Patent Description:
The subject invention is directed to endoscopic surgery, and more particularly, to a surgical gas circulation system with multi-lumen tube set connected with a single lumen gas sealed access port and a single lumen valve sealed access port for use during an endoscopic or laparoscopic surgical procedure.

Laparoscopic or "minimally invasive" surgical techniques are becoming commonplace in the performance of procedures such as cholecystectomies, appendectomies, hernia repair and nephrectomies. Benefits of such procedures include reduced trauma to the patient, reduced opportunity for infection, and decreased recovery time. Such procedures within the abdominal (peritoneal) cavity are typically performed through a device known as a trocar or cannula, which facilitates the introduction of laparoscopic instruments into the abdominal cavity of a patient.

Additionally, such procedures commonly involve filling or "insufflating" the abdominal cavity with a pressurized fluid, such as carbon dioxide, to create an operating space, which is referred to as a pneumoperitoneum. The insufflation can be carried out by a surgical access device, such as a trocar, equipped to deliver insufflation fluid, or by a separate insufflation device, such as an insufflation (veress) needle. Introduction of surgical instruments into the pneumoperitoneum without a substantial loss of insufflation gas is desirable, in order to maintain the pneumoperitoneum.

During typical laparoscopic procedures, a surgeon makes three to four small incisions, usually no larger than about twelve millimeters each, which are typically made with the surgical access devices themselves, often using a separate inserter or obturator placed therein. Following insertion, the obturator is removed, and the trocar allows access for instruments to be inserted into the abdominal cavity. Typical trocars provide a pathway to insufflate the abdominal cavity, so that the surgeon has an open interior space in which to work.

The trocar must also provide a way to maintain the pressure within the cavity by sealing between the trocar and the surgical instrument being used, while still allowing at least a minimum amount of freedom of movement for the surgical instruments. Such instruments can include, for example, scissors, grasping instruments, and occluding instruments, cauterizing units, cameras, light sources and other surgical instruments. Sealing elements or mechanisms are typically provided on trocars to prevent the escape of insufflation gas from the abdominal cavity. These sealing mechanisms often comprise a duckbill-type valve made of a relatively pliable material, to seal around an outer surface of surgical instruments passing through the trocar.

SurgiQuest, Inc. , a wholly owned subsidiary of ConMed Corporation has developed unique gas sealed surgical access devices that permit ready access to an insufflated surgical cavity without the need for conventional mechanical valve seals, as described, for example, in <CIT>. These devices are constructed from several nested components including an inner tubular body portion and a coaxial outer tubular body portion. The inner tubular body portion defines a central lumen for introducing conventional laparoscopic surgical instruments to the abdominal cavity of a patient and the outer tubular body portion defines an annular lumen surrounding the inner tubular body portion for delivering insufflation gas to the abdominal cavity of the patient and for facilitating periodic sensing of abdominal pressure.

While these earlier developed dual lumen gas sealed access devices provide significant benefits and improvements over conventional single lumen valve sealed access devices, they do present certain disadvantages in the performance of a laparoscopic surgical procedure. In particular, because these earlier developed dual lumen gas sealed access devices are constructed with two coaxial tubular body portions, the effective outer diameter of the tubular body of the access device is significantly greater than the effective outer diameter of the tubular body of a conventional single lumen valve sealed access device.

For example, the outer diameter of the dual lumen gas sealed access device may be at least <NUM> greater than the outer diameter of a conventional single lumen valve sealed access device. Consequently, the length of the incision that is required to introduce the dual lumen access device into the abdominal cavity will be greater than the typical incision that is made for introducing a conventional single lumen valve sealed access device. This larger incision can increase the degree of patient trauma, cause larger and more visible scars for the patient, more pain or pain medication, and more difficult wound closure for the surgeon.

It would be beneficial therefore to provide a gas sealed surgical access device that overcomes the disadvantages associated with earlier developed dual lumen gas sealed access devices, such as those disclosed in <CIT>, while maintaining the substantial benefits they provide over conventional single lumen valve sealed access devices. The subject invention provides such a novel access device and a filtered tube set for the device for use in endoscopic surgery, which is described in detail herein below.

<CIT> discloses systems for insufflation and recirculation of insufflation fluid in a surgical procedure that include a control unit having a fluid pump, a supply conduit, a return fluid conduit and a pressure-controlled valve. The pressure-controlled valve is in fluid communication with an insufflation gas supply, the supply conduit and the return conduit and is adapted and configured to respond to pressure control signals to adjust position and thereby system flow parameters, to reduce entrainment of air from the surrounding environment, and to increase the concentration of insufflation gas in an operative space, and/or to reduce an overpressure condition in the operative space.

