Patent Description:
The subject application relates to an endoscope cleaning system.

In a selected procedure, a viewing instrument may be used to view a portion of a subject. For example, a scope may be used to view a portion of a nasal cavity during a selected procedure, such as a debridement or resection thereof. The scope may be passed through a nasal portion into a sinus cavity and/or to view the nasal cavity. The scope, therefore, may be used by the user, such as a surgeon, to view internal portions of a subject.

The scope, however, may become covered with material that is removed from the subject during a procedure. The material may include tissue, blood, and other material. Therefore, viewing through the scope may be obstructed during a procedure. The user may, therefore, be required to remove the scope from the subject and clean the scope to allow for appropriate viewing of the surgical area.

While current endoscope cleaning systems are suitable for their intended use, they are subject to improvement. An example of a cleaning system according to the preamble of claim <NUM> is disclosed in <CIT>. With current systems, after about only <NUM> to <NUM> seconds of debrider operation in a two to four hour surgery, the lens of the scope must be cleaned. As a result, a surgeon will typically have to pause the surgery, look down to the floor to find a lens cleaning button, press the button with his or her foot, and wait for the lens to be cleaned in the middle of a surgical procedure. This slows the surgery and undesirably adds to the surgeon's workload during surgery. The present disclosure includes an improved endoscope cleaning system that provides numerous advantages and unexpected results, as explained in detail herein and as one skilled in the art will appreciate.

The present disclosure provides for a method for cleaning an endoscope during a surgical procedure performed with a surgical instrument. The method not falling under the scope of the claims includes: measuring with a processor module an aggregate activation time of the surgical instrument during the surgical procedure; and activating an endoscope cleaning system with the processor module to clean a lens of the surgical instrument after the processor module determines that the measured aggregate activation time of the surgical instrument has reached a target duration.

The present invention as defined in independent claim <NUM> provides an intraoperative surgical cleaning system configured for use during a surgical procedure including a surgical instrument. The system has an endoscope, a sheath, a pump, and a processor module. The endoscope includes a scope tube with a lens at a distal end thereof. The sheath assembly includes a sleeve tube configured to receive the scope tube of the endoscope therein. The pump is configured to pump a lens cleaning solution to the lens through passages defined between the scope tube and the sleeve tube for cleaning the lens. The processor module is configured to: measure an aggregate activation time of the surgical instrument during the surgical procedure; and activate the pump to clean the lens of the endoscope ins eminent after the aggregate activation time of the surgical instrument reaches a target duration.

In embodiments, the surgical instrument is provided and is any one of a debrider, a drill, a mill, or a cauterizer.

In embodiments, the surgical procedure is a sinus procedure.

In embodiments, the target duration of the aggregate activation time is <NUM> - <NUM> seconds.

In embodiments, the processor module is configured to activate the endoscope cleaning system only after the aggregate activation time of the surgical instrument reaches the target duration and the surgical instrument has been deactivated for a predetermined deactivation period.

In embodiments, the predetermined deactivation period is <NUM> to <NUM> seconds.

In embodiments, during the deactivation period, the speed of the surgical instrument is zero.

In embodiments, the control module is configured to operate the pump for about <NUM> seconds.

In embodiments, the target duration of the aggregate activation time of the surgical instrument is set by the processor module to be equal to an average interval between manual activations of the endoscope cleaning system by a surgeon performing the surgical procedure as determined by the processor module.

With initial reference to <FIG>, a cleansing or cleaning system <NUM> is illustrated. The cleansing system <NUM> may include various portions, including those discussed further herein. The cleansing system <NUM> may include portions for at least one of cleaning, lavage, suction, etc..

Generally, the cleansing system <NUM> may be operated relative to and/or include a selected scope <NUM>. The scope <NUM> may be any appropriate scope, such as an endoscope, laparoscope, or the like. In various embodiments, for example, the scope <NUM> may include an endoscope such as a Sharpsite® endoscope sold by Medtronic, Inc. , and/or Medtronic ENT, having a place of business in Minnesota and/or Florida. It is understood, however, that the scope <NUM> may be any appropriate scope. Further, the scope <NUM> is not required for provision and/or operation of all or parts of the cleansing system <NUM>.

