CN109963605A - 对到体腔的连续气流进行连续压力监测的多模态手术气体递送*** - Google Patents
对到体腔的连续气流进行连续压力监测的多模态手术气体递送*** Download PDFInfo
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Abstract
本发明公开了用于在内窥镜手术过程期间向患者体腔递送吹入气体的***,所述***包括:吹气导管,所述吹气导管用于以某一流速通过流动路径将连续吹入气体流递送到体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;和吹入器,所述吹入器用于以驱动压力驱动气流通过所述吹气导管,其中,所述***可被配置成使得通过所述吹气导管的所述气体流速或保持所述指定流速所需的驱动压力可根据体腔压力变化。
Description
相关申请的交叉引用
本申请要求于2016年11月14日提交的美国临时专利申请序列号62/421,480的优先权的权益,该临时专利申请的公开内容以引用方式全文并入本文。
发明背景
1.技术领域
本发明涉及手术气体递送***,并且更具体地涉及用于手术吹气、烟气疏散和/或再循环的多模态气体递送***,所述***还被配置成对到体腔的连续气流进行连续压力监测。
2.背景技术
诸如内窥镜和腹腔镜手术过程的微创手术技术已变得越来越常见。此类过程的益处包括减少对患者的创伤,降低感染的机会和减少恢复时间。腹(腹膜)腔内的腹腔镜手术过程通常通过称为套管针或插管的装置进行,这有助于将手术器械引入患者的腹腔中。
另外,此类过程通常涉及用加压流体(例如二氧化碳)填充或“吹入”腹(腹膜)腔以产生被称为气腹的现象。吹气可以借助于配备的手术进入装置(有时称为“插管”或“套管针”)或者通过单独的吹气装置,例如吹气(气腹)针进行,以递送吹入流体。将手术器械引入到气腹中而不大量损失吹入气体是期望的,以便保持气腹。
在典型的腹腔镜过程期间,外科医生切三至四个小的切口,这些切口通常每个不长于约十二毫米,通常是用外科进入装置本身进行的,通常使用设置在外科进入装置中的单独的***器或阻塞器来完成。在***之后,***器被去除,且套管针允许器械进入以便将器械***到腹腔中。典型的套管针提供了对腹腔吹气的方式,使得外科医生具有在其中手术和操作的开放的内部空间。
套管针必须通过在套管针与从其穿过的任何手术器械之间提供密封,保持腹腔内的压力,同时仍允许手术器械的至少最小移动自由度。这种器械可以包括例如剪刀、抓握器械和封闭器械、烧灼单元、摄像头、光源和其它手术器械。
密封元件或机构通常设置在套管针内以防止吹入气体逸出。这些元件通常包括由相对柔韧的材料制成的鸭嘴型阀,以围绕穿过套管针的手术器械的外表面进行密封。
在不需要常规机械密封的情况下允许密封地进入吹气手术腔的手术进入装置或套管针在本领域中是已知的。这些装置被适于和配置成通过使用由加压吹入气体的循环流动生成并保持的气动或气体密封来提供对手术腔的可密封进入。这种装置在美国专利号7,854,724和8,795,223中有所描述,这两个专利的公开内容通过引用整体并入本文。本领域中还已知多模态手术气体递送***,其与这种气动密封的套管针结合使用,以用于将吹入气体递送到体腔,用于通过套管针循环手术气体以产生并保持气动密封并且用于促进从体腔中疏散烟气。
多模态***的使用有助于通过仅需要购买一个***来降低成本,同时实现多个功能,并且由此减少手术室中所需的设备的数量,因此减少混乱状况并允许有供其它必需设备使用的空间。这种***例如在美国专利号8,715,219和8,961,451以及美国专利号9,295,490和9,375,539中有所描述,这些专利的公开内容以引用方式整体并入本文。
在某些应用中,在吹气期间实时监测体腔(例如腹腔)处的压力是有利的。实时压力监测有助于更好地检测在体腔内手术部位处的压力变化,并对其做出响应。连续监测手术腔压力的常规方法,例如美国专利号6,299,592中公开的方法,将吹气和压力监测分开,需要专用的压力感测管腔、端口或与体腔的连接。
本文中描述的***不需要专用的压力感测管腔或连接,而是使用提供给手术腔的新的或再循环的吹入气体的一致流。此外,因为感测压力不需要停止到手术腔的新吹入气体流,所以本文公开的***通过使气体通过气动密封的进入装置再循环,提供改善的烟气去除。
发明内容
