM> and low-flow fitting <NUM> are fabricated integral with one another to form insufflation fitting <NUM> in accordance with this disclosure. In another example, however, low-flow fitting <NUM> may be fabricated as a separate component and then be coupled to high-flow fitting <NUM>. For example, low-flow fitting <NUM> may be fabricated as a separate component and then be coupled to high-flow fitting <NUM> using, for example, an adhesive or by welding low-flow fitting <NUM> to high-flow fitting <NUM>.

In the example of insufflation fitting <NUM>, high-flow fitting <NUM> includes first internal/inner (sometimes referred to as "female") sealing surface <NUM> and first coupling portion <NUM>. Low-flow fitting <NUM> includes second internal/inner sealing surface <NUM> and second coupling portion <NUM>. First sealing surface <NUM> of high-flow fitting <NUM> is a female tapered surface, the diameter of which decreases from free end <NUM> of high-flow fitting <NUM> toward valve <NUM> and device body <NUM>. Additionally, first sealing surface <NUM> is an annular sealing surface. Similarly, second sealing surface <NUM> of low-flow fitting <NUM> is a female tapered surface, the diameter of which decreases from free end <NUM> of low-flow fitting <NUM> toward high-flow fitting <NUM>, valve <NUM>, and device body <NUM>. Second sealing surface <NUM> is also an annular sealing surface.

First coupling portion <NUM> is on first external surface <NUM> of high-flow fitting <NUM>, which external surface is generally reverse of first internal sealing surface <NUM>. Second coupling portion <NUM> is on second external surface <NUM> of low-flow fitting <NUM>, which external surface is generally reverse to second internal sealing surface <NUM>. First coupling portion <NUM> of high-flow fitting <NUM> and second coupling portion <NUM> of low-flow fitting <NUM> include threads. In one example, first coupling portion <NUM> and second coupling portion <NUM> include Luer-type threads. In another example, first coupling portion <NUM> and second coupling portion <NUM> include another type of thread, lugs, or another locking/coupling mechanism.

Low-flow fitting <NUM> is concentric with and nested partially within high-flow fitting <NUM>. High-flow fitting <NUM> and low-flow fitting <NUM> share a common centerline axis <NUM>, which also defines a flow path centerline through the flow passage <NUM> of insufflation fitting <NUM>. High-flow fitting <NUM> is an annulus including first external surface <NUM> and first internal sealing surface <NUM>, which extend from body <NUM> of instrument seal assembly <NUM> to free end <NUM> of high-flow fitting <NUM>. Low-flow fitting <NUM> is an annulus including second external surface <NUM> and second internal sealing surface <NUM>, which extend from body <NUM> within the annular internal sealing surface <NUM> of high-flow fitting <NUM> to free end <NUM> of low-flow fitting <NUM>.

Although insufflation fitting <NUM> is depicted in association with an instrument seal assembly/access port device, in other examples fittings in accordance with this disclosure may be used in association with various other medical devices that supply or receive gaseous or liquid fluids. Such medical devices may be used for various medical functions such as body or irrigation fluid suction, smoke evacuation, irrigation fluid supply, supplemental oxygen supply, endosocope lens cleaning and defogging, etc..

Therefore, in accordance with an aspect a standard medical device fitting, such as female Luer-type fitting, is surrounded by a concentric second female fitting. The female Luer-type fitting receives a corresponding male Luer-type fitting to establish a fluid flow path through the coupled female and male Luer-type fittings, but as explained below this flow path is restricted by the Luer-type fitting design. And so the surrounding second female fitting can receive a corresponding second male fitting to establish a fluid flow path through the standard female fitting that is not restricted by the standard female/male fitting design.

<FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. In <FIG>, seal assembly <NUM> is coupled with a low-flow Luer-type connector <NUM> connected to low-flow insufflation line <NUM>. The example of <FIG> depicts the manner in which insufflation fitting <NUM> in accordance with this disclosure can be fit to a Luer-type connector <NUM> for relatively low-flow insufflation (low relative to, e.g., the example of <FIG> described below). In particular, the example of <FIG> depicts the manner in which low-flow fitting <NUM> of insufflation fitting <NUM> can be fit to a Luer-type connector <NUM> for relatively low-flow insufflation.