The subject invention is directed to a new and useful system for performing an endoscopic or laparoscopic surgical procedure in a surgical cavity of a patient. The subject invention is defined by the combination of features of the independent claim <NUM>.

The dependent claims contain advantageous embodiments of the invention No surgical methods are claimed.

The system includes a multi-lumen tube set including a dual lumen portion and a single lumen portion. The dual lumen portion of the tube set has a pressurized gas line and a return gas line, which together facilitate gas recirculation relative to the surgical cavity of the patient. The single lumen portion of the tube set has a gas supply and sensing line for delivering insufflation gas to the surgical cavity of the patient and for periodically sensing pressure within the surgical cavity of the patient. Preferably, the tube set is operatively associated with a multi-path filter cartridge assembly.

The system further includes a first access port having a proximal housing portion and an elongated tubular body portion extending distally from the proximal housing portion and defining a central cannula or bore. The proximal housing portion of the first access port has an inlet path for communicating with the pressurized gas line of the tube set and an outlet path for communicating with the return gas line of the tube set. The proximal housing portion accommodates an annular jet assembly for receiving pressurized gas from the inlet path and for generating a gaseous sealing zone within the central cannula of the body portion to maintain a stable pressure within the surgical cavity of the patient.

The system also includes a second access port having a proximal housing portion and a tubular body portion extending from the proximal housing portion. The proximal housing portion of the second access port accommodates a mechanical valve for sealing the tubular body portion and an inlet path for communicating with the gas supply and sensing line of the tube set.

Preferably, the first access port is adapted and configured to perform smoke evacuation from the surgical cavity of the patient in conjunction with the second access port. In one embodiment, the first access port is adapted and configured to permit air entrainment, emergency relief of cavity pressure and instrument access into the central cannula during a surgical procedure. In another embodiment, the first access port is adapted and configured to permit air entrainment and emergency relief of cavity pressure, but without permitting instrument access into and/or through the central cannula. In this regard, the central bore of the cannula may be shaped, dimensioned, louvered or otherwise configured to prevent instrument access therethrough.

In another embodiment, the first access port includes a proximal housing portion that is adapted to be selectively coupled with the tubular body portion thereof, and wherein the tubular body portion is configured for manipulation by a robotic surgical system, such as, for example, Da Vinci robotic system manufactured by Intuitive Surgical, Inc. For example, the proximal housing portion may be selectively coupled to the tubular body portion by a pair of diametrically opposed cantilevered or spring loaded locking tabs or the like. The locking tabs can be provided on the proximal housing portion or on the tubular body portion. The tubular body portion would include a grasping flange for enabling a robotic manipulator to grasp and move the abdominal port during a surgical procedure.

Alternatively, in this embodiment, the first access port includes a proximal housing portion that is adapted to be selectively coupled with the tubular body portion thereof, wherein the tubular body portion is of a proprietary design, or wherein the tubular body portion is of a non-proprietary design.

In accordance with a preferred embodiment, the proximal housing portion includes a manifold defining the gas inlet path and the gas outlet path for the access port. Preferably, the inlet and outlet paths are concentrically arranged within the manifold, and the dual lumen portion of the tube set includes a coaxial connector for coupling with the manifold. Alternatively, the inlet and outlet paths are arranged in parallel within the manifold, and the dual lumen portion of the tube set includes a suitable connector for coupling with the manifold. In comparison, the single lumen portion of the tube set can include a luer type connector for coupling with a conventional luer type fitting associated with the inlet path of the second access port.

The system further includes a gas recirculation apparatus including a pump having an outlet for delivering pressurized gas to the tube set and an inlet for receiving depressurized gas from the return line of the tube set through the filter cartridge assembly. The apparatus is also configured to deliver insufflation gas to the gas supply and sensing line of the tube set from a gas source, as disclosed, for example, in commonly assigned <CIT>. In accordance with a preferred embodiment, the gas recirculation apparatus may include a programmable controller with software that is adapted and configured to detect the presence of the bifurcated multi-lumen tube set and is able to differentiate it from a different type tube set.

The disclosure is also directed to a surgical access port for performing an endoscopic surgical procedure in a surgical cavity of a patient, which includes a proximal housing portion and an elongated tubular body portion extending distally from the proximal housing portion and defining a central cannula or bore. The proximal housing portion has an inlet path for communicating with a pressurized gas line of a tube set and an outlet path for communicating with a return gas line of the tube set. The proximal housing portion accommodates an annular jet assembly for receiving pressurized gas from the inlet path and for generating a gaseous sealing zone within the central cannula of the body portion to maintain a stable pressure within the surgical cavity of the patient.