本发明涉及用于在内窥镜或腹腔镜手术过程期间将吹入气体递送到患者体腔的新的且有用的***。在本发明的一个实施例中,所述***包括:吹气导管,所述吹气导管用于以可变流速通过流动路径将连续吹入气体流递送到患者体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;和吹入器,所述吹入器用于以给定驱动压力驱动气流通过所述吹气导管,其中,通过所述吹气导管的气体流速将根据体腔压力变化。此***还包括:流量计,所述流量计与所述吹气导管连通且定位在所述吹入器与所述体腔之间,以用于连续地测量通过所述吹气导管的气流;和处理器,所述处理器用于基于来自所述流量计的气流测量值确定与给定驱动压力对应的体腔压力。
优选的是,所述处理器基于所述流动路径的已知阻力特性依赖于存储在存储器查询表中的数据,并且在最初未知所述流动路径的阻力特性时,利用校准算法确定所述流动路径的阻力特性。所述***还包括沿所述流动路径定位的压力传感器,所述压力传感器用于进行周期性静态压力测量,并使那些静态压力测量值与周期性流量测量值相关联。
在本发明的另一实施例中,所述***包括:吹气导管,所述吹气导管用于以指定流速通过流动路径将连续吹入气体流递送到患者体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;和吹入器,所述吹入器用于以可变驱动压力驱动气流通过所述吹气导管,其中,保持所述指定流速所需的驱动压力将根据体腔压力变化。此***还包括:驱动压力传感器,所述驱动压力传感器与所述吹气导管连通,并定位在所述吹入器与所述体腔之间,以用于连续地测量所述吹气导管中的可变驱动压力;和处理器,所述处理器用于确定为保持通过所述流动路径到所述体腔的吹入气体的指定流速所需的驱动压力量。所述处理器还被配置成基于来自所述驱动压力传感器的驱动压力测量值确定与给定气体流速对应的体腔压力。
所述处理器基于所述流动路径的已知阻力特性依赖于存储在存储器查询表中的数据,并且在最初未知所述流动路径的阻力特性时,利用校准算法确定所述流动路径的阻力特性。所述***还包括流量计,所述流量计向所述吹入器提供反馈,使得所述吹入器能够保持对所述体腔的指定流速。所述***还包括沿所述流动路径定位的第二压力传感器,所述第二压力传感器用于进行周期性静态压力测量,并使那些静态压力测量值与周期性驱动压力测量值相关联。
在本发明的另一实施例中,所述***包括:吹气导管,所述吹气导管用于以某一流速通过流动路径将连续吹入气体流递送到体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;和吹入器,所述吹入器用于在驱动压力下驱动气流通过所述吹气导管,其中,所述***可被配置成使得通过所述吹气导管的气体流速或保持所述指定流速所需的驱动压力可根据体腔压力变化。
当所述***被配置成使得通过所述吹气导管的气体流速根据体腔压力变化时,所述吹入气体的流速将是可变的且将指定所述吹入气体的驱动压力。当所述***被配置成使得保持所述指定流速所需的驱动压力根据体腔压力变化时,所述吹入气体的流速将被指定,且所述吹入气体的驱动压力将是可变的。
通过结合下文描述的若干图式对本发明的优选实施例的以下描述,本发明的多模态气体递送***的这些和其它特征对于本领域普通技术人员将变得更显而易见。
附图说明
所以,所属领域的技术人员将容易地了解不过度实验如何制备和使用本发明的气体递送***和方法,下面参照附图在本文中详细描述本发明的优选实施例,其中:
图1是根据本发明的实施例构造的多模态手术气体递送***的示意性图示,多模态手术气体递送***被配置成对到体腔的连续气流进行连续压力监测;
图2是形成图1的多模态手术气体递送***的一部分的计算环境的示意性流程图;
图3是根据本发明的另一个实施例构造的多模态手术气体递送***的示意性图示,多模态手术气体递送***被配置成对到体腔的连续气流进行连续压力监测;
图4是由本发明的多模态气体递送***在可变流量和60mmHg的指定驱动压力下递送的吹入气体的查询表的图形说明;以及
图5是由本发明的多模态气体递送***在3升/分钟的指定流量和可变驱动压力下递送的吹入气体的查询表的图形说明。
具体实施方式
现在参考附图,其中相同参考数字标识本发明的类似结构元件或特征,在图1中示出了根据本发明的优选实施例构造的多模态手术气体递送***,其大体上由参考数字100指示。如下文更详细地描述的,气体递送***100被设计成用于多模态操作,以促进对体腔吹气、从体腔疏散烟气和/或气体通过与体腔连通的进入端口再循环。另外,手术气体递送***100被配置成在手术过程期间当在体腔内使用抽吸时保持体腔压力,以从体腔去除固体碎屑、液体和气体。