Generally, the scope <NUM> may include a viewing area or portion <NUM> and a lighting portion or connection <NUM>. The lighting portion or section <NUM> may provide light to a distal end or through a scope tube <NUM>. The scope tube <NUM> may include a distal end <NUM> through which a view of a surgical or operational area is made. The distal end <NUM> may include a lens or portion to view through the viewing end <NUM>. The lens or distal portion <NUM> may become obstructed during use, as discussed further herein.

The system <NUM> may further include a sheath assembly <NUM>. The sheath assembly <NUM> may include a scope connection region or portion <NUM>. The scope connection portion <NUM> may include or one or more depressions or passages <NUM> formed between selected projections, such as projections <NUM> and <NUM>. The depression <NUM> may be positioned relative to the scope <NUM>, such as to allow for passage or engagement with the light connection <NUM>. The sheath assembly <NUM>, therefore, may include a plurality of the depressions <NUM> to allow for arrangement of the sheath assembly <NUM> relative to the scope <NUM> and a plurality of positions. As illustrated in <FIG>, the sheath <NUM> may include four depressions, designated 58a, 58b, 58c, and 58d.

The sheath may further include a fluid connection or passage member or portion <NUM>. The fluid connection <NUM> may form or provide paths, as discussed herein, to direct fluid relative to portions of the sheath assembly <NUM>. The sheath assembly <NUM> further includes a scope tube cover <NUM> and a cleaning fluid passage <NUM>. The scope tube cover <NUM> and the cleaning fluid passage <NUM> may both be formed or provided as elongated members extending to a distal end, as discussed. The sheath assembly <NUM> may be positioned relative to the scope <NUM>, as discussed further herein.

The system <NUM> may further include a control assembly or panel <NUM>. The control assembly <NUM> may include various control portions, and/or inputs and/or outputs. In various embodiments, the control assembly <NUM> may include an input screen <NUM>, which may be a touch screen. It is understood that various soft buttons may be displayed on the touch screen <NUM> to allow for input from the user or from a selected user. In various embodiments, various hard buttons may also be provided. The control system may include a processor or processor module <NUM> to execute selected instructions for operation of the system <NUM>, as discussed herein.

In this application, including the definitions below, the term "module" may be replaced with the term "circuit. " The term "module" may refer to, be part of, or include processor hardware (shared, dedicated, or group) that executes code and memory hardware (shared, dedicated, or group) that stores code executed by the processor hardware. The code is configured to provide the features of processor module <NUM> and the endoscope cleaning system <NUM> (<FIG>) described herein. The term memory hardware is a subset of the term computer-readable medium. The term computer-readable medium, as used herein, does not encompass transitory electrical or electromagnetic signals propagating through a medium (such as on a carrier wave); the term computer-readable medium is therefore considered tangible and non-transitory. Non-limiting examples of a non-transitory computer-readable medium are nonvolatile memory devices (such as a flash memory device, an erasable programmable read-only memory device, or a mask read-only memory device), volatile memory devices (such as a static random access memory device or a dynamic random access memory device), magnetic storage media (such as an analog or digital magnetic tape or a hard disk drive), and optical storage media (such as a CD, a DVD, or a Blu-ray Disc).

The inputs may be used to select what operations to perform. Additionally, the control system <NUM> may include selected outputs, such as one or more ports <NUM>. The ports <NUM> may include a power port <NUM> which may include power for the light connection <NUM> to allow for powering a light of the scope <NUM>. The control assembly <NUM> may include the integrated power console or powered console IPC® system, sold by Medtronic, Inc.

The control console <NUM> may also assist in controlling or allowing control of fluid flow through various portions of the sheath <NUM>, as discussed further herein. Accordingly, the console <NUM> may include a pump <NUM> and/or control the pump <NUM>. The control console <NUM> may further include a valve system or portion <NUM>. The pump <NUM> may pump fluid from a source <NUM>, such as a saline bag, fluid storage area, or the like. Nevertheless, the pump <NUM> may pump fluid though a fluid delivery system or assembly <NUM>. The fluid may flow from the source <NUM> through the fluid delivery system <NUM> to one or more ports or connections of the sheath <NUM>. For example, the sheath <NUM> may include a cleaning connection <NUM>. The sheath <NUM> may also or alternately include a lavage or rinsing connection <NUM>. The sheath <NUM> may further interconnect to a suction or vacuum port <NUM> to a suction or vacuum line <NUM> in line with the vacuum line and the vacuum portion <NUM> may be a vacuum canister or collection area <NUM>. It is understood, however, that a collection canister <NUM> is not required. The control system <NUM> may further include the pinch valve or valve assembly <NUM> to selectively control a vacuum through the sheath <NUM>. Thus, the sheath <NUM> may be provide and the system <NUM> operated to move and/or directed selected fluids as discussed herein.