Low-flow Luer-type connector <NUM> includes locking collar <NUM> coupled to male Luer-type fitting <NUM>, which is coupled to low-flow insufflation gas source line <NUM>. Locking collar <NUM> includes coupling portion <NUM>, which can include, for example, threads, lugs, or another locking mechanism. Male Luer-type fitting <NUM> includes external male sealing surface <NUM>. External sealing surface <NUM> of male Luer-type fitting <NUM> is a male tapered surface, the diameter of which decreases as external sealing surface <NUM> extends toward the free end male Luer-type fitting <NUM>. In <FIG>, the diameter of external sealing surface <NUM> decreases as it extends into low-flow fitting <NUM>.

Locking collar <NUM> is configured to be coupled to low-flow fitting <NUM> via second coupling portion <NUM>. For example and as depicted in <FIG>, coupling portion <NUM> of locking collar <NUM> is threadedably engaged to second coupling portion <NUM> of low-flow fitting <NUM>. As locking collar <NUM> is threaded onto second coupling portion <NUM>, Luer-type connector <NUM> including Luer-type fitting <NUM> is drawn into engagement with fitting <NUM>, and in particular male external sealing surface <NUM> of Luer-type fitting <NUM> is drawn into sealing engagement with female internal first sealing surface <NUM> of low-flow fitting <NUM>.

In the example of <FIG>, in which low-flow fitting <NUM> of insufflation fitting <NUM> in accordance with this disclosure is fit to low-flow Luer-type connector <NUM> and associated Luer-type fitting <NUM>, the minimum internal diameter of Luer-type connector <NUM> limits the flow (rate and/or volume) of insufflation gas. In particular and as depicted in <FIG>, the inner diameter of low-flow Luer-type fitting <NUM> limits insufflation fluid flow.

<FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. In <FIG>, seal assembly <NUM> is coupled with high-flow Luer-type connector <NUM> connected to high-flow insufflation gas supply line <NUM>. The example of <FIG> depicts the manner in which high-flow fitting <NUM> of insufflation fitting <NUM> in accordance with this disclosure can be fit to a high-flow Luer-type connector <NUM> for relatively high-flow (rate and/or volume) insufflation.

High-flow Luer-type connector <NUM> includes locking collar <NUM> coupled to high-flow male Luer-type fitting <NUM>, which is coupled to high-flow insufflation line <NUM>. In some examples, high-flow Luer-type connector <NUM> is packaged with and preconnected to high-flow insufflation line <NUM>. In other examples, however, high-flow Luer-type connector <NUM> is packaged separately from high-flow insufflation line <NUM> and is configured to be connected to an insufflation line, e.g., line <NUM>. Locking collar <NUM> includes coupling portion <NUM>, which can include, for example, threads, lugs, or another locking mechanism. High-flow male Luer-type fitting <NUM> includes external male sealing surface <NUM>. External sealing surface <NUM> of male Luer-type fitting <NUM> is a male tapered surface, the diameter of which decreases as external sealing surface <NUM> extends toward the free end male Luer-type fitting <NUM>. In <FIG>, the diameter of external sealing surface <NUM> decreases as it extends into high-flow fitting <NUM>.

Locking collar <NUM> is configured to be coupled to high-flow fitting <NUM> via first coupling portion <NUM>. For example and as depicted in <FIG>, coupling portion <NUM> of locking collar <NUM> is threadedably engaged to first coupling portion <NUM> of high-flow fitting <NUM>. As locking collar <NUM> is threaded onto first coupling portion <NUM>, high-flow Luer-type connector <NUM> including high-flow Luer-type fitting <NUM> is drawn into engagement with fitting <NUM>, and, in particular, male external sealing surface <NUM> of Luer-type fitting <NUM> is drawn into sealing engagement with female internal first sealing surface <NUM> of high-flow fitting <NUM>.

In the example of <FIG> in which high-flow fitting <NUM> of insufflation fitting <NUM> in accordance with this disclosure is fit to high-flow Luer-type connector <NUM> and associated high-flow Luer-type fitting <NUM>, the minimum inner diameter of low-flow fitting <NUM> limits the flow (rate and/or volume) of insufflation gas. In particular and as depicted in <FIG>, the inner diameter of low-flow fitting <NUM>, which is the minimum inner diameter of second internal sealing surface <NUM> limits insufflation flow. As noted above, in the example of <FIG>, the inner diameter of low-flow Luer-type fitting <NUM> limits insufflation flow. Because the minimum diameter of second internal sealing surface <NUM> is larger than the inner diameter of low-flow Luer-type fitting <NUM>, larger insufflation flow is possible with high-flow fitting <NUM> of insufflation fitting <NUM> coupled to high-flow Luer-type connector <NUM> (<FIG>) than with low-flow fitting <NUM> coupled to low-flow Luer-type connector <NUM>.