如图1中所示,气体递送***100适于与三个手术进入装置或套管针(131、133、135)一起工作,所述三个手术进入装置或套管针与患者的体腔190连通。可以设想,气体递送***100也可以与两个手术进入装置或套管针一起使用,例如在共同受让的美国专利号9,375,539中所公开的。备选地,该***可以与单个手术进入装置一起使用,例如在共同受让的美国专利号9,295,490中所公开的。
多模态气体递送***100包括由通用计算***驱动的计算机控制的控制单元110,该控制单元在图2中最佳看到。要理解并要认识到,计算***便于多模态气体递送***100的选择性操作模式。
参考图2,控制单元110的计算***10包括至少一个处理器12、存储器14、至少一个输入装置16和至少一个输出装置18,这些装置全部经由总线11耦合在一起。存储装置14可以是任何形式的数据或信息存储装置,例如,易失性或非易失性存储器、固态存储装置或磁性装置。
在本发明的某些实施例中,输入装置16和输出装置18可以是同一装置。还可以提供接口15以用于将计算***10联接到一个或多个***装置。例如,接口15可以是PCI卡或PC卡。存储器或存储装置14可以容纳或保存至少一个数据库17。存储器14可以是任何形式的存储器装置,例如,易失性或非易失性存储器、固态存储装置或磁性装置。
输入装置16接收输入数据19,并且可以包括例如键盘、指针装置(诸如笔状装置)、鼠标、触摸屏或任何其它合适的装置,诸如调制解调器或无线数据适配器或数据采集卡。输入数据19可来自不同来源,例如键盘指令,其结合通过网络接收的数据。
输出装置18产生或生成输出数据20,且可包括例如显示装置或监视器,在这种情况下输出数据20是可视的。输出数据20可以是不同的并且可从不同的输出装置(例如监视器上的视觉显示器)得到,其结合传输到网络的数据。用户可以在例如监视器上或使用打印机查看数据输出或对数据输出的解译。
使用中,计算***10适于允许数据或信息经由有线或无线通信手段存储在存储器14中存储的至少一个数据库17中和/或从所述至少一个数据库检索。接口15可以允许处理单元12与可以用于专用目的的***部件之间进行有线和/或无线通信。
优选地,处理器12经由输入装置16接收作为输入数据19的指令,并且可通过利用输出装置18将处理后的结果或其它输出显示给用户。可以提供多于一个输入装置16和/或输出装置18。应当认识,计算***10可以呈任何形式,但是它优选地与手术气体递送***100的控制单元110设置成一体。
要认识到,计算***10可以是联网通信***的一部分。计算***10可以连接到网络,例如互联网或WAN。输入数据19和输出数据20可以通过网络传送到其它装置。可以使用有线通信手段或无线通信手段实现通过网络的信息或数据的传输。服务器可以促进在网络与一个或多个数据库之间的数据传输。服务器和一个或多个数据库提供信息源的一个实例。
因此,计算***10可使用到一个或多个远程计算机的逻辑连接在联网环境中操作。远程计算机可以是个人计算机、服务器、路由器、网络PC、平板电脑、对等装置或其它公共网络节点,并且通常包括上述元件中的许多或全部元件。
再次参考图1,多模态手术气体递送***100包括流体泵111,该流体泵被适于和配置成使加压吹入流体通过***100循环。供应导管114与流体泵111的输出流体连通,且被配置和适于成用于将加压吹入流体递送到控制单元110的输出端口183。
返回导管112与流体泵111的输入流体连通,以用于将吹入流体递送到流体泵111,并且被配置和适于成用于将吹入流体返回控制单元110的输入端口181。可调节背压控制阀113被设置成与供应导管114和返回导管112流体连通,且被适于和配置成通过打开且将流体从供应导管114引导到返回导管112而响应于超过设定压力的供应导管压力。背压控制阀113可以是机械阀,例如弹性偏置阀。备选地,背压控制阀113可以是机电阀,其对来自***100内的一个或多个压力传感器(例如117)的高压信号进行响应。
