阅读说明：本技术 自动化流体管理系统 (Automated fluid management system ) 是由 彼得·J·佩雷拉 迈尔·基兰·帕特尔 威廉·斯坦霍普 埃里克·王 约瑟夫·斯朗达 克里斯托 于 2018-05-21 设计创作，主要内容包括：一种流体管理系统,包括泵,所述泵构造成以一定的流体流量泵送流体通过系统。所述系统包括处理器,所述处理器包括用户界面,所述用户界面允许用户输入一组系统操作参数,所述处理器构造成控制所述泵以基于该组系统操作参数维持目标流体流量。所述系统进一步包括联接至所述泵以将流体输送到目标手术部位的镜装置,所述镜装置包括从其远侧端部延伸的细长轴,所述细长轴包括至少一个传感器,所述传感器将与目标手术部位相关的传感器数据传输到所述处理器。所述处理器自动向所述泵发信号,以基于所述传感器数据调节流体流量。(A fluid management system includes a pump configured to pump a fluid through the system at a fluid flow rate. The system includes a processor including a user interface allowing a user to input a set of system operating parameters, the processor configured to control the pump to maintain a target fluid flow based on the set of system operating parameters. The system further includes a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongate shaft extending from a distal end thereof, the elongate shaft including at least one sensor that transmits sensor data related to the target surgical site to the processor. The processor automatically signals the pump to adjust fluid flow based on the sensor data.)

1. A fluid management system, comprising:

a pump configured to pump fluid from a fluid supply through the system at a fluid flow rate;

a processor comprising a user interface allowing a user to input a target pressure, the processor configured to control the pump to maintain a target fluid flow range based on the target pressure; and

a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongate shaft extending from a distal end thereof, the elongate shaft including at least one sensor that transmits sensor data related to the target surgical site to the processor;

wherein the processor automatically signals the pump to adjust fluid flow based on the sensor data.

2. The system of claim 1, wherein the sensor is a pressure sensor.

3. The system of claim 1 or 2, further comprising a heating assembly configured to heat the fluid to a target temperature.

4. The system of any one of claims 1 to 3, wherein the processor further comprises a display screen configured to display fluid flow and sensor data in real time.

5. The system of claim 4, wherein if the processor detects that the fluid flow is outside of a target pressure range, a visual alert is displayed on a display screen.

6. The system of any one of claims 1 to 5, wherein the mirror device further comprises a temperature sensor on the elongated shaft.

7. The system of any one of claims 1 to 6, configured for use in one of a flexible ureteroscopy, hysteroscopy, or cystoscopy procedure.

8. The system of any one of claims 1 to 7, further comprising a weight sensor for measuring the weight of the fluid bag in real time.

9. A fluid management system, comprising:

a pump configured to pump fluid from a fluid supply through the system at a fluid flow rate;

a processor configured to control the pump; and

a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongate shaft extending from a distal end thereof, the elongate shaft including a camera that transmits video feedback related to the target surgical site to the processor;

wherein the processor includes image recognition software to detect changes in the video feedback and automatically signal the pump to adjust fluid flow based on the changes.

10. The system of claim 9, wherein the processor comprises a user interface that allows a user to input a set of system operating parameters.

11. The system of claim 9 or 10, wherein the processor comprises a display screen configured to display the visual feedback and the flow rate in real time.

12. The system of any one of claims 9 to 11, wherein the mirror device further comprises a temperature sensor on the elongated shaft.

13. The system of any of claims 9-12, further comprising a heating assembly configured to heat the fluid to a target temperature.

14. The system of any one of claims 9 to 13, wherein the fluid supply is a fluid bag.

15. The system of any of claims 9 to 14, further comprising a weight sensor for measuring the weight of the fluid bag in real time.

Background

Flexible ureteroscopy (jurs) procedures require the circulation of fluids for several reasons. Today, surgeons deliver fluids in various ways, such as, for example, by hanging a fluid bag and using gravity to deliver the fluid, filling a syringe and manually injecting the fluid or using a peristaltic pump to deliver the fluid from a reservoir at a fixed pressure or flow rate. A drawback of these and other delivery methods is that the user does not have complete knowledge of what the pressure collection system or anatomical structure (ureters, bladder, kidney) is experiencing, which increases the risk of injury to the patient. Conservative surgeons typically circulate fluid at low pressures. However, reducing the flow rate to maintain low pressure may directly affect visualization of the surgical area because blood, clots, and particulate matter may not be adequately cleared at low pressure. In contrast, high perfusion flow rates may achieve the desired clear visibility, but may result in excessively high intraluminal pressures. High intraluminal pressure allows bacteria and endotoxins to be readily absorbed into the blood, which can lead to post-operative fever. Other conditions that may occur due to high intraluminal pressures include lymph node and venous return, thereby resulting in fluid leakage, post-operative pain, urosepsis and renal injury.