The system <NUM> may include selected control mechanisms, including those discussed above such as the touch screen <NUM>. In various embodiments, however, the system <NUM> may further include inputs or additional and/or alternative inputs <NUM>. The input <NUM> may include a foot switch, hand switch, or the like. The input <NUM>, for example, may be operated by a user to select one or more operations of the system <NUM>, as discussed further herein.

Turning reference to <FIG>, the scope and sheath system <NUM> may be used to view an area within a subject <NUM>. For example, the scope <NUM> having the sheath assembly <NUM> positioned relative thereto may be passed into a nostril <NUM> of the subject <NUM>. The scope <NUM> may be used to view the interior of the nostril through the scope <NUM>. A user <NUM> may hold the scope <NUM> and/or the sheath assembly <NUM>. As discussed further herein, the user <NUM> may use any of the selected inputs, such as the input <NUM>, to operate the control system or controller <NUM> to irrigate a portion within the subject <NUM>, suction within the subject <NUM>, and/or cleanse the lens or terminal end <NUM> of the scope <NUM>. The user <NUM>, therefore, may perform a procedure within the subject <NUM> efficiently and effectively with the assistance of cleaning an area within the subject <NUM>, cleaning or rinsing a portion of the scope <NUM>, and/or removing a portion of material from within the subject <NUM>. It is understood, however, that at least one of the features need not be provided. For example, the system <NUM> may not provide suction or a vacuum through the sheath <NUM> relative to the scope <NUM>. Nevertheless, the control system <NUM> may provide or deliver a selected liquid or fluid for performing selected portions relative to the subject <NUM>, such as irrigating or lavaging within the subject <NUM> and/or cleaning or cleansing the terminal end <NUM> of the scope <NUM>.

<FIG> illustrates an exemplary surgical operation including a surgical instrument <NUM>. The surgical instrument <NUM> may be any surgical instrument that when used proximate to the scope <NUM> may cause a lens <NUM> (see <FIG>) at the distal end <NUM> of the scope <NUM> to become obstructed by, for example, tissue, blood, liquids, bone debris, etc. Exemplary surgical instruments include, but are not limited to, any suitable debrider, drill, mill, burr, or cauterizer. In the example of <FIG>, the surgical instrument <NUM> is inserted up one nostril <NUM> of the subject <NUM>. The scope tube cover <NUM> and the scope tube <NUM> therein are inserted into the other nostril. As explained herein, the cleaning system <NUM> advantageously cleans the lens at the distal end <NUM> so the surgeon will have a clear view of the surgical site.

The sheath assembly <NUM>, with reference to <FIG>, will be described in further detail here. The sheath assembly <NUM> may include various portions, such as those described above, including the outer scope tube <NUM>. The tube <NUM> may include a wall <NUM> that defines an outer surface <NUM> and an interior surface <NUM>. The inner surface <NUM> may define or form a bore or passage through which the scope body <NUM> may pass. The inner surface <NUM>, therefore, may define a through-bore though the tube <NUM>.

The sheath tube <NUM> may be connected to the connection region <NUM> that includes a first member or tube connection portion <NUM>. The tube connection portion <NUM> may include a distal end or flange <NUM> that defines an internal bore or passage <NUM>. The sheath tube <NUM>, therefore, may be fixed to and/or in the inner bore <NUM>. Generally, a proximal end <NUM> of the sheath tube <NUM> may be connected at or within the bore <NUM> and/or formed therewith. The first member <NUM> may further include a bore <NUM> into which or at which a proximal end <NUM> of the lavage tube <NUM> may be connected. The lavage tube <NUM> may include a wall <NUM> that extends from the proximal end <NUM> to a distal end <NUM>. The lavage tube, therefore, may also define or form a bore or through-bore and passage therethrough. The distal end <NUM> may engage or be received in or is operable with a directing member or portion <NUM> at or near a distal end <NUM> of the sheath tube <NUM>. Further, the lavage tube <NUM> is generally formed or placed exterior to the scope sheath tube <NUM>.