提供吹气子单元121,且其被适于和配置成接收来自例如如所示的本地罐的源140或来自中央分配***的吹入气体(例如,二氧化碳)的供应,中央分配***还可在进入气体递送***100之前通过压力调节器141。吹气子单元121通过吹气导管118将吹入气体传递到***100的其余部分。吹气子单元121包括内部压力传感器(未示出),所述内部压力传感器感测通过吹气导管118的手术腔190的压力。
气体递送***100由用户通过控制面板操作或以其它方式控制,控制面板例如设置在控制单元110上,或以其它方式与控制单元相连。这种控制面板优选地被适于和配置成允许用户例如借助于开关、触摸屏或其它用户接口选择多模态手术气体递送***的模式。举例来说,可提供图形用户界面(GUI),其准许选择操作模式以及特定模式的操作参数。要理解并要认识到,控制面板可与***100一体化设置,或可使用已知的数据通信手段与其远程地定位。
操作模式可以包括但不限于吹气、烟气疏散、组合烟气疏散和吹气、再循环或组合再循环和烟气疏散。用于模式的操作参数可以包括例如流速(例如,升/分钟)、压力(例如,mmHg)和调节参数(例如,温度和湿度)等。
如本文中所使用,“再循环”模式单独地或与其它模式组合,是适合提供足够的操作压力和流动速率以驱动气动密封的手术进入装置的模式,例如在共同受让的美国专利号7,854,724和8,795,223中所描述的那些,这两个专利以引用方式并入本文。
还提供管组150,并且其被适于和配置成在一端连接到供应导管114、返回导管112和吹气导管118,并且在相对的一端连接至与手术腔190流体连通的多个手术进入装置131、133、135。如上所述,取决于所需实施方式,管组150的配置可以变化。在***100的情况下,管组150优选地具有与输入181、输出183和吹气185端口的单一多管腔连接以及与个别手术装置131、133、135的单独的连接。可以设想,管组150可具有从端口181、183、185的连接开始距控制单元110预定距离的组合多管腔管,并且在中间点处,分叉155产生多个分开的管。在***100的情况下,三个单独的管分别引向手术装置131、133、135中的每一个,所述手术装置可以是具有吹气能力的手术进入装置,或者其它器械,诸如一个或多个气腹针。手术装置131、133、135因此个别地连接到供应导管114、返回导管112和吹气导管118中的一个,并且因此分别实现所述功能。
如上文所阐述,在一个优选方面,管组150的单独远端管部分借助于常规配件(例如常规手术装置上的鲁尔锁(luer-lock)配件)连接。管组150的精确配置可根据所需配置变化。用于多管腔管组的配件的实例在共同受让的美国专利号9,526,886中有所描述,该专利的公开内容以引用的方式整体并入本文。
一次性过滤器116也与管组150或者分开或者成一体地关联。适用于具有吹气、烟气疏散和再循环功能的与专用气动密封手术进入装置一起使用的多模态气体递送***100的过滤器在美国专利号9,067,030和9,526,849中公开,这两个专利的公开内容通过引用整体并入本文。
可以设想,与***100结合使用的一次性管组150和/或过滤器116可以设置有识别装置,该识别装置允许授权使用或以其它方式防止未授权使用。此类识别装置可包括但不限于射频识别(RFID)应答器、计算机可读数据芯片、条形码或其上提供的其它承载数据的元件。还设想,在过滤器或管组上的识别装置可以使得或以其它方式指示气体递送***100自动切换到或启动进入特定操作模式(例如,再循环、烟气疏散或标准吹气)。
继续参照图1,***100还包括与流体供应导管114连接的第二倾泄阀115。另外,对于上文所描述的背压控制阀113的短路动作,***100设置有压力传感器117,所述压力传感器可为如图所示的机械或电子式的。传感器117与吹气导管118或其它腹压源流体连通。当感测到过压条件时,压力传感器117给倾泄阀115发信号以将流体释放出***100。
***100可以与一个手术装置131和另一手术装置135一起使用,一个手术装置被用于吹气和感测功能,另一个手术装置用于从腹部去除吹入气体,吹入气体接着例如在返回泵111之前通过过滤器,例如超低渗透空气(“ULPA”)过滤器元件116。过滤器116优选地被配置和适于成从穿过其中的气体清除所有或基本上所有的烟气和碎屑,其中气体通过第三手术装置133返回到腹腔190。如所示出的,可提供另一过滤器元件116,其与从泵111引出的供应导管114连接。
出于解释和说明而非限制的目的,根据本发明的另一方面的手术气体递送***的示例性实施例的示意性图示在图3中示出并且大体上由参考数字200指示。与图1的***100相比,***200仅需要两个手术装置231、233。上文结合图1的***100描述的部件的功能与图2的***200的对应部件相同,除非下文另有说明。