Disclosure of Invention

The present disclosure relates to a fluid management system. The system comprises: a pump configured to pump fluid from a fluid supply through the system at a fluid flow rate; a processor comprising a user interface allowing a user to input a set of system operating parameters, the processor configured to control the pump to maintain a target fluid flow range based on the set of system operating parameters; and a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongate shaft extending from a distal end thereof, the elongate shaft including at least one sensor that transmits sensor data related to the target surgical site to the processor, wherein the processor automatically signals the pump to adjust fluid flow based on the sensor data.

In one embodiment, the sensor is a pressure transducer.

In an embodiment, the system includes a heating assembly configured to heat the fluid to a target temperature.

In one embodiment, the processor further comprises a display screen configured to display the fluid flow and sensor data in real time.

In one embodiment, if the processor detects that the fluid flow is outside of the target fluid flow range, a visual alert is displayed on the display screen.

In an embodiment, the mirror device further comprises a temperature sensor located on the elongate shaft.

In one embodiment, the fluid supply is a fluid bag.

In an embodiment, the system comprises a weight sensor for measuring the weight of the fluid bag in real time.

The present disclosure also relates to a fluid management system. The system comprises: a pump configured to pump fluid from a fluid supply through the system at a fluid flow rate; a processor configured to control the pump; and a scope device coupled to the pump to deliver fluid to a target surgical site, the scope device including an elongated shaft extending from a distal end thereof, the elongated shaft including a camera that transmits video feedback related to the target surgical site to the processor, wherein the processor includes image recognition software to detect changes in the video feedback and automatically signal the pump to adjust fluid flow based on the changes.

In one embodiment, the processor includes a user interface that allows a user to input a set of system operating parameters.

In one embodiment, the processor includes a display screen configured to display the video feedback and the flow rate in real-time.

In an embodiment, the mirror device further comprises a temperature sensor located on the elongate shaft.

In an embodiment, the system includes a heating assembly configured to heat the fluid to a target temperature.

In one embodiment, the fluid supply is a fluid bag.

In an embodiment, the device comprises a weight sensor for measuring the weight of the fluid bag in real time.

Drawings

FIG. 1 is a schematic view of a fluid management system according to an exemplary embodiment of the present disclosure;

FIG. 2 is another schematic view of the fluid management system of FIG. 1 according to an exemplary embodiment of the present disclosure;

FIG. 3 shows a touch screen interface of the system of FIG. 1 according to a first exemplary embodiment;

FIG. 4 shows a touch screen interface of the system of FIG. 1 according to a second exemplary embodiment;

FIG. 5 shows a touch screen interface of the system of FIG. 1 according to a third exemplary embodiment;

FIG. 6 illustrates a perspective view of a touch screen interface and pump system of the system of FIG. 1, according to an example embodiment;

FIG. 7 illustrates a visual feedback display of the system of FIG. 1 according to an example embodiment;

FIG. 8 illustrates a perspective view of various human user interfaces of the system of FIG. 1, according to an exemplary embodiment;

FIG. 9 shows a side view of a mirror arrangement of the system of FIG. 1 according to an exemplary embodiment;

FIG. 10 shows a top view of the mirror arrangement of FIG. 9;

FIG. 11 illustrates a side view of a heater assembly of the system of FIG. 1 according to an exemplary embodiment;

FIG. 12 illustrates a top view of a heater cartridge of the heater assembly of FIG. 11 in accordance with an exemplary embodiment;

figure 13 illustrates a perspective view of a waste management system of the system of figure 1, according to an exemplary embodiment;

figure 14 shows a schematic diagram of a waste management system of the system of figure 1 according to a second exemplary embodiment;

figure 15 shows a schematic diagram of a waste management system of the system of figure 1 according to a third exemplary embodiment;

figure 16 shows a schematic diagram of a waste management system of the system of figure 1 according to a fourth exemplary embodiment;

figure 17 shows a schematic diagram of a waste management system of the system of figure 1 according to a fifth exemplary embodiment;

figure 18 shows a schematic diagram of a waste management system of the system of figure 1 according to a sixth exemplary embodiment;

figure 19 shows a perspective view of a waste management system ceiling mount according to an exemplary embodiment;

figure 20 shows a perspective view of a waste management system mount according to another exemplary embodiment;

figure 21 shows a perspective view of a waste management system mount according to another exemplary embodiment;

figure 22 illustrates a perspective view of a waste collection module according to an exemplary embodiment of the present disclosure;

figure 23 shows a perspective view of a waste collection module according to another exemplary embodiment of the present disclosure;

figure 24 shows a perspective view of a waste management system configuration according to an exemplary embodiment of the present disclosure;

figure 25 shows a perspective view of a waste management system configuration according to another exemplary embodiment;

figure 26 shows a perspective view of a waste management system configuration according to a third exemplary embodiment;

figure 27 shows a perspective view of a waste management system configuration according to a fourth exemplary embodiment;

figure 28 shows a perspective view of a waste management system configuration according to a fourth exemplary embodiment;

figure 29 shows a perspective view of a waste management system configuration according to a fifth exemplary embodiment;

figure 30 shows a perspective view of a waste management system configuration according to a sixth exemplary embodiment;

figure 31 shows a perspective view of a waste management system configuration according to a seventh exemplary embodiment;

figure 32 shows a perspective view of a waste management system configuration according to an eighth exemplary embodiment;

figure 33 shows a perspective view of a waste management system configuration according to a ninth exemplary embodiment;

figure 34 shows a perspective view of a waste management system configuration according to a tenth exemplary embodiment;