The first connection or directing member <NUM> may further have a plurality of seal engaging regions or portions or seal portions <NUM>, <NUM>, <NUM>. Each of the seal portions <NUM>-<NUM> may seal within or relative to a second fluid directing or member <NUM> of the connection portion <NUM>. Further, in various embodiments, seal members, such as O-rings, may be engaged within the seal regions <NUM>-<NUM>. For example, in various embodiments, seal members <NUM>, <NUM>, and <NUM> may be respectively engaged in the seal regions <NUM>-<NUM>.

The first member <NUM>, therefore, may be received within a bore or passage <NUM> of the second member <NUM>. The bore <NUM> may be formed by an outer wall or body portion <NUM> of the second member <NUM>. The second member <NUM>, therefore, as discussed further herein, may seal relative to various portions of the first member <NUM>. The second member <NUM> may further include connections for paths formed through and/or by the first member <NUM>, the second member <NUM>, the sheath tube <NUM>, and/or the lavage tube <NUM>. The second member <NUM>, for example, may include the lavage connection <NUM>, the lens cleaning connection <NUM>, and/or the vacuum connection <NUM>.

As discussed further herein, the second member <NUM>, therefore, may provide the direct connections from the sheath assembly <NUM> to the various pumps and/or vacuums as discussed above. The sheath assembly <NUM> may further include the scope engaging portion or scope body engaging portion <NUM>. The scope body engaging portion <NUM> may include one or more of the depressions <NUM> to assist in engaging or holding the sheath assembly <NUM> relative to the scope <NUM>. The scope engaging portion <NUM> may further include a through bore <NUM> that is formed or defined near a proximal end of the body <NUM>. A sealing member, such as an O-ring <NUM>, may be sealed between the first member <NUM> and a wall <NUM> of the scope engaging portion <NUM>. As discussed further herein, therefore, the scope tube <NUM> may pass through the bore <NUM> and be sealed relative to the first and second fluid directing members <NUM>, <NUM> with the seal member <NUM>. As discussed further herein, therefore, fluid will generally not pass toward or near the light directing portion or light post <NUM> of the scope assembly <NUM>.

With continuing reference to <FIG>, and further reference to <FIG>, the fluid directing portion <NUM> is illustrated in detail with the scope tube <NUM> passing through the fluid directing area or portion <NUM> and the sheath tube <NUM>. The scope tube <NUM> may be passed through the fluid directing portion <NUM>, as discussed above. The fluid directing portion <NUM> includes the internal or first member <NUM> and the external or second member <NUM>. The sealing portion <NUM>-<NUM> may separate to seal various portions of the fluid directing area <NUM> relative to one another. Accordingly, as illustrated in <FIG>, the various connection hubs or portions may be connected to fluid transfer lines. The fluid transfer lines may include a lavage transfer line <NUM> that may be connected to the lavage connection <NUM>. Further, a fluid collection line <NUM> may be connected to the lens cleaning barb or connection <NUM> and a third fluid connection <NUM> may be connected to the vacuum connection <NUM>.

As illustrated in <FIG>, the lavage connection <NUM> connected to the inlet <NUM> may be provided or provide fluid through an internal passage or path <NUM> formed in the second connector member <NUM>. With continuing reference to <FIG> and additional reference to <FIG>, the internal passage <NUM> may be provided in various configurations, such as a substantially vertical and/or angled configuration. Regardless, the internal passage <NUM> may direct fluid to a second passage region <NUM> that may be formed or defined between the external or second fluid directing member <NUM> and the first directing member <NUM>. The passage <NUM> may be formed or defined as a space between the two members <NUM>, <NUM>. Further, the sealing member or portions <NUM>, <NUM> may further define or assist in defining the region. The first directing member <NUM> may also include a passage or through area that connects to an internal bore <NUM> that may receive the proximal end <NUM>. The lavage tube <NUM> may then allow fluid to pass through the lavage tube <NUM>, such as in a through bore or cannula formed therein. Accordingly, fluid may be provided from a fluid source, such as the source <NUM> and pumped through the pump <NUM> through the inlet tube <NUM>. The various connections and passaged in the fluid directing members <NUM>, <NUM> allow the fluid to then be directed to the proximal end <NUM> of the lavage tube <NUM>.