***200在许多方面与***100类似,但是增加了分流阀295,其具有从其它活动内部***部件引出的三个导管112、114、118以及分别引向两个不同的手术装置231、233的两个导管251、253。
如图所示,在控制单元210内一体地提供分流阀295,如由数字210标示的设置的虚线示意性地指示的。分流阀295设置有三个操作位置-对应于不同功能的位置A、B和C,如下所述。当***200的感测功能激活时,分流阀295定位在位置“A”,允许通过其连接吹气/感测导管118,通过管组250的一个或两个导管251、253连接至手术装置231、233中的一者或两者。
如果被配置成将吹气/感测导管118连接到多于一个手术装置,则减少了这种手术装置的管腔被阻塞因此不提供准确的读数的可能性。当分流阀295定位在位置A处并且将吹气/感测导管118连接至管组250的导管251、253并且因此连接至手术装置231、233时,允许吹气子单元121感测腹压。在位置A,来自泵111的输出进入分流阀295,并且在这种情况下通过相互连接供应导管114和返回导管112而立即返回到泵111。此配置允许泵111在感测期间继续运行,并因此避免在泵111停止和重新起动时可能发生的任何功率尖峰。
如果***200被设定成合适的模式(例如组合式烟气疏散和吹气),那么当吹气子单元121完成感测腹压时,分流阀295从位置A切换到位置B,以便将供应导管114连接到管组250的对应导管251,并将返回导管112连接到管组250的对应导管253。在位置B,吹气导管118连接到返回导管112,从而允许通过返回导管112将吹入气体添加到***200中。同时,吹气子单元121可仅被设置成吹气模式,因此仅将气体添加到***200且不感测压力。而在位置B,分流阀295允许流体通过其在泵111、过滤器216和手术装置231、233之间递送和返回,并且因此允许气体与来自手术腔190的吹入气体交换并对吹入气体进行过滤。
如果泵和管体积被视为与手术腔190的体积组合的一个受控体积,那么根据优选方面,吹气子单元121独自-从感测切换为供应二氧化碳的功能如常规手术吹入器中那样被执行。因此,如上所述,在图3的***200中,仅当分流阀295允许吹入器控件121向手术腔190提供气体时才执行烟雾疏散和过滤。在这种布置中,切换到烟气疏散/过滤和压力感测以及从其切换可以根据期望或需要被配置为正常感测模式或者配置为正常过滤模式。正常感测模式可能相比正常过滤模式是优选的,因为对腹压的监测通常是优先的。
如图所示,分流阀295的位置C允许***200在再循环模式下操作,这适合提供足够的压力和流速,以驱动气动密封的手术进入装置,例如美国专利号7,854,724和8,795,223中描述的那些。在此模式中,通常提供具有三个管腔的单个管,每一管腔与供应导管112、返回导管114和吹气导管118中的每一个流体连通。
在某些应用中,在吹气期间实时地监测手术腔190处的压力是有利的。实时压力监测有助于更好地检测手术腔的压力变化,并对其做出响应。此外,连续压力监测结合新的或再循环的吹入气体的一致流动还有助于改善从手术腔移除烟气。
继续参考图1-3,***100、200包括定位在吹入气体源140与腹腔190之间的流量计123。流量计123测量通过相关联的吹气导管118的流体流量。实时监测腹压通过以下方式实现:通过使用吹气子单元121调节从源140提供的压力,驱动流体流以恒定源压力通过导管118。
随着流过导管118的流体量变化,根据手术腔190处的压力量,流量计123测量流体流量。对于由源140提供的给定源压力,***100、200的处理器12使用来自流量计123的流体流量读数来确定手术腔190处的压力。手术腔190处的压力可以由处理器12使用存储在***100、200的存储器14中(例如,在查询表中)的数据,或通过校准到手术腔190的流体路径或两者的组合来确定。当使用存储在***100、200的存储器14中的数据时,由处理器12基于到手术腔190的流体路径的一部分的已知尺寸来选择适当的数据,所述部分例如将手术腔190连接到***100、200的套管针或插管的鲁尔(luer)连接。