FIG. 35 illustrates a perspective view of a saline bag configuration according to an exemplary embodiment of the present disclosure;

FIG. 36 shows a perspective view of a saline bag construction according to another exemplary embodiment;

FIG. 37 shows a perspective view of a saline bag construction according to a third exemplary embodiment;

FIG. 38 shows a perspective view of a saline bag configuration according to the fourth exemplary embodiment;

FIG. 39 illustrates a fluid management system modular cart configuration according to an exemplary embodiment of the present disclosure;

FIG. 40 illustrates a fluid management system modular cart configuration according to another exemplary embodiment;

FIG. 41 illustrates a fluid management system modular cart configuration according to a third exemplary embodiment; and

fig. 42 shows a fluid management system modular cart configuration according to a fourth exemplary embodiment.

Detailed Description

The invention may be understood by reference to the following description and the appended drawings, wherein like elements are referred to by like reference numerals. The invention relates to a method for passingControlled flow and sensor feedback systems, methods, devices, and kits for delivering fluid in a fURS procedure. An exemplary embodiment describes a modular system, comprising: a user-controlled or automated pump; ureteroscopy devices, such as for example LithoVue with a sensor at the tip^TMA mirror device; a fluid management system; and in some embodiments a drainage collection system. The pump system may include a heating source to heat the fluid to body temperature, if desired by the user. Other exemplary embodiments describe a fluid management system kit that may include any combination of any two or more of a flush tube, a tool with a pressure or temperature sensor, a drain tank, and a printed material with one or more of stored information and instructions on how to set the flush tube. It should be noted that the terms "proximal" and "distal" as used herein are intended to refer to directions toward (proximal) and away from (distal) a user of the device.

Fig. 1-2 illustrate an exemplary modular fluid management system 10. Fluid management system 10 may be coupled to a surgical device that allows fluid to flow therethrough and includes a pressure sensor, such as for example, LithoVue^TMA mirror device 20. In an exemplary embodiment, the apparatus 20 further comprises: a temperature sensor to provide temperature feedback to the system 10; and/or a camera to provide visual feedback to the fluid management system 10. The fluid management system 10 also includes a fluid hanger module 100. The example fluid hanger module 100 may include one or more fluid container supports, such as fluid bag hangers 102, each of which supports one or more fluid bags 104. In an embodiment, the placement of the fluid bag 104 may be detected using a remote sensor. The fluid bag hanger 102 may receive fluid bags 104 of various sizes, such as, for example, 1 liter (L) to 5L bags. It should be appreciated that any number of fluid containers may be used. Still further, any size fluid container may be used, depending on the procedure. The example fluid management unit 100 may be mounted to a rolling stand, which may include a stem 106 and/or a base 108. Base 108 may include a plurality of wheels to facilitate easy movement of fluid management during useA cell 100. However, it will be appreciated that the fluid bag 104 may also be suspended from or between the ceiling depending on clinical preference. The fluid bag hanger 102 extends from the stem 106 and may include one or more hooks 110, and one or more fluid bags 104 may be suspended on the hooks 110. The fluid used in the fluid management system 100 may be 0.9% saline. However, it should be understood that other fluids of various viscosities may be used depending on the procedure.

The fluid management system 10 may also include one or more user interface components, such as a touch screen interface 112. The touch screen interface 112 includes a display screen 113 and may include switches or knobs in addition to touch capabilities. The touch screen interface 112 allows a user to input/adjust various functions of the system 10, such as, for example, flow, pressure, or temperature. The user may also configure parameters and alarms (such as a maximum pressure alarm), information to be displayed, and program modes. Touch screen interface 112 allows a user to add, modify, or discontinue use of the various modular systems within fluid management system 10. The touch screen interface 112 may also be used to change the system 10 between automatic and manual modes of various programs.

Fig. 3-6 illustrate an exemplary touch screen interface 112. Portions of the touch screen interface 112 may be configured to look like buttons and/or may provide functionality similar to physical buttons, as will be understood by those skilled in the art. The display screen 113 may be configured to show icons 114 associated with the modular systems and devices included in the fluid management system 10. For example, in fig. 3, the display screen 113 provides real-time video feedback 116 to the user from the scope or target tissue/vessel/lumen of the medical device 20. The display screen 113 may also include a flow display 118 as shown in fig. 5. The flow display 118 may be determined based on a desired threshold for flow set by the user prior to programming, based on a known common value, or the like. In some embodiments, the operating parameters may be adjusted by touching the corresponding portion of the touch screen interface 112. The example flow display 118 then provides a flow scale 120 having, for example, different low, medium, and high ranges based on the user-entered operating parameters and the actual flow 122. In real time, the flow display 118 adjusts the actual flow 122 and rate markings on the flow scale 120. If the flow rate enters the high range, a visual alarm 125 and/or an audible alarm may be automatically actuated in this embodiment, as shown in FIG. 5. As shown in fig. 4, a similar pressure display 119 may be provided on the display screen 113. Again, the pressure scale 123 may be determined based on parameters previously entered by the user or by known common values. The display 113 may also display the actual pressure 121 in real time. In other embodiments, the display screen 113 may also show the system power 127, the amount of fluid remaining in the fluid bag 131, and any other information that a user may find useful in a surgical procedure, as can be seen in fig. 5.