The disclosure is also directed to a multi-lumen tube set for performing an endoscopic surgical procedure in a surgical cavity of a patient, which includes a multi-path filter cartridge assembly, a dual lumen portion communicating with the filter cartridge assembly and having a pressurized gas line and a return gas line for facilitating gas recirculation relative to the surgical cavity of the patient, and a single lumen portion communicating with the filter cartridge assembly and having a gas supply and sensing line for delivering insufflation gas to the surgical cavity of the patient and for periodically sensing pressure within the surgical cavity of the patient. Preferably, the dual lumen portion of the tube set includes a unique coaxial connector, and the single lumen portion of the tube set can include a conventional luer type connector.

The disclosure is also directed to a method of retrofitting a separable two-part valve sealed surgical access port to perform an endoscopic surgical procedure in a surgical cavity of a patient. The method includes the step of obtaining a separable two-part surgical access port having a valve sealed proximal housing portion that is detachably engaged to a single lumen tubular body portion.

The method further incudes the steps of detaching the valve sealed proximal housing portion from the single lumen tubular body portion and then attaching a gas sealed proximal housing portion to the single lumen tubular body portion, wherein the tubular body portion may be configured for manipulation by a robotic surgical system. The method further includes the step of connecting the gas sealed proximal housing portion to a source of pressurized gas for generating a gaseous sealing zone within a central cannula of the single lumen tubular body portion to maintain a stable pressure within the surgical cavity of the patient.

The disclosure is also directed to a method of retrofitting a reusable portion of a separable two-part valve sealed surgical access port to perform an endoscopic surgical procedure in a surgical cavity of a patient. The method includes the step of obtaining a reusable portion of a surgical access port normally having a valve sealed proximal housing portion that is detachably engaged to a reusable single lumen tubular body portion.

The method further incudes the steps of attaching a gas sealed proximal housing portion to the reusable single lumen tubular body portion, wherein the reusable tubular body portion may be configured for manipulation by a robotic surgical system. The method further includes the step of connecting the gas sealed proximal housing portion to a source of pressurized gas for generating a gaseous sealing zone within a central cannula of the reusable single lumen tubular body portion to maintain a stable pressure within the surgical cavity of the patient.

These and other features of the gas circulation system and the single lumen gas sealed access device will become more readily apparent to those having ordinary skill in the art from the detailed description of the preferred embodiments taken in conjunction with the following brief description of the drawings.

So that those skilled in the art will readily understand how to make and use the gas circulation system and gas sealed abdominal access devices of the disclosure without undue experimentation, preferred embodiments thereof will be described in detail herein below with reference to the figures wherein:.

Referring now to the drawings wherein like reference numerals identify similar structural elements and features, there is illustrated in <FIG> a gas circulation system for performing an endoscopic surgical procedure in a surgical cavity of a patient, and more particularly, for performing a laparoscopic surgical procedure in the abdominal cavity of a patient that is constructed in accordance with a preferred embodiment of the subject disclosure and is designated generally by reference numeral <NUM>.

The gas circulation system <NUM> is specifically designed to cooperate with a programmable multi-modal gas delivery system <NUM>. The gas delivery system <NUM> is of the type described in commonly assigned <CIT>. The gas delivery system <NUM> includes a graphical user interface <NUM> for setting operating parameters and a pump <NUM> for facilitating the recirculation of pressurized gas relative to the surgical cavity of the patient. The gas delivery system <NUM> is connected to a source of surgical gas <NUM> for delivering insufflation gas to the surgical cavity of the patient.

In brief, the gas circulation system <NUM> incudes a multi-lumen filtered tube set <NUM> including a dual lumen portion <NUM> and a single lumen portion <NUM>, a first gas sealed single lumen access port <NUM> operatively connected to the dual lumen portion <NUM> of the tube set <NUM> and a second valve sealed single lumen access port <NUM> operatively connected to the single lumen portion <NUM> of the tube set <NUM>. Each of these components of the gas circulation system <NUM>, and variations thereof, will be described in greater detail herein below.

Referring to <FIG>, the gas circulation system <NUM> includes a multi-lumen filtered tube set designated generally by reference numeral <NUM> that includes a dual lumen portion <NUM> and a single lumen portion <NUM>. The dual lumen portion <NUM> has a pressurized gas line <NUM> and a return gas line <NUM> for facilitating gas recirculation relative to the surgical cavity of the patient. The single lumen portion <NUM> has a gas supply and sensing line <NUM> for delivering insufflation gas to the surgical cavity of the patient and for periodically sensing pressure within the surgical cavity of the patient.

The tube set <NUM> is operatively associated with a multi-path filter cartridge assembly <NUM>. More particularly, the gas lines of the tube set <NUM> extend from a fitting <NUM> on the end cap <NUM> of the filter cartridge assembly <NUM>. A filter cartridge assembly of this type is disclosed for example in commonly assigned <CIT>. The filter cartridge assembly <NUM> is preferably designed for a single use and is thereafter disposable. It is specifically designed to cooperate with the multi-modal gas delivery system <NUM>, illustrated in <FIG> and described in commonly assigned <CIT>.