<FIG> is a perspective view depicting example surgical instrument seal assembly <NUM> in accordance with the present invention. <FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. Referring to <FIG> and <FIG>, instrument seal assembly <NUM> includes device body <NUM>, insufflation fitting <NUM>, and valve <NUM>. Valve <NUM> is fluidically connected to the fluid passageway insufflation fitting <NUM> and configured to control the flow of insufflation gas into device body <NUM>. Valve <NUM> can be a variety of different valves including a stopcock valve as depicted in the example of <FIG> and <FIG>.

Insufflation fitting <NUM> extends from device body <NUM>, and a flow passage is defined through fitting <NUM> and into device body <NUM>. Insufflation fitting <NUM> includes high-flow fitting portion <NUM> and low-flow fitting portion <NUM>. In the embodiment of insufflation fitting <NUM> according to the present invention, high-flow fitting portion <NUM> includes external/outer ("male") sealing surface <NUM> and first coupling portion <NUM>. Low-flow fitting portion <NUM> includes internal/inner ("female") sealing surface <NUM> and second coupling portion <NUM>.

Outer sealing surface <NUM> of high-flow fitting portion <NUM> is a male tapered surface, the diameter of which decreases from free end <NUM> of insufflation fitting <NUM> toward valve <NUM> and device body <NUM>. Additionally, outer sealing surface <NUM> is an annular sealing surface. Inner sealing surface <NUM> of low-flow fitting portion <NUM> is a female tapered surface, the diameter of which decreases from free end <NUM> of insufflation fitting <NUM> toward high-flow fitting portion <NUM>, valve <NUM>, and device body <NUM>. Inner sealing surface <NUM> is also an annular sealing surface.

First coupling portion <NUM> is on first external surface <NUM> of high-flow fitting portion <NUM>, and external surface <NUM> is located toward valve <NUM> and device body <NUM> from external sealing surface <NUM>. First coupling portion <NUM> and first external surface <NUM> form a shoulder, which radially offsets coupling portion <NUM> and surface <NUM> from external sealing surface <NUM> and makes the outer diameter of first external surface <NUM> larger than the outer diameter of external sealing surface <NUM>.

Second coupling portion <NUM> is on second external surface <NUM> of low-flow fitting portion <NUM>, and external surface <NUM> is generally reverse from internal sealing surface <NUM>. First coupling portion <NUM> of high-flow fitting portion <NUM> and second coupling portion <NUM> of low-flow fitting portion <NUM> include threads. In one example, first coupling portion <NUM> and second coupling portion <NUM> include Luer-type threads. In another example, first coupling portion <NUM> and second coupling portion <NUM> include another type of thread, lugs, or another locking/coupling mechanism.

High-flow fitting portion <NUM> extends from and is coupled device body <NUM>. In the example of <FIG> and <FIG>, high-flow fitting portion <NUM> is coupled to valve <NUM>, which is coupled to device body <NUM>. Low-flow fitting portion <NUM> is concentric and integral with, and extends from high-flow fitting portion <NUM>. High-flow fitting portion <NUM> and low-flow fitting portion <NUM> share a common axis <NUM>, which also defines a flow path through the flow passage <NUM> of insufflation fitting <NUM>. High-flow fitting portion <NUM> is an annulus including outer sealing surface <NUM>, first external surface <NUM> and an internal surface extending toward body <NUM> of instrument seal assembly <NUM> from internal sealing surface <NUM> of high-flow fitting portion <NUM>. Low-flow fitting portion <NUM> is an annulus including second external surface <NUM> and internal sealing surface <NUM>, which extend from high-flow fitting portion <NUM> to free end <NUM> of low-flow fitting portion <NUM>.

Although insufflation fitting <NUM> is depicted in association with an instrument seal assembly/access port device, in other examples insufflation fittings in accordance with this disclosure may be used in association with various other medical devices.

Therefore, in accordance with another inventive aspect a standard medical device fitting, such as female Luer-type fitting, is aligned with a concentric male second fitting. As already described, the female Luer-type fitting receives a corresponding male Luer-type fitting to establish a fluid flow path through the coupled female and male Luer-type fittings, and this flow path is restricted by the Luer-type fitting design. And so the aligned male second fitting can receive a corresponding second female fitting to establish a fluid flow path through the standard female fitting that is not restricted by the standard female/male fitting design.

<FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. In <FIG>, seal assembly <NUM> is coupled with a low-flow Luer-type connector <NUM> connected to low-flow insufflation line <NUM>. The example of <FIG> depicts the manner in which insufflation fitting <NUM> in accordance with the present invention can be fit to a Luer-type connector <NUM> for relatively low-flow insufflation (low relative to, e.g., the example of <FIG> described below). In particular, the example of <FIG> depicts the manner in which low-flow fitting <NUM> of insufflation fitting <NUM> can be fit to a Luer-type connector <NUM> for relatively low-flow insufflation.

Low-flow Luer-type connector <NUM> includes locking collar <NUM> coupled to male Luer-type fitting <NUM>, which is coupled to low-flow insufflation line <NUM>. Locking collar <NUM> includes coupling portion <NUM>, which can include, for example, threads, lugs, or another locking mechanism. Male Luer-type fitting <NUM> includes external male sealing surface <NUM>. External sealing surface <NUM> of male Luer-type fitting <NUM> is a male tapered surface, the diameter of which decreases as external sealing surface <NUM> extends toward the free end male Luer-type fitting <NUM>. In <FIG>, the diameter of external sealing surface <NUM> decreases as it extends into low-flow fitting portion <NUM>.

Locking collar <NUM> is configured to be coupled to low-flow fitting portion <NUM> via second coupling portion <NUM>. For example and as depicted in <FIG>, coupling portion <NUM> of locking collar <NUM> is threadedably engaged to second coupling portion <NUM> of low-flow fitting portion <NUM>. As locking collar <NUM> is threaded onto second coupling portion <NUM>, Luer-type connector <NUM> including Luer-type fitting <NUM> is drawn into engagement with fitting portion <NUM>, and, in particular, male external sealing surface <NUM> of Luer-type fitting <NUM> is drawn into sealing engagement with female internal sealing surface <NUM> of low-flow fitting portion <NUM>.

In the example of <FIG> in which low-flow fitting portion <NUM> of insufflation fitting <NUM> in accordance with the present invention is fit to low-flow Luer-type connector <NUM> and associated Luer-type fitting <NUM>, the minimum diameter of Luer-type connector <NUM> limits the flow (rate and/or volume) of insufflation gas. In particular and as depicted in <FIG>, the inner diameter of low-flow Luer-type fitting <NUM> limits insufflation flow.

<FIG> is a cross-section elevation view depicting example surgical instrument seal assembly <NUM>. In <FIG>, seal assembly <NUM> is coupled with high-flow Luer-type connector <NUM> connected to high-flow insufflation line <NUM>. The example of <FIG> depicts the manner in which high-flow fitting portion <NUM> of insufflation fitting <NUM> in accordance with the present invention can be fit to a high-flow Luer-type connector <NUM> for relatively high-flow (rate and/or volume) insufflation.

High-flow Luer-type connector <NUM> includes locking collar <NUM> coupled to high-flow female Luer-type fitting <NUM>, which is coupled to high-flow insufflation line <NUM>. In some examples, high-flow Luer-type connector <NUM> is packaged with and preconnected to high-flow insufflation line <NUM>. In other examples, however, high-flow Luer-type connector <NUM> is packaged separately from high-flow insufflation line <NUM> and is configured to be connected to an insufflation line, e.g., line <NUM>. Locking collar <NUM> includes coupling portion <NUM>, which can include, for example, threads, lugs, or another locking mechanism. High-flow female Luer-type fitting <NUM> includes inner female sealing surface <NUM>. Inner sealing surface <NUM> of female Luer-type fitting <NUM> is a female tapered surface, the diameter of which increases as inner sealing surface <NUM> extends toward the free end of female Luer-type fitting <NUM>. In <FIG>, the diameter of inner sealing surface <NUM> decreases as it extends onto and into sealing engagement with high-flow fitting portion <NUM>.

Locking collar <NUM> is configured to be coupled to high-flow fitting portion <NUM> via first coupling portion <NUM>. For example and as depicted in <FIG>, coupling portion <NUM> of locking collar <NUM> is threadedably engaged to first coupling portion <NUM> of high-flow fitting portion <NUM>. As locking collar <NUM> is threaded onto first coupling portion <NUM>, high-flow Luer-type connector <NUM> including high-flow Luer-type fitting <NUM> is drawn into engagement with fitting portion <NUM>, and, in particular, female inner sealing surface <NUM> of Luer-type fitting <NUM> is drawn into sealing engagement with female inner sealing surface <NUM> of high-flow fitting portion <NUM>.