流体路径的那部分的已知尺寸,在这种情况下是套管针或插管鲁尔连接,可以是行业标准,例如ISO 594-1:1986或ISO 594-2:1998,或者是兼容部件的已知尺寸,例如,美国专利号7,854,724或者8,795,223中公开的套管针中的一个,其公开内容整体并入本文。已知尺寸允许对给定驱动压力下通过流体路径的那部分的流量进行假设,这又可用于使用例如存储在***100、200的存储器14中的查询表来推断手术腔190处的压力。图4说明在由吹入气体源140提供的可变流速下60毫米汞柱的驱动压力的查询表的实例。
当流体路径不包括已知尺寸时,手术腔190处的压力可以由***100、200的处理器12使用校准算法来确定。当使用校准算法时,***100、200感测手术腔190处的压力,例如,使用包括在吹气子单元121中的压力传感器或使用沿着到手术腔190的流体路径定位的专用压力传感器122。可通过使用上述压力传感器中的一个进行周期性静态压力测量并使那些压力测量值与使用流量计123获得的周期性流量测量值相关联来实现校准。在某些情况下,将校准与上述的推断技术结合可能是有利的。
或者,实时监测腹压可以通过以下方式实现:通过使用吹气子单元121调节从源140提供的压力,驱动流体流以可变源压力通过导管118。通过导管118的流体流量被指定并且使用从流量计123到吹气子单元121的反馈来保持。保持通过流体路径的指定流量所需的源压力的量取决于手术腔190处的压力量。压力传感器,例如包括在吹气子单元121中的压力传感器或例如沿着到手术腔190的流体路径定位的压力传感器122(例如,靠近压力源或子单元121),测量保持通过流体路径的指定流量所需的可变源压力。
在该实施例中,手术腔190处的压力可以由处理器12使用存储在***100、200的存储器14中(例如,在查询表中)的数据,或通过校准手术腔190的流体路径或两者的组合来确定。当使用存储在***100中的数据时,基于到手术腔190的流体路径的一部分的已知尺寸来选择适当的数据,所述部分例如将手术腔190连接到***100、200的套管针或插管的鲁尔连接。流体路径的那部分的已知尺寸,在这种情况下是套管针或插管鲁尔连接,可以是行业标准,例如ISO 594-1:1986或ISO 594-2:1998,或者是兼容部件的已知尺寸,例如,美国专利号9,095,372、7,854,724或8,795,223中公开的套管针中的一个,其公开内容整体并入本文。
已知尺寸允许对保持通过流体路径的那部分的指定流体流量所需的源压力的量进行假设,这又可以用于使用例如存储在***100中的查询表来推断手术腔190处的压力。图5示出了对于通过流体路径的3升/分钟的指定流体流量的查询表的实例。
当流体路径不包括已知尺寸时,可以使用校准算法确定手术腔190处的压力。当使用校准算法时,***100、200感测手术腔190处的压力,例如,使用包括在吹气子单元121中的压力传感器或使用专用压力传感器,例如沿着到手术腔190的流体路径定位的压力传感器122。可通过使用上述压力传感器中的一个进行周期性静态压力测量并使那些压力测量值与由子单元121调节的对应驱动压力相关联来在***100、200的处理器12中实现校准。在某些应用中,将校准与上文针对特定流体流量描述的推断技术结合可能是有利的。
虽然已参考优选实施例展示和描述了本公开,但所属领域的技术人员将容易了解,在不脱离本发明的范围的情况下,可以对其进行改变和/或修改。
Claims (14)
1.一种用于在内窥镜手术过程期间将吹入气体递送到患者体腔的***,包括:
a)吹气导管,所述吹气导管用于以可变流速通过流动路径将连续吹入气体流递送到体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;
b)吹入器,所述吹入器用于以指定驱动压力驱动气流通过所述吹气导管,其中,通过所述吹气导管的气体流速将根据体腔压力变化;
c)流量计,所述流量计与所述吹气导管连通并且定位在所述吹入器与所述体腔之间,以用于连续地测量通过所述吹气导管的气流;和
d)处理器,所述处理器用于基于来自所述流量计的气流测量值确定与给定驱动压力对应的体腔压力。
2.根据权利要求1所述的***,其中,所述处理器基于所述流动路径的已知阻力特性依赖于存储在存储器查询表中的数据。
3.根据权利要求1所述的***,还包括驱动压力传感器,所述驱动压力传感器与所述吹气导管连通以用于向所述吹入器提供反馈,使得所述吹入器能够保持对所述吹气导管的吹入气体的指定驱动压力。