With continuing reference to <FIG> and <FIG>, and additional reference to <FIG>, the lavage tube <NUM> may include or define an internal cannula or passage <NUM> that allows fluid to pass therethrough. The lavage tube <NUM> may then be held or terminate in a directing portion or section <NUM> of the sleeve assembly <NUM>. As illustrated in <FIG>, the scope tube <NUM> may be positioned within the sleeve tube <NUM>. The lavage tube <NUM> is provided external to, or away from, the scope tube <NUM>. Therefore, the lavage tube <NUM> may generally be positioned off-axis of the scope tube. Generally, the scope tube <NUM> may extend along an axis <NUM>. The lavage tube <NUM> may extend along an axis <NUM>. As illustrated in <FIG>, therefore, the axis <NUM> and <NUM> may be substantially spaced part but parallel along a path thereof. In various embodiments, however, as discussed herein, the scope <NUM>, such as the distal end <NUM>, thereof, may be formed of an angle relative to the axis <NUM>. Nevertheless, the lavage tube <NUM> may be provided a distance, such as a distance <NUM> from the central axis <NUM> of the scope tube <NUM>.

The flow directing portion <NUM>, as illustrated in <FIG>, may further allow or direct fluid relative to the scope tube <NUM>, such as within the sleeve tube <NUM>. Turning reference to <FIG>, for example, the lens cleaning connection <NUM> that is connected to the lens cleaning tube <NUM>, may have fluid provided therethrough, such as by operation of the pump <NUM>. It is understood that the control system <NUM> may include two pumps, such as a first and second pump to operate separately for the lavage and/or the lens cleaning as discussed further herein. In an alternative and/or additionally thereto, the single pump <NUM> may be sequentially operated to provide for lavage through the lavage tube <NUM> and/or for lens cleaning.

With continuing reference to <FIG> and additional reference to <FIG>, the lens cleaning connection <NUM> connected to the supply line <NUM> may provide or direct fluid through a lens cleaning passage or path <NUM> (<FIG>) in the second member <NUM>. The fluid may then be directed through the lens cleaning passage <NUM> in the first member through a lens cleaning passage <NUM> in the first member <NUM>. The passage <NUM> may then direct fluid through passages of spaces formed by the internal wall <NUM> of the sleeve tube <NUM> and the outer wall 36w of the scope tube <NUM>. In various embodiments, for example, a first space or passage <NUM> may be formed relative to the scope tube wall 36w and a second passage <NUM> may also be formed relative to the scope wall 36w. The passages <NUM>, <NUM> may be formed between the internal wall surface <NUM> of the sleeve tube <NUM> and the external wall surface 36w of the scope tube <NUM>. The passages <NUM>, <NUM> allow fluid, such as lens cleaning fluid, to pass in the spaces <NUM>, <NUM> to or toward the distal end <NUM> of the scope tube <NUM> and the distal end <NUM> of the sleeve tube <NUM>. It is understood that any appropriate number of the passages <NUM>, <NUM> may be provided and may be formed based upon or in a selected geometry of the internal surface <NUM> of the sleeve tube wall <NUM>. Regardless, the fluid may flow from the proximal end <NUM> of the sleeve tube to the distal end <NUM>. At the distal end the fluid may engage or pass the distal end <NUM> of the scope tube <NUM>. As the fluid passes the distal end <NUM> of the scope tube <NUM>, the fluid may cleanse the distal end <NUM>. The distal end <NUM> may include a lens or objective portion of the scope <NUM> and, therefore, cleaning the distal end <NUM> may assist in viewing the area of the subject <NUM>.

In various embodiments, the fluid directing portion <NUM> may further include the vacuum connection <NUM>. The third fluid line <NUM> may, therefore, be connected to the vacuum source or suction source <NUM>. The system <NUM> may operate the valve <NUM> to open the valve and allow access of the vacuum connection <NUM> to the vacuum <NUM> through the connection line <NUM>.