In the example of <FIG> in which high-flow fitting portion <NUM> of insufflation fitting <NUM> in accordance with the present invention is fit to high-flow Luer-type connector <NUM> and associated high-flow Luer-type fitting <NUM>, the minimum inner diameter of low-flow fitting portion <NUM> limits the flow (rate and/or volume) of insufflation gas. In particular and as depicted in <FIG>, the inner diameter of low-flow fitting portion <NUM>, which is the minimum diameter of second internal sealing surface <NUM> limits insufflation flow. As noted above, in the example of <FIG>, the inner diameter of low-flow Luer-type fitting <NUM> limits insufflation flow. Because the minimum inner diameter of second internal sealing surface <NUM> is larger than the inner diameter of low-flow Luer-type fitting <NUM>, larger insufflation flow is possible with high-flow fitting portion <NUM> of insufflation fitting <NUM> coupled to high-flow Luer-type connector <NUM> (<FIG>) than with low-flow fitting portion <NUM> coupled to low-flow Luer-type connector <NUM>.

Persons of skill in the art will understand that any of the features described above may be combined with any of the other example features, as long as the features are not mutually exclusive. All possible combinations of features are contemplated, depending on clinical or other design requirements. In addition, if manipulating system units are combined into a single system (e.g., telesurgery system), each individual unit may have the same configuration of features, or, one patient-side unit may have one configuration of features and another patient-side unit may have a second, different configuration of features.

The examples (e.g., methods, systems, or devices) described herein may be applicable to surgical procedures, non-surgical medical procedures, diagnostic procedures, cosmetic procedures, and non-medical procedures or applications. The examples may also be applicable for training, or for obtaining information, such as imaging procedures. The examples may be applicable to handling of tissue that has been removed from human or animal anatomies and will not be returned to a human or animal, or for use with human or animal cadavers. The examples may be used for industrial applications, general robotic uses, manipulation of non-tissue work pieces, as part of an artificial intelligence system, or in a transportation system.

The drawings show, by way of illustration, specific embodiments in which the invention may be practiced. Such embodiments may include elements in addition to those shown or described. But, the present inventors also contemplate embodiments in which only those elements shown or described are provided.

In this document, the terms "including" and "in which" are used as the plain-English equivalents of the respective terms "comprising" and "wherein," Also, in the following claims, the terms "including" and "comprising" are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim.

Geometric terms, such as "parallel", "perpendicular", "round", or "square", are not intended to require absolute mathematical precision, unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "round" or "generally round", a component that is not precisely circular (e.g., one that is slightly oblong or is a many-sided polygon) is still encompassed by this description. Coordinate systems or reference frames are provided for aiding explanation, and implantations may use other reference frames or coordinate systems other than those described herein.

Claim 1:
A medical device (<NUM>) comprising:
a device body (<NUM>) and an insufflation fitting (<NUM>) coupled to and extending from the device body (<NUM>);
the insufflation fitting (<NUM>) comprising an annular high-flow fitting portion (<NUM>) extending away from the device body (<NUM>), an annular low-flow fitting portion (<NUM>) extending away from the annular high-flow fitting portion (<NUM>), and a single flow passageway (<NUM>), the single flow passageway defining a flow path for insufflation gas through the insufflation fitting (<NUM>) into the device body (<NUM>);
the annular high-flow fitting portion (<NUM>) comprising:
a first inner surface;
a radially outward sealing surface (<NUM>) generally reverse from the first inner surface;
a second radially outer surface (<NUM>) offset axially from the radially outward sealing surface toward the device body; and
a coupling portion (<NUM>) on the second radially outer surface;
the annular low-flow fitting portion (<NUM>) comprising:
an inner sealing surface (<NUM>);
a first radially outward surface (<NUM>) generally reverse from the inner sealing surface (<NUM>); and
a coupling portion (<NUM>) on the first radially outer surface;
the first inner surface of the annular high-flow fitting portion and the inner sealing surface (<NUM>) of the annular low-flow fitting portion (<NUM>) defining the single flow passageway (<NUM>);
a low-flow connector (<NUM>) comprising a radially outer male sealing surface (<NUM>) configured for sealing engagement with the inner sealing surface; and
a high-flow connector (<NUM>) configured to surround the annular low-flow fitting portion and comprising an inner female sealing surface (<NUM>) configured for sealing engagement with the radially outward sealing surface of the annular high-flow fitting portion.