In an exemplary embodiment, the fluid management system 100 also includes additional user interface components, such as foot pedals 117, heater interface 168, fluid control interface 127, or other devices to manually control the various modular systems. For example, foot pedal 117 may be used to manually control the flow.

The touch screen interface 112 is operatively connected to or an integral part of a main processing device 124, such as a computer. The main processing device 124 may be operatively connected to one or more system components, such as, for example, a pump assembly, a heating assembly, and a fluid starvation management system. The main processing device 124 is capable of performing various functions such as computation, control, calculation, display, and the like. The main processing device 124 is also capable of tracking and storing data related to the operation of the management system 10 and each of its components. In an exemplary embodiment, the primary processing device 124 includes a network communication capability, such as WiFi, by which the device can connect to, for example, a social area network. The main processing device 124 may also receive sensor signals from the system 10. In one embodiment, the main process 124 may communicate with a database for maintenance and best practices recommendations for patient records that may be displayed to the user on the display screen 113.

The fluid management system 10 may be user selectable between different modes based on program, patient characteristics, and the like. For example, the different modes may include: namely fURS mode, BPH mode, hysteroscopy mode and cystoscopy mode. Once the user has selected the mode, the user is provided with mode parameters such as flow, pressure, fluid deficiency, and temperature via the display screen. Exemplary parameters for a particular mode may be predetermined and loaded onto the main processing device 124 using, for example, software. Thus, when the user selects a program from the initial display on the touch screen interface display 113, these known parameters are loaded from the processor to the various components of the fluid management system, i.e., the pump, the heating assembly, the fluid starvation management system. The fluid management system 10 may also be user selectable between automatic and manual modes. For example, for certain programs, a user may wish to manually adjust flow, pressure, or other parameters. Once the user selects the manual mode, for example, on the touch screen interface 112, the user may adjust the flow or pressure via other manual interfaces such as foot pedal 117 or fluid control interface 127.

The main processing device 124 may be configured to include vision software/image recognition software that can detect visual noise based on changes in brightness (i.e., light monitoring), contrast, or color animation. If it is determined that the image provided to the primary processing device 124 is not clear or legible, the fluid management system 10 increases the flow of fluid to wash away the debris 129 to make the image legible/legible. The flow rate is increased for a temporary time (i.e., a predetermined period of time) or until the field of view is deemed sufficiently clear. This temporary increase ensures that the time for the flow increase is limited to ensure that the pressure does not exceed a safe limit. For example, the system 10 may identify a red hue (evidence of blood) as shown in fig. 7 in the flush and signal a set of peristaltic pumps 126 to increase the flow until the blood is cleared from the field of view. Alternatively, the processor may provide a visual alarm on the display screen 113 or an audible alarm to a doctor or nurse that a turbid view has been detected, and the user may then manually adjust the flush flow. In another example, where there is a large amount of debris, the light reflected from the debris will substantially brighten the image. In this case, the main processing device 124 detects this excessive brightness and signals the pump 126 to increase the flow rate to remove debris. Once the reflected light has diminished as debris is flushed out of the field of view of the vision system, the pump 126 is controlled by the main processing device 124 to reduce the flow rate. Preferably, the physician may create a baseline level for visibility at which he or she prefers to initiate a view clearing fluid flow of fluid and enter these parameters into the system 10 via the touch screen interface 112 prior to the procedure. Once the baseline has been created, the system 10 monitors visual feedback to obtain changes in the image and adjusts the flow as needed.

To regulate the flow of fluid through the system 10, the fluid management unit 100 may include one or more pressurization devices, such as a pump 126. An exemplary pump 126 may be a peristaltic pump. The pump 126 may be electrically driven and may receive power from a line source, such as a wall outlet, or an external or internal electrical storage device, such as a disposable or rechargeable battery. The peristaltic pump 126 may operate at any desired speed sufficient to deliver the fluid at the target pressure (such as, for example, 5mmHg to 50 mmHg). As previously noted, the pump 126 may be automatically adjusted based on, for example, pressure and temperature readings within the patient and visual feedback from the scope 20. The pump 126 may also be adjusted manually via, for example, a foot pedal 117, the touch screen interface 112, or a separate fluid controller 127 (as shown in fig. 4). Fluid controller 127 may be a separate user interface that includes buttons that allow a user to increase or decrease each separate pump 126. It should be understood that any number of pumps may be used. In one embodiment, the system 10 may include multiple pumps having different flow capacities. The flow meter is located before or after the pump.