While not shown here, the filter cartridge assembly <NUM> includes a first filtered flow passage communicating with the pressurized gas line <NUM> of the dual lumen portion <NUM> of the tube set <NUM>, a second filtered flow passage communicating with the return gas line <NUM> of the dual lumen portion <NUM> of the tube set <NUM>, and a third filtered flow passage communicating with the gas supply and sensing line <NUM> of the single lumen portion <NUM> of the tube set <NUM>.

As shown in <FIG>, <FIG>, the single lumen portion <NUM> of the tube set <NUM> includes a standard luer type connector <NUM> for connecting to a luer connection <NUM> on the valve sealed access port <NUM>. The dual lumen portion <NUM> of the tube set <NUM> includes a dual lumen manifold connector <NUM> with coaxial flow passages for mating with a dual lumen manifold connector <NUM> on gas sealed access portion <NUM>. In a preferred embodiment, the dual lumen portion <NUM> of the tube set <NUM> is at least partially formed as a conjoined extrusion, as best seen in <FIG>. Alternatively, as shown in <FIG>, the dual lumen portion <NUM> of tube set <NUM> can be distally bifurcated into two separated gas lines <NUM> and <NUM>, each with a single connector for mating with a correspondingly configured access port manifold, as shown for example in <FIG>.

With continuing reference to <FIG> and <FIG> in conjunction with <FIG>, the circulation system <NUM> includes a gas sealed single lumen access port <NUM> that is adapted and configured to provide gas sealed access to the surgical cavity of a patient during an endoscopic surgical procedure. In this regard, access port <NUM> functions similar to the dual-lumen trocar assembly that is disclosed, for example, in commonly assigned <CIT>. However, access port <NUM> differs significantly from the trocar assembly disclosed in <CIT> in that it has only one central lumen.

The access port <NUM> does not have a second annular lumen surrounding the central lumen, as shown for example in the prior art <FIG>. Thus, access port <NUM> is not capable of delivering insufflation gas to the surgical cavity of a patient, nor is it capable of sensing cavity pressure. Rather, access port <NUM> is configured to provide gas sealed instrument access while facilitating the maintenance of stable cavity pressure and smoke evacuation from the surgical cavity. The access port <NUM> will be described in greater detail below with regard to <FIG>.

Referring now to <FIG>, there is illustrated in more detail the single lumen gas sealed access port <NUM>, which includes a proximal housing portion <NUM> and an elongated tubular body portion <NUM> extending distally from the proximal housing portion <NUM> and defining a central cannula <NUM>. The proximal housing portion <NUM> of access port <NUM> has an inlet path <NUM> for communicating with the pressurized gas line <NUM> of the tube set <NUM> and an outlet path <NUM> for communicating with the return gas line <NUM> of the tube set <NUM>.

More particularly, as best seen in <FIG> and <FIG>, to manage gas flow in the access port <NUM>, the proximal housing portion <NUM> includes a manifold <NUM> defining the inlet path <NUM> and the outlet path <NUM> which are concentrically arranged within the manifold <NUM>. The dual lumen portion <NUM> of the tube set <NUM> includes the coaxial connector <NUM> for coupling with the manifold <NUM> of the proximal housing portion <NUM>, as best seen in <FIG>. A dual lumen coupled connection of this type is disclosed, for example, in <FIG> of commonly assigned <CIT>. Alternatively, the single lumen gas sealed access port <NUM> could have a manifold <NUM> with two independent parallel connectors <NUM> and <NUM>, as shown in <FIG>.

Referring to <FIG> and <FIG>, the proximal housing portion <NUM> of access port <NUM> defines an interior chamber <NUM> to accommodate a two-part annular jet assembly <NUM>, which is best seen in <FIG>. An end cap <NUM> covers the interior chamber <NUM> and defines an entry path for the central cannula <NUM>. The annular jet assembly <NUM> is adapted and configured to receive pressurized gas from the inlet path <NUM> and for generating a gaseous or pneumatic sealing zone within the central cannula <NUM> of the tubular body portion <NUM> to maintain a stable pressure within the surgical cavity of the patient.

Referring to <FIG>, the annular jet assembly <NUM> includes an upper jet ring <NUM> having a nozzle tube <NUM> and a lower jet ring <NUM> defining a nozzle seat <NUM> for receiving the nozzle tube <NUM>. The upper jet ring <NUM> and lower jet ring <NUM> each has an O-ring <NUM> and they are joined together by a plurality of interfitting lugs <NUM>. The annular jet assembly <NUM> is disclosed in great detail in commonly assigned <CIT> and <CIT>.