The vacuum connection <NUM> may be connected to or directed through a passage or path <NUM> formed in the second connection portion or directing portion <NUM>. The internal passage <NUM> may also pass through the connection or passage <NUM> formed in the first directing member <NUM>. The bore <NUM> may be formed in the first directing member <NUM> between the seal portions <NUM>, <NUM>. A channel may be formed in the first directing member <NUM> to allow the through portion <NUM> to have access or act upon the entire volume defined between the seal portions <NUM>, <NUM> and the first directing member <NUM> and the second directing member <NUM>. Therefore, the fluid through the tube or line <NUM> may pass through the bore <NUM> and the vacuum formed through the vacuum tube <NUM> may also pass through the bore <NUM>.

As the vacuum may be formed through the bore <NUM>, the vacuum may also be formed through the passages or spaces <NUM>, <NUM>, as discussed above. Therefore, the passages <NUM>, <NUM> may be provided to either direct a fluid toward the distal end <NUM> of the scope tube <NUM> and/or the distal end <NUM> of the sleeve tube <NUM> and/or used to draw a vacuum relative to the distal ends <NUM>, <NUM>. The directing portion <NUM>, therefore, may be provided to direct both a fluid to the distal end <NUM> of the sleeve tube <NUM> and/or a vacuum relative to the distal end <NUM> of the sleeve tube <NUM>.

The sleeve tube <NUM> may be fixed to the first directing member <NUM>, as discussed above. The first directing member <NUM> may also be fixed or connected to the scope attaching body <NUM>. As discussed above, the scope attaching body <NUM> may be fixed relative to the scope <NUM>, such as through the positioning of the light tube or light source <NUM> with the passage or depression <NUM>. The various supply lines <NUM>-<NUM>, however, may be connected to the control assembly <NUM> or portions relative thereto. Therefore, during use of the scope <NUM>, the user <NUM> may attempt to move or manipulate the scope <NUM> for viewing selected portions of the subject <NUM>. The seals and seal portions of the first member <NUM> relative to the second directing member <NUM> may allow the second directing member <NUM> to rotate relative to the first directing member <NUM>. That is, during use the passages from the supply lines <NUM>-<NUM> to the selected portions, such as the lavage tube <NUM> and/or the passages <NUM>, <NUM> through the sleeve tube <NUM>, may be maintained while the second directing member <NUM> is able to rotate, such as generally in the direction of the double headed arrow <NUM>, relative to the first directing member <NUM> and the axis <NUM>. Therefore, the supply lines <NUM>-<NUM> may be positioned for efficient or ease of operation of scope <NUM>.

The sleeve assembly <NUM>, as discussed above, may be used with the scope assembly <NUM>, as also discussed above. With continuing reference to <FIG>, and with further reference to <FIG>, the scope tube <NUM> may include the distal end <NUM> that is positioned within the sleeve tube <NUM>. As discussed above, the axis <NUM> of the scope tube <NUM> may be aligned or parallel with the access <NUM> of the lavage tube <NUM>. The directing portion <NUM> may include a directing port <NUM> that is also substantially aligned with the axis <NUM>. Therefore, lavage fluid directed through the directing port <NUM> may be substantially aligned with the axis <NUM>. As the terminal end <NUM> is substantially perpendicular to the axis <NUM>, the area for lavage may generally be defined by the cone <NUM> and is generally substantially viewable or directly in front of the viewing area of the terminal end <NUM>.

With continuing reference to <FIG> and additional reference to <FIG>, however, in various embodiments, the scope tube <NUM> may have a terminal end <NUM>' that extends along a plane or axis <NUM> that defines an obtuse angle <NUM> relative to the axis <NUM> of the scope tube <NUM>. The angle <NUM> may be an obtuse angle, as illustrated in <FIG>. It is understood that the angle <NUM> may be any appropriate angle such as <NUM>°, <NUM>°, or generally between <NUM>° and about <NUM>°.

The lavage tube <NUM> may also generally extend along the axis <NUM> which is parallel with the axis <NUM>. The directing portion <NUM> may include a directing port <NUM>, however, that generally directs the lavage fluid into an area <NUM> that has a central or middle portion <NUM> at an angle <NUM> that acts in concert with the angle <NUM> such that the cone <NUM> is in the viewing area of the distal end <NUM> of the scope <NUM>.