In this embodiment, the flow rate of fluid at any given time is displayed on the display screen 113 to allow any varying Operating Room (OR) visibility. If the OR personnel notices a too high OR too low flow change, the user can manually adjust the flow back to the preferred level. This may occur, for example, when a physician inserts and removes tools into the working channel of the scope 20. As previously discussed, the system 10 may also monitor and automatically adjust the flow based on previously set parameters. This feature may also be beneficial when flow is provided manually, such as when an assistant injects a flush through a syringe.

As noted above, in one embodiment, the system 10 may include vision software or image recognition and analysis software. In this embodiment, the system 10 may detect whether a tool has been inserted and which tool is being used via the camera 128 positioned on the endoscope 20 inside the body. For example, the tool may have a recognizable marker that the visual software can see to inform the system what type of tool is being used. The fluid management system 10 may then automatically adjust the flow based on the tool identified by the vision software. When the tool is retracted from the working channel, the fluid management system 10 correspondingly reduces the pump rate.

In another embodiment, the system 10 automatically adjusts the flow based on the pressure and/or temperature detected within the patient. Pressure and/or temperature may be measured in parallel by a tool used in conjunction with system 10, such as mirror 20. The system 10 may include pressure monitoring software such that the pump 126 may be configured by a user to be automatically started, stopped, and/or adjusted in speed by the system 10 to maintain the pressure of the fluid delivered to the surgical site at a target pressure and/or within a predetermined pressure segment. For example, a mirror pressure sensor may detect intra-renal pressure and automatically change the flow within the system 10 based on the monitored intra-renal pressure. If the intrarenal pressure is too high, the system 10 will reduce flow and vice versa. In an exemplary temperature control mode, the system 10 may include temperature monitoring software such that the heater may be controlled (e.g., activated, deactivated, and adjusted) to maintain the temperature of the fluid delivered to the surgical site at about the target temperature and/or within a predetermined temperature pressure band, as will be described in greater detail below. For example, temperature may be monitored in vivo or in vitro, and fluid flow altered based on temperature feedback provided. In an exemplary embodiment, the system 10 may compare the sensed temperature and pressure within the kidney to known values and provide a warning when the parameters are outside of predetermined safe zones. The warning may be a visual or audible alarm.

In an embodiment, the system 10 may monitor movement of a target structure (such as, for example, a kidney stone). The system may calculate the rate of movement based on the initial position of the stone and its new position. If the movement exceeds a predetermined threshold, the user may be alerted to manually adjust the flow of the system. As described above, the flow rate may be manually adjusted via foot pedal 117, touch screen interface 112, or pump interface. In one embodiment, if the system 10 is in the automatic mode, the system 10 will automatically adjust the flush flow automatically as needed. This ability may be very beneficial during procedures such as lithotripsy to control the retreat of stones.

As shown in fig. 9-10, the scope device 20 may be, for example, a ureteroscope, such as a LithoVue^TMA mirror. LithoVue^TMThe scope is lighter in weight than many existing models, thereby reducing the clinician's workload. The scope 20 delivers fluid from the fluid management system 10 to the target tissue via the scope shaft 169. As described above, the mirror 20 is connected to the fluid management system 10 via a supply line (i.e., a tube). The supply lines from the fluid management system 10 to the mirror 20 are preferably formed of a material that helps to inhibit peristaltic motion produced by the pump 126. As shown in fig. 9, the scope 20 may include a pressure transducer 170 at the distal tip of the scope shaft 169 to measure, for example, intra-renal pressure. The mirror 20 may also comprise other sensors, such as for example a temperature sensor. In an exemplary embodiment, the distal end 172 of the scope 20 may also include at least one camera 128 to provide a visual feed to the user on the display screen 113. In another embodiment, the mirror 20 may include two cameras 128 having different communication requirements, such that different information may be conveyed to the user by each camera 128. In this embodiment, the user may optionally toggle back and forth between the cameras 128 through the touch screen interface 112. Mirror 20 includes a handle 174. Handle 174 may have a fluid flow on/off switch 176 that allows the user to control when fluid flows through scope 20 and into the patient. The handle 174 may further include other buttons 177 to perform other various functions. For example, in one embodiment, the scope handle 174 may include a button for controlling the temperature of the scope or fluid. In another embodiment, the mirror handle 174 may include a laser so that the user may emit laser energy. In an exemplary embodiment, the laser may be a Lumenis or StarMed Tech laser. The laser fiber can be connected to a laser system and inserted through the ureteroscope working channel. The user can emit laser light to enable energy to be transmitted fromThe laser fiber tip emits, which strikes the debris/stone to break it up. In an exemplary embodiment that includes a laser button on the mirror, a communication link (i.e., hardwired or wireless) between the laser system and the mirror is maintained. It should be understood that while the exemplary embodiment describes a ureteroscope, the features detailed above may also be integrated directly into a cystoscope, hysteroscope, or virtually any device with imaging capabilities. Mirror 20 may also include a drain port 178 that may be connected to a drain system as will be described in more detail below.