4.根据权利要求2所述的***,其中,在最初未知所述流动路径的阻力特性时,所述处理器利用校准算法确定所述流动路径的阻力特性。
5.根据权利要求4所述的***,还包括沿所述流动路径定位的压力传感器,所述压力传感器用于进行周期性静态压力测量,并且使那些静态压力测量值与周期性流量测量值相关联。
6.一种用于在内窥镜手术过程期间将吹入气体递送到患者体腔的***,包括:
a)吹气导管,所述吹气导管用于以指定流速通过流动路径将连续吹入气体流递送到体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;
b)吹入器,所述吹入器用于以可变驱动压力驱动气流通过所述吹气导管,其中,保持所述指定流速所需的驱动压力将根据体腔压力变化;
c)驱动压力传感器,所述驱动压力传感器与所述吹气导管连通,并且定位在所述吹入器与所述体腔之间,以用于连续地测量所述吹气导管中的可变驱动压力;和
d)处理器,所述处理器用于确定为保持通过所述流动路径到所述体腔的吹入气体的指定流速所需的驱动压力量。
7.根据权利要求6所述的***,其中,所述处理器被配置成基于来自所述驱动压力传感器的驱动压力测量值确定与给定气体流速对应的体腔压力。
8.根据权利要求6所述的***,其中,所述处理器基于所述流动路径的已知阻力特性依赖于存储在存储器查询表中的数据。
9.根据权利要求6所述的***,还包括流量计,所述流量计向所述吹入器提供反馈,使得所述吹入器能够保持对所述体腔的指定流速。
10.根据权利要求8所述的***,其中,在最初未知所述流动路径的阻力特性时,所述处理器利用校准算法确定所述流动路径的阻力特性。
11.根据权利要求10所述的***,还包括另一压力传感器,所述另一压力传感器沿所述流动路径定位以用于进行周期性静态压力测量,并且使那些静态压力测量值与周期性驱动压力测量值相关联。
12.一种用于在内窥镜手术过程期间将吹入气体递送到患者体腔的***,包括:
a)吹气导管,所述吹气导管用于以某一流速通过流动路径将连续吹入气体流递送到体腔,所述流动路径与防止所述体腔过压的气动密封的套管针连通;和
b)吹入器,所述吹入器用于在驱动压力下驱动气流通过所述吹气导管,其中,所述***能够被配置成使得通过所述吹气导管的气体流速或保持所述指定流速所需的驱动压力能够根据体腔压力变化。
13.根据权利要求12所述的***,其中,当所述***被配置成使得通过所述吹气导管的气体流速根据体腔压力变化时,所述吹入气体的流速将是可变的并且将指定所述吹入气体的驱动压力。
14.根据权利要求12所述的***,其中,当所述***被配置成使得保持所述指定流速所需的驱动压力根据体腔压力变化时,所述吹入气体的流速将被指定,并且所述吹入气体的驱动压力将是可变的。
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KR102321995B1 (ko) | 2021-11-05 |
JP2019535394A (ja) | 2019-12-12 |
AU2017357115B2 (en) | 2020-07-16 |
CA3040920A1 (en) | 2018-05-17 |
EP3538188A2 (en) | 2019-09-18 |
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US11033299B2 (en) | 2021-06-15 |
US20180132895A1 (en) | 2018-05-17 |
WO2018089986A3 (en) | 2018-07-26 |
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CA3040920C (en) | 2021-03-23 |
AU2017357115A1 (en) | 2019-05-30 |
EP3538188B1 (en) | 2022-03-30 |
WO2018089986A2 (en) | 2018-05-17 |
EP3538188A4 (en) | 2020-08-26 |
ES2921080T3 (es) | 2022-08-17 |
CN109963605B (zh) | 2021-10-15 |
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