Thus, the directing port <NUM> may be provided to direct the lavage material into an optimal or selected position for cleaning an area being viewed by the terminal end <NUM>, <NUM>'. The directing port may be defined in the directing portion <NUM> and/or may be integrated into the lavage tube <NUM>. Regardless, the lavage tube <NUM> is generally away from or exterior to the sleeve tube <NUM> so as not to obstruct a view of the scope <NUM>, such as the terminal end <NUM>, <NUM>', during lavage or at any other time.

Turning reference to <FIG>, a sleeve assembly <NUM> is illustrated. The sleeve assembly <NUM> may include portions similar to those discussed above and those details will not be repeated here. The sleeve assembly <NUM>, however, may include alternative or additional portions, which will be discussed here. Briefly, therefore, the sleeve assembly <NUM> may include the sleeve tube <NUM> and the lavage tube <NUM>. The sleeve tube may include the directing portion <NUM> at or near the terminal end <NUM>. Further the sleeve tube <NUM> may include the proximal end <NUM>. The sleeve assembly <NUM> may further include the scope engaging portion or member <NUM> that may engage or be connected with the scope <NUM>. The scope <NUM> may include portions substantially similar to those as discussed above.

The sleeve assembly <NUM>, however, may include a fluid directing portion <NUM>. The fluid directing portion <NUM> may include an external directing portion <NUM> and an internal directing portion <NUM>. The external directing portion may include a first connection of a lavage connection <NUM> and a lens cleansing connection <NUM>. The fluid directing portion <NUM>, therefore, may not include a vacuum or suction connection. The fluid directing portion <NUM> may include passages and seals similar to the fluid directing portion <NUM>, as discussed above. However, the external portion <NUM> may include one less connection as opposed to the external or second portion <NUM> as discussed above. The first or internal portion <NUM> may include portions that are substantially similar or identical to the first directing member <NUM> as discussed above. For example, to allow for passage of the lens cleansing material through the passages <NUM>, <NUM> formed between the internal surface <NUM> of the sleeve tube <NUM> and the wall 36w of the scope tube <NUM>. Similarly, the fluid directing portion <NUM> may include passage portions to allow passage of the lavage fluid therethrough to the lavage tube <NUM>. Accordingly, the sleeve assembly <NUM> may not include a suction or vacuum passage but only include the fluid input or directing portions, as discussed above.

Accordingly, the sleeve assembly, according to various embodiments, may include selected directing portions. The sleeve assembly may include all of a lavage path, a lens-cleaning path, and a suction path. In various embodiments, the sleeve assembly may define only a lavage pathway and a lens-cleaning pathway without a suction pathway. Further, it is understood that the sleeve assembly may also define only a lavage pathway and a suction pathway without a separate lens-cleaning pathway. Therefore, the passages <NUM>, <NUM> may be provided to only create or allow passage of suction without also directing fluid or passing fluid therethrough.

<FIG> illustrates an exemplary cleaning method <NUM> in accordance with the present disclosure for cleaning an instrument, such as an endoscope, during surgery. For example, the cleaning method <NUM> may be used to clean the lens <NUM> at the distal end <NUM> of the scope <NUM>. The cleaning method <NUM> may be performed using the cleaning system <NUM> described above, or any other suitable cleaning system as well. The cleaning method <NUM> is described herein as using the cleaning system <NUM> to clean the lens <NUM> of the scope <NUM> for exemplary purposes only.

With initial reference to block <NUM> of <FIG>, the cleaning method <NUM> generally begins when the surgeon starts any suitable surgical procedure including the surgical instrument <NUM> and a scope, such as the scope <NUM>. Suitable surgical procedures include, but are not limited to, the following: debridement; cutting; drilling; etc. <FIG> illustrates an exemplary sinus surgical procedure including the scope <NUM> and the surgical instrument <NUM>.

From block <NUM>, the method <NUM> proceeds to block <NUM>. At block <NUM>, the surgeon activates the surgical instrument <NUM>, such as by stepping on the center pedal <NUM> of the input <NUM>. When activated, the surgical instrument <NUM> will rotate or otherwise actuate at a particular speed, such as a speed measured in revolutions per minute. With reference to block <NUM>, from time to time during the surgical procedure, the surgeon will typically deactivate the surgical instrument <NUM>, such as by lifting his/her foot off of the center pedal <NUM>. During such periods of deactivation, the surgeon may manually activate the cleaning system <NUM> to clean the lens <NUM> of the scope <NUM> by pressing the first side pedal <NUM> (or in some applications the second side pedal <NUM>). In response to the surgeon pressing the first side pedal <NUM> (or second side pedal <NUM>), the processor module <NUM> is configured to activate the pump <NUM> to direct cleaning solution to the lens <NUM>, as described above. The processor module <NUM> may also be configured and set, such as by the surgeon or other technician, to activate the cleaning system <NUM> for the surgeon so the surgeon is not bothered during surgery with having to manually actuate the first side pedal <NUM> (or the second side pedal <NUM>), as explained below.