There are several advantages to employing the gas circulation system <NUM> as compared to a system that utilizes the gas sealed access port disclosed for example in <CIT>. In particular, with respect to the access port <NUM>, by removing the need for both an inner and outer cannula, because of the use of a separate conventional cannula for insufflation and sensing, there is a significant reduction in the effective outer diameter of the tubular body of the access port <NUM>.

<FIG> illustrate this comparison, wherein <FIG> shows the tubular body portion <NUM> and central bore <NUM> of a <NUM> dual lumen gas sealed access device constructed in accordance with the disclosure of <CIT>, which has an effective outer diameter D<NUM> of about <NUM>, whereas <FIG> shows a <NUM> version of the single lumen gas sealed access device <NUM>, which has a tubular body portion <NUM> with an effective outer diameter D<NUM> , for example, of about <NUM>. It should be understood that the respective central bores <NUM>, <NUM> of body portions <NUM>, <NUM> have the same inner diameters.

This significant difference in the effective outer diameter of the single lumen gas sealed access port <NUM> enables surgery with a smaller patient incision, while maintaining similar functionality (i.e., gaseous sealing for instrumentation, stable pneumoperitoneum and smoke evacuation). A smaller incision size can also lead to smaller or invisible scars for the patient, less pain or pain medication, easier wound closure for the surgeon, etc. In addition, the single lumen gas sealed access port <NUM> uses less plastic and has fewer components than the gaseous sealed access port disclosed for example in <CIT>, and the single lumen design eliminates several mating features. This could allow for lower component and assembly costs, as well as more efficient product qualification.

Those skilled in the art will readily appreciate that the tubular body portion <NUM> of the access port <NUM> can be introduced into the abdominal cavity of a patient through the abdominal wall using an inserter or obturator. In this regard, as best seen in <FIG> and <FIG> the end cap <NUM> on the proximal housing <NUM> includes diametrically opposed flanges 78a and 78b which are designed to cooperate with an obturator or introducer of the type described and illustrated in commonly assigned <CIT>. Other types of obturators or introducers could also be utilized for this purpose.

Referring now to <FIG>, while the single lumen gas sealed access port <NUM> described above is adapted and configured to perform gaseous sealing for surgical instrumentation passing therethrough, stable cavity pressure and smoke evacuation of the surgical cavity, as well as being constructed to permit air entrainment and emergency relief of cavity pressure, it is also envisioned and well within the scope of the subject disclosure that an embodiment does not necessarily have to provide instrument access to the surgical cavity, but rather it can be configured as a single lumen gas sealed trocar without an instrument passage.

For example, there is illustrated in <FIG>, a gas sealed trocar <NUM> that is adapted and configured to maintain stable cavity pressure and effect smoke evacuation of a surgical cavity, as well as permit air entrainment and emergency pressure relief, by way of a concentric dual lumen manifold <NUM>, but without permitting instrument access into and through the central cannula bore <NUM> of the body portion <NUM>. In this regard, the central bore <NUM> of the gas sealed trocar <NUM> is covered by a louvered end cap <NUM> on housing portion <NUM> that includes a set of spaced apart slots <NUM>, which physically prevent or otherwise block instrument access into and through the central bore <NUM> of the trocar <NUM>.

Because surgical instruments are not inserted into this gas sealed trocar <NUM>, the inside diameter (and therefore the outside diameter of the device) can be reduced signficantly without sacrificing gaseous sealing functionality, as shown for example in <FIG>, described in more detail below. This can further increase the potential size-based advantages of the port.

A gas sealed trocar of this type can have many alternative embodiments. For example, shown in <FIG> and later described, the trocar device could include a thinner and/or flatter channel or an oblong channel, since the conduit does not have to be cylindrical in order to provide a gaseous seal around cylindrical surgical instruments. This design may allow for clinical advantages as the elliptical or oblong geometry of this embodiment aligns more closely with the linear skin incision made by the surgeon and therefore may provide for easier insertion and less trauma to the tissue surrounding the incision.

The trocar device also does not have to include a straight or longitudinal pathway. For example, as shown in <FIG>, a gas sealed trocar <NUM> with a proximal housing portion <NUM> having a louvered end cap <NUM> and bi-lumen manifold <NUM> could include a non-linear body portion <NUM> that is configured to bend <NUM> degrees from its axis. Ths construction allows for a number of improvements such as anchoring to a patient's abdominal wall during a laparscopic surgical procedure, providing enhanced or user-directed smoke evacuation range and coverage, and eliminating clutter within the working space both inside and outside of the abdominal cavity.