The fluid management system 10 may include a fluid deficiency monitoring system 130. In an exemplary embodiment, the fluid deficiency monitoring system 130 monitors the amount of fluid (i.e., saline) in the fluid bag 104 by weight. In this embodiment, a weight sensor 132, such as a scale, is suspended from the hook 110. The weight sensor 132 may also include a hook 134, with the one or more fluid bags 104 suspended from the hook 134. The weight sensor 132 determines the weight of the fluid bag 104 attached to the hanger module 100 to compare the initial amount of fluid in the fluid bag 104 to the amount of fluid currently remaining in the fluid bag 104. The scale reading is shown to the user on the display screen 113, as shown in fig. 4-5. As the procedure progresses, the scale reading is updated in real time to alert the physician how much fluid remains in the fluid bag 104, which can then be used to determine the amount of fluid that has been infused into the patient. In an exemplary embodiment, the system 10 provides the amount of time remaining before a new bag is needed based on the weight of the bag 104 and the rate (i.e., flow rate) at which the bag 104 is emptied. In another embodiment, the amount of fluid remaining may be shown as a fluid starvation bar 131, as can be seen in fig. 6. When, for example, 10% saline remains in the bag 104, an alarm with an audible signal may be displayed on the display screen 113. In an exemplary embodiment, the weight sensor 132 may be connected to the display screen 113 via a WiFi signal. In another exemplary embodiment, the weight sensor 132 may be connected to the display screen 113 via a hard-wired connection.

In another exemplary embodiment, the fluid starvation monitoring system 130 may include a pressure sensor connected in-line between the fluid bag 104 and the device 20. In this embodiment, the pressure is determined based on the height of the fluid bag 104. As the bag empties, the amount of discharge pressure decreases. When the pressure drops below a user-set threshold, an alarm is shown on the display 113 and an audible signal is emitted. In another exemplary embodiment, the under-fluid monitoring system 130 may be set to a particular flow rate based on the amount of time that has elapsed. The physician may enter a bag fluid volume into the system 10 and the system 10 then calculates the amount of fluid that has been used and how much remains based on the known flow rate and the amount of time the system 10 has been used.

The fluid management system 10 may employ a small diameter pump tube 136 to connect the various components. An exemplary tube 136 for a flush procedure may have a diameter less than or equal to 1/16 inches. However, it should be understood that the tube dimensions may vary depending on the application. The tube may be disposable and provided sterile, and ready for use. Different types of tubing may be used for various functions within the system 10. For example, one type of tube may be used for fluid heating and fluid flow control to the device 20, while another type of tube may be used for irrigation in vivo.

In an exemplary embodiment, the fluid management system 10 may optionally include a heater assembly 138 for heating fluid to be delivered to a patient, as shown in fig. 11-12. The heater assembly 138 includes a heater 140, a heater cartridge 142, and a clamping mechanism 144 for the cartridge 142. The example cartridge 142 may include a fluid outlet port 148 and a fluid inlet port 146 located on lateral sides of the cartridge 142. Fluid inlet port 146 and fluid outlet port 148 each include an inlet connector 150 and an outlet connector 152, respectively, extending from a lateral side of cartridge 142. The connectors 150, 152 may be in the form of luer lock fittings, barb fittings, quick connect fittings, and the like. Connectors 150, 152 connect heater assembly 138 to other components of fluid management system 10. For example, fluid inlet port 146 may be connected to pump 126 via fluid tube 136, while fluid outlet port 148 is connected to device 20. In an exemplary embodiment, cartridge 142 includes an internal flow path along passage 154 through which fluid may flow from inlet connector 150 to outlet connector 152, as shown in fig. 12. The cartridge 142 may include one fluid path or multiple fluid paths. If multiple fluid paths are present, one or more walls 156 may separate the respective fluid channels 154. Exemplary fluid passage 154 includes a horizontal section 158 and a vertical section 160 to form a swirling fluid path between fluid inlet port 146 and fluid outlet port 148. Fluid channel 154 is configured to provide a large amount of outwardly facing surface area relative to the interior volume to facilitate effective warming of the fluid by heater 140. In an exemplary embodiment, fluid enters cartridge 142 via inlet port 146 and enters lower horizontal section 158 a. The fluid flows through vertical section 160a and reverses direction to flow through first intermediate horizontal section 158 b. The fluid follows the channel 154 in this manner until it flows through the outlet port 148. The sections 158, 160 of the channel 154 are separated by a horizontal wall 156. The cassette 142 may be formed of, for example, polycarbonate or any high heat rated biocompatible plastic, and formed as a single piece or as multiple pieces permanently bonded to one another. The inlet connector 150 and the outlet connector 152 may be integrally formed with the cassette 142, or may be separately disposed pieces, as will be understood by those skilled in the art.