From block <NUM>, the method <NUM> proceeds to block <NUM>. At block <NUM>, the processor module <NUM> measures the aggregate activation time of the surgical instrument (during block <NUM>), and determines whether the aggregate activation time has reached a target duration. The target duration may be any suitable duration, such as in the range of <NUM>-<NUM> seconds. The target duration time may be set by the surgeon, such as by way of the input screen <NUM>. The target duration may also be "learned" by the processor module <NUM> based on how often the surgeon manually activates the cleaning system <NUM> by pressing the first side pedal <NUM> (or the second side pedal <NUM>). For example, the processor module <NUM> may be configured in a learning mode during which the processor module <NUM> tracks manual aggregate activation times of the surgical instrument <NUM> before each manual activation of the cleaning system <NUM> by the surgeon. The processor module <NUM> will then set the target duration at block <NUM> to be equal to an average of the manual aggregate activation times.

If the processor module <NUM> determines that the aggregate activation time of the surgical instrument <NUM> is less than the target duration, the method <NUM> returns to block <NUM> from block <NUM>. If at block <NUM> the processor module determines that the aggregate activation time of the surgical instrument <NUM> is greater than the target duration, the method <NUM> proceeds to block <NUM>. At block <NUM>, the processor module <NUM> automatically activates the cleaning system <NUM> based on the parameters of the method <NUM> to clean the lens <NUM>, such as described above. The processor module <NUM> may be set to run the cleaning for any suitable duration, such as for about <NUM> seconds. After the lens <NUM> is cleaned, the method <NUM> returns to block <NUM>.

Between block <NUM> and block <NUM>, the system <NUM> may optionally include block <NUM>. At block <NUM>, the processor module <NUM> determines how long the surgical instrument <NUM> has been deactivated at block <NUM> prior to activating the cleaning system <NUM> at block <NUM>. If the processor module <NUM> determines that the surgical instrument <NUM> has been deactivated for a predetermined deactivation period, then the method <NUM> proceeds to block <NUM>. If the processor module <NUM> determines that the surgical instrument <NUM> has not been deactivated for the predetermined period of time, then the method <NUM> proceeds to block <NUM>. The predetermined deactivation period may be any suitable period of time such that the processor module <NUM> does not activate the cleaning system <NUM> when the surgeon very briefly stops the surgical instrument <NUM> mid-procedure, such as <NUM> to <NUM> seconds at a speed of zero (<NUM> rpm).

The present disclosure thus advantageously provides for the improved cleaning system <NUM> and cleaning method <NUM> for cleaning a lens <NUM> of a scope <NUM> during surgery, which cleans the lens <NUM> without the surgeon having to manually press a foot pedal (such as first or second side pedals <NUM>, <NUM>) or another button during the surgery. The present disclosure thus lightens the surgeon's workload.

The same may also be varied in many ways within the scope of the invention as defined by the claims.

Claim 1:
An intraoperative surgical cleaning system configured for use during a surgical procedure including a surgical instrument, the system comprising:
a surgical instrument (<NUM>);
an endoscope (<NUM>) including a scope tube (<NUM>) with a lens (<NUM>) at a distal end (<NUM>) thereof;
a sheath assembly (<NUM>) including a sleeve tube (<NUM>) configured to receive the scope tube of the endoscope therein;
a pump (<NUM>) configured to pump a lens cleaning solution to the lens through passages (<NUM>, <NUM>) defined between the scope tube and the sleeve tube for cleaning the lens; and
a processor module (<NUM>);
characterized in that the processor module is configured to
measure an aggregate activation time of the surgical instrument during the surgical procedure; and
activate the pump to clean the lens of the endoscope after the aggregate activation time of the surgical instrument reaches a target duration.