Referring now to <FIG>, there is illustrated a gas sealed trocar <NUM> for performing an endoscopic surgical procedure in a surgical cavity of a patient, which includes a proximal housing portion <NUM> and an elongated single lumen tubular body portion <NUM> extending distally from the proximal housing portion <NUM> and defining a central cannula <NUM>. The proximal housing portion <NUM> has an inlet path <NUM> for communicating with a pressurized gas line <NUM> of a tube set <NUM> and an outlet path <NUM> for communicating with a return gas line <NUM> of the tube set <NUM>. The proximal housing portion <NUM> includes a manifold <NUM> defining the inlet path and the outlet path, wherein the inlet and outlet paths are arranged in parallel within the manifold <NUM>. Alternatively, paths <NUM> and <NUM> could be formed in a manner that is integral with the proximal housing portion <NUM>, without requiring a separate manifold.

The proximal housing portion <NUM> accommodates an annular jet assembly <NUM> for receiving pressurized gas from the inlet path <NUM> and for generating a gaseous sealing zone within the central cannula <NUM> of the tubular body portion <NUM> to maintain a stable pressure within the surgical cavity of the patient, wherein the proximal housing portion <NUM> is adapted and configured to permit air entrainment, but the body portion <NUM> is closed off to prevent access through the central cannula <NUM> into the surgical cavity, as described further below.

The proximal housing portion <NUM> includes a manifold <NUM> defining the inlet path and <NUM> the outlet path <NUM>, wherein the inlet and outlet paths are arranged in parallel within the manifold <NUM>. The proximal housing portion <NUM> also includes suture securement tangs <NUM> to facilitate securement of the device <NUM> during a surgical procedure. The proximal housing portion <NUM> further includes an end cap <NUM> with circumferentially disposed radial slots <NUM> to permit air entrainment and emergency relief of cavity pressure. The end cap <NUM> is also configured with a central aperture <NUM> to receive a plug <NUM> for closing the central cannula <NUM> of the tubular body portion <NUM>, and thereby prevent air entrainment, if the need arises.

A distal end section of the tubular body portion <NUM> forms a closed conical tip <NUM> for facilitating percutaneous introduction of the device. Moreover, the closed distal tip <NUM> prevents the passage of a surgical instrument into the patient's body cavity through the central cannula <NUM>. The distal end section of the tubular body portion <NUM> includes a plurality of apertures <NUM> for facilitating gas/fluid communication between the central cannula <NUM> of the tubular body portion <NUM> and the surgical cavity of the patient.

Referring now to <FIG>, there is illustrated a gas sealed trocar <NUM> for performing an endoscopic surgical procedure in a surgical cavity of a patient, which includes a proximal housing portion <NUM> and an elongated single lumen tubular body portion <NUM> extending distally from the proximal housing portion <NUM> and defining a central cannula <NUM>.

The proximal housing portion <NUM> includes an end cap <NUM> that permits air entrainment and a dual lumen manifold <NUM> defining the inlet path <NUM> and the outlet path <NUM>, wherein the inlet and outlet paths are arranged in a concentric manner within the manifold <NUM>, rather than in a parallel manner as shown in <FIG>. The proximal housing portion <NUM> further includes suture securement tangs <NUM>.

In this embodiment, the tubular body portion <NUM>, and more particularly the central bore or cannula <NUM> is dimensioned to prevent the passage of a surgical instrument therethrough. For example, the bore <NUM> could be dimensioned to prevent the introduction of a standard <NUM> endoscopic surgical device commonly used during laparoscopic surgery. Thus, the inner diameter "d" of bore <NUM> would be less than <NUM>. However, in such an instance, the obturator or introducer <NUM> would be dimensioned to pass through the central bore <NUM> to facilitate the percutaneous introduction of the trocar <NUM>.

Referring now to <FIG>, there is illustrated a gas sealed trocar <NUM> for performing an endoscopic surgical procedure in a surgical cavity of a patient, which includes a proximal housing portion <NUM> and an elongated single lumen tubular body portion <NUM> extending distally from the proximal housing portion <NUM> and defining a central cannula <NUM>. The proximal housing portion <NUM> includes a manifold <NUM>, wherein the inlet and outlet paths are arranged in a parallel manner.

As best seen in <FIG>, the tubular body portion <NUM> has a non-circular cross-sectional configuration. More particularly, as shown in <FIG>, the tubular body portion <NUM> has an elliptical cross-sectional configuration. Also, an adhesive pad <NUM> is operatively associated with the tubular body portion <NUM> for retaining the trocar <NUM> in place during a surgical procedure.