The cartridge 142 is coupled to the heater 140 via a clamping mechanism 144. In the exemplary embodiment of fig. 11, the clamping mechanism 144 is configured as two side plates 162, with a slot 164 extending between the side plates 162 for receiving the cassette 142. In an exemplary embodiment, the slot 164 may include guides (not shown) to assist a user in inserting the cartridge 142 into the slot 164. When inserted into the slot 164, the side plate 162 is clamped around the cassette 142 by two knobs 166. Rotation of the knob 166 in a first direction moves the side plates 162 closer together to clamp the case 142 in place between the side plates 162, while rotation of the knob 166 in a second direction moves the side plates 162 apart to allow the case 142 to slide out of the slot 164. The clamping mechanism 144 may be attached to the stem 106 by any means, such as, for example, an adjustable stem clamp, such that the clamping mechanism 144 and the heater assembly 138 may be slid along the stem 106 to a desired position.

The cartridge 142 is designed such that when the cartridge 142 has been inserted into the slot 164 of the heater assembly 138 (as shown in fig. 11), the channel sections 158, 160 are generally aligned with the heater 140. The heater 140 may include one or more heat sources using electrical energy, such as, for example, a side-by-side coil or platen system in a fluid supply line. The heating may be specifically designed and tailored to suit the flow rate required in the particular application of the system 10. The heater 140 may be located in one or both of the side plates 162. In an exemplary embodiment, the heater 140 encompasses the entire inner surface area of the plate 162. In another exemplary embodiment, the heater 140 may be located only at an upper portion of one or both of the plates 162. It should be appreciated that the heater 140 may be located anywhere on the heater assembly 138 adjacent to the fluid flowing therethrough.

The heater assembly 138 may include a heater user interface 168. The heater user interface 168 may simply be a display screen (not shown) that may provide a digital display of the internal temperature of the heater. In another embodiment, the user interface 168 may also include a temperature adjustment button to increase or decrease the temperature of the heater 140. In this embodiment, a heater display screen (not shown) may indicate the current temperature of the heater and the target temperature to be reached. It should be noted that all information output from the heater assembly 138 may be transmitted directly to the display screen 113, such that the heater user interface 168 is not required.

In an exemplary embodiment, the temperature sensors are mounted in the heater assembly 140 such that they detect the temperature of the fluid flowing through the cartridge 142. These sensors may be located at or near fluid inlet port 146 and fluid outlet port 148. In an exemplary embodiment, the temperature sensors may be mounted such that they detect the temperature of the fluid flowing through the cartridge 142 before the fluid enters the channel 154 and after the fluid exits the fluid channel 154. In some embodiments, additional sensors may be located in the middle portion of the channel 154 such that they detect the progression of the temperature increase of the fluid in the cartridge 142. The sensors may send any information to the display screen 113 remotely, or they may send information to the heater user interface display screen. In another embodiment, the sensor is hardwired to the heater user interface 168, whereby the heater user interface 168 is capable of remotely transmitting the desired information to the system display screen 113.

The fluid management system 10 may include a waste management system 200. An exemplary waste management system may simply be a tube leading from a fluid disposal port in the scope 20 to a drain bag or collection container 180. The collection of waste may be via a tank on the platform or a direct feed to an alternative system. In the embodiment shown in fig. 13, for example, one or more waste collection containers or canisters 202 (five in this embodiment) may be used in combination with a vacuum pump (not shown) to draw waste from the patient to the collection containers 202. It will be understood that although the embodiments herein show five collection containers, any number of containers may be used. For example, fig. 34 shows another exemplary embodiment using three collection containers. Tube 236 linearly connects each of collection containers 202 to one another such that collection containers 202 are filled one at a time. Specifically, when the first collection container 202 is full, waste begins to flow into subsequent collection containers, and so on until each collection container is full. One problem with such "daisy chain" systems, however, is that the vacuum (not shown) must be turned off to swap a full waste collection container 202 out of the system. In addition, the system 200 is not easily pre-plumbed for placement or removal as a group when full, increasing potential vacuum down time.

In FIG. 14, a waste management system 300 is shown that addresses the problem of the "daisy chain" system, according to an alternative embodiment. In this embodiment, five collection containers 302A-302E and a vacuum pump 304 are used, similar to the waste management system 200. However, it should be understood that any number of collection containers may be used depending on the procedure. In this embodiment, an intermediate holding chamber 306, an on/off valve 308, and a conventional pinch valve 310 are also included in the system. The intermediate holding chamber 306 is connected to the patient, the first collection container 302A and the two-position pinch valve 310. Pinch valve 310 is positioned between intermediate holding chamber 306 and first collection container 302A and is operable to allow or prevent fluid waste from flowing into first collection container 302A. The first collection container 302A is connected to the second container 302B, the second container 302B is connected to the third container 302C, and so on. The vacuum pump 304 is connected to the intermediate holding chamber 306 and the final collection container 302E via a pipe 336 and a two-position pinch valve 308, the two-position pinch valve 308 being a Y-pinch valve as shown in fig. 14. The two-position pinch valve 308 may be activated to allow flow to the waste collection containers 302A-302E or the intermediate holding chamber 306.