Referring now to <FIG>, there is illustrated another embodiment of a single lumen gas sealed trocar, which is designated generally by reference numeral <NUM>. Gas sealed trocar <NUM> includes a proximal housing portion <NUM> and an elongated single lumen tubular body portion <NUM> extending distally from the proximal housing portion <NUM> and defining a central cannula <NUM>. The proximal housing portion <NUM> includes a manifold <NUM>, wherein the inlet and outlet paths are arranged in a parallel manner.

The proximal housing portion <NUM> further includes a hinged end cap <NUM> that is mechanically actuated and mounted to move from an open position shown in <FIG> to a closed position shown in <FIG> upon the removal of an obturator <NUM> from the trocar <NUM> to prevent access to the central cannula <NUM>. More particularly, the proximal housing portion <NUM> and the hinged end cap <NUM> are operatively connected to one another by biasing bands <NUM> that bias the end cap <NUM> into a normally closed position.

The end cap <NUM> has louvers or spaced apart slots <NUM> that permit air entrainment into the central cannula <NUM> and emergency relief of cavity pressure without permitting instrument access into and through the central cannula <NUM> of the tubular body portion <NUM>. In addition, a locking mechanism <NUM> is provided on the proximal housing portion <NUM> for retaining the hinged end cap <NUM> is the closed position, as best seen in <FIG>. More particularly, the locking mechanism <NUM> includes a pair of locking tabs 685a and 685b for capturing and retaining the flange <NUM> of the end cap <NUM>.

Referring to <FIG>, there is illustrated another embodiment of the gas circulation system which is designated generally by reference numeral <NUM>, and which is configured for use in robotically assisted minimally invasive surgical procedures. More particularly, the gas circulation system <NUM> is adapted for use in conjunction with a Da Vinci Xi type robotic system that is manufactured and sold by Intuitive Surgical, Inc.

Referring to <FIG>, the gas circulation system <NUM> includes a multi-lumen tube set <NUM> having a dual lumen portion <NUM>, a single lumen portion <NUM> and a multi-path filter cartridge assembly <NUM>. The dual lumen portion <NUM> is adapted and configured to communicate with a separable two-part single lumen gas sealed access port designated generally by reference numeral <NUM>. The single lumen portion <NUM> is adapted and configured to communicate with a separable two-part single lumen valve sealed access port designated generally by reference numeral <NUM>.

Referring to <FIG>, the gas sealed access port <NUM> is particularly configured for use in robotic surgery. It includes a proximal housing portion <NUM> that is adapted to be selectively coupled with a separate tubular body portion <NUM>, as described in more detail below. The tubular body portion <NUM> is configured for manipulation by a robotic surgical system. More particularly, the proximal reception portion <NUM> of the tubular body portion <NUM> includes a radially outwardly extending grasping flange <NUM> for enabling a Da Vinci Xi type robotic manipulator (not shown) to grasp and move the abdominal port <NUM> during a minimally invasive surgical procedure.

With reference to <FIG>, the proximal housing portion <NUM> of the gas sealed access port <NUM> includes a lower housing portion <NUM> dimensioned and configured to be accommodated within the upper reception portion <NUM> of the tubular body portion <NUM>. An O-ring <NUM> is provided within the upper reception portion <NUM> to seal against the exterior of lower housing portion <NUM>. A tubular stem <NUM> extends through and from the lower housing portion <NUM> to communicate directly with the tubular bore or cannula <NUM> of the tubular body portion <NUM>, when the two structures are attached together for use.

Referring to <FIG>, the proximal housing portion <NUM> further includes an interior chamber to accommodate an annular jet assembly <NUM>. The annular jet assembly <NUM> is configured to receive pressurized gas from the inlet path <NUM> and generate a gaseous or pneumatic sealing zone within the tubular stem <NUM>. Because the tubular stem <NUM> is in pneumatic communication with the central cannula bore <NUM> of the tubular body portion <NUM>, the device can maintain a stable cavity pressure and provide smoke evacuation.

With reference to <FIG> and <FIG>, the proximal housing portion <NUM> of access port <NUM> is configured to be selectively or otherwise detachably coupled to the tubular body portion <NUM> by a pair of diametrically opposed spring-loaded locking tabs 740a and 740b. As best seen in <FIG>, the separable housing portion <NUM> also includes a dual lumen manifold <NUM> to manage the flow of the pressure and return lines through concentric paths <NUM>, <NUM>. Alternatively, as shown in <FIG>, the manifold <NUM> could include parallel inlet and outlet paths <NUM> and <NUM>.

Referring now to <FIG>, there is illustrated another embodiment of the gas circulation system which is designated generally by reference numeral <NUM>, which is adapted and configured for use in endoscopic surgical procedures. The system <NUM> includes a multi-lumen tube set <NUM> having a dual lumen portion <NUM>, a single lumen portion <NUM> and a multi-path filter cartridge assembly <NUM>.

Referring to <FIG>, the dual lumen portion <NUM> of tube set <NUM> is adapted and configured to communicate with a two-part single lumen gas sealed access port designated generally by reference numeral <NUM>, which includes a proximal housing portion <NUM> and a separable tubular body portion <NUM>. The single lumen portion <NUM> of tube set <NUM> is adapted and configured to communicate with a two-part single lumen valve sealed access port designated generally by reference numeral <NUM>, which includes a proximal housing portion <NUM> and a separable tubular body portion <NUM>. Those skilled in the art will readily appreciate that the single lumen portion <NUM> of tube set <NUM> can be connected to a one-piece valve sealed access port.

Referring to <FIG>, the gas sealed access port <NUM> includes a proximal housing portion <NUM> that is adapted to be selectively coupled with the upper reception portion <NUM> of tubular body portion <NUM>. More particularly, the proximal housing portion <NUM> of the access port <NUM> is configured to be selectively coupled to the upper reception portion <NUM> of tubular body portion <NUM> by a pair of diametrically opposed spring-loaded locking tabs 840a and 840b operatively associated with the upper reception portion <NUM>.

The separable housing portion <NUM> includes an end cap <NUM> and a dual lumen manifold <NUM> to manage the flow of the pressure and return lines. Housing portion <NUM> also has an interior chamber that accommodates an annular jet assembly <NUM> configured to generate a gaseous or pneumatic sealing zone within the central cannula bore of the separable tubular body portion <NUM>, to maintain a stable cavity pressure and provide smoke evacuation.

Referring to <FIG>, the disclosure is also directed to a method of retrofitting a separable two-part valve sealed surgical access port to perform an endoscopic surgical procedure in a surgical cavity of a patient. As shown in <FIG>, the method first includes the step of obtaining a separable two-part surgical access port <NUM> having a valve sealed proximal housing portion <NUM> that is detachably engaged to a single lumen tubular body portion <NUM>. The proximal housing portion <NUM> includes a mechanical duckbill valve <NUM> and a conventional luer type fitting <NUM>.

The method further incudes the steps of detaching the valve sealed proximal housing portion <NUM> from the single lumen tubular body portion <NUM>, as shown in <FIG>, and then selectively attaching a gas sealed proximal housing portion <NUM> with manifold <NUM> to the single lumen tubular body portion <NUM>, as shown in <FIG>. Then, as shown in <FIG>, the method further includes the step of connecting the gas sealed proximal housing portion <NUM> of the assembled port <NUM> to a source of pressurized gas for generating a gaseous sealing zone within a central cannula of the single lumen tubular body portion <NUM> to maintain a stable pressure within the surgical cavity of a patient.

Claim 1:
A system (<NUM>) for performing an endoscopic surgical procedure in a surgical cavity of a patient, comprising:
a) a multi-lumen tube set (<NUM>) including a dual lumen portion (<NUM>) having a pressurized gas line (<NUM>) and a return gas line (<NUM>) for facilitating gas recirculation relative to the surgical cavity of the patient, and a single lumen portion (<NUM>) having a gas supply and sensing line (<NUM>) for delivering insufflation gas to the surgical cavity of the patient and for periodically sensing pressure within the surgical cavity of the patient, wherein the multi-lumen tube set (<NUM>) comprises a multi-path filter cartridge assembly (<NUM>) that includes a first filtered flow passage communicating with the pressurized gas line (<NUM>), a second filtered flow passage communicating with the return gas line (<NUM>), and a third filtered flow passage communicating with the gas supply and sensing line (<NUM>);
b) a first access port (<NUM>) having a proximal housing portion (<NUM>) and an elongated single lumen tubular body portion (<NUM>) extending distally from the proximal housing portion (<NUM>) and defining a central cannula, the proximal housing portion (<NUM>) of the first access port (<NUM>) having an inlet path (<NUM>) for communicating with the pressurized gas line (<NUM>) of the tube set (<NUM>) and an outlet path (<NUM>) for communicating with the return gas line (<NUM>) of the tube set (<NUM>), wherein the proximal housing portion (<NUM>) of the first access port (<NUM>) includes a manifold (<NUM>) that defines the inlet path (<NUM>) and the outlet path (<NUM>), wherein the inlet and outlet paths (<NUM>, <NUM>) are concentrically arranged within the manifold (<NUM>); and
c) a second access port (<NUM>) having a proximal housing and a single lumen tubular body portion extending from the proximal housing portion of the second access port (<NUM>), the proximal housing portion of the second access port (<NUM>) having a mechanical valve for sealing the tubular body portion and an inlet path for communicating with the gas supply and sensing line (<NUM>) of the tube set (<NUM>).