In use, waste fluid is pumped from the patient through the intermediate holding chamber 306 and into the waste collection container 302. When the waste collection container 302 is full, the pinch valve 310 and the on-off valve 308 are activated, thereby obstructing the connection between the patient and the waste collection container 302, preventing waste from flowing into the collection container 302, thereby allowing the user to replace the full container with an empty one or empty and replace the full one. When this occurs, the intermediate holding chamber 306 collects waste from the patient until the pinch valves 308, 310 are switched back to allow flow to the collection container 302 again. Thus, the system 300 allows a user to easily switch out a used collection container 302 without having to turn off the vacuum 304 or stop the waste stream from the patient.

In an exemplary embodiment, according to fig. 15, two manifold waste management systems 400 are shown. In this embodiment, the waste management system uses one manifold 406 for waste and another manifold 408 for the vacuum pump 404. Specifically, one line 410 extends from the patient and branches into individual tubes 410A-410E, wherein each of the tubes 410A-410E extends to a corresponding one of the collection containers 402. A second line 412 extends from the vacuum pump 404 and similarly branches into individual tubes 412A-412E, each of the tubes 412A-412E extending to a corresponding one of the collection vessels 402A-402E. Thus, the patient and vacuum 404 are both individually and separately connected to each of the collection containers 402A-402E. A plurality of pinch valves 414A-414E are provided, each positioned on a respective one of the lines 410A-410E, 412A-412E to control vacuum suction and waste flow to the respective collection containers 402A-402E, as shown in fig. 15. In use, pinch valves 414A-414E may be activated to turn off the vacuum pump 404 and inhibit the flow of waste stream to unused collection containers, thereby controlling the flow to enter only one collection container at a time. Further, when collection container 402 is full, the corresponding pinch valve 414 may be activated to shut off vacuum and waste flow to the full collection container and allow removal of the full collection container without disturbing the waste flow to other collection containers having free space.

Figure 16 illustrates an exemplary embodiment having a single manifold waste management system 402'. In this embodiment, the waste management system uses a single tube manifold 406' that attaches both the patient and the vacuum pump to the various collection containers. Specifically, two lines 410 'extending from the patient and the vacuum pump 404' branch into separate tubes 410A-410E ', each of which extends a corresponding one of the collection containers 402'. Similar to system 400, each collection vessel 402A-402E 'has an associated pinch valve 414A-414E' that controls flow to the corresponding collection vessel such that, for example, flow may be allowed to only a single collection vessel at a time. Thus, the pinch valve may be operated to allow or prevent flow to the collection container in any desired combination, thereby allowing removal of a full collection container without disturbing the waste stream to other collection containers having remaining space.

In another exemplary embodiment, according to fig. 17, the waste management system 500 includes three vacuum pumps 504 and a two-position pinch valve 506. In this embodiment, each group 502, 502 '(502A and B in group 502 and 502A' and 502B 'in group 502') with two collection containers has its own vacuum pump 504. The separate collection vessel 502 "includes a pump 504 for suspension. A line 510 extends from the patient and branches at pinch valve 506 into individual tubes 510', 510 ", each tube extending to a corresponding collection container in collection container set 502, 502'. That is, the first collection containers 502B, 502B 'in each set of collection containers 502 are connected to the patient via tubes 510' and 510 ", respectively, while the second collection containers 502A, 502A 'in each set 502 are connected to the first collection containers 502A, 502A' via connecting tubes 511 and 511', respectively, and to the vacuum pump 514 via tubes 513, 513', respectively. A two-position pinch valve 506 is positioned between the patient and the collection container set 502 and is operated to allow waste to flow into only one collection container at a time. This restriction on the waste stream allows a full waste collection container to be replaced or emptied as needed while continuing to flow to another container. In another exemplary embodiment shown in fig. 18, the system may be used as a dual vacuum system without a pendant vacuum.

In use, the components of the waste management system 200-500 can be arranged in various configurations to facilitate accessibility and functionality depending on the procedure. In a first embodiment, as shown in fig. 19, a waste management system 200 may be mounted to the ceiling 192. It should be understood that any of the waste management systems 300, 400', and 500 may be arranged using the various configurations described herein. In this embodiment, the waste collection containers 202 may be nested in the front shelf 194 and side-by-side with each other for easy access and removal. The ceiling mount assembly 190 keeps the floor from cluttering during procedures where space is limited. In another exemplary embodiment shown in fig. 20 (which is discussed further below), the waste management system 200 may include a universal mount (not shown) to facilitate mounting to, for example, an IV pole. It should be appreciated that the universal mount may also be used to mount the waste management system 200 to a wall mount or even a desktop configuration. In another exemplary embodiment, the waste collection container in use may be attached to the IV pole 106 at waist height to allow for easier removal and disposal, as can be seen in fig. 21. In this embodiment, two or four waste collection containers 202 are held in each lumbar horizontal assembly 196, with the ready (unused) waste collection containers 202 located on the lower storage platform 198. In another exemplary embodiment, as shown in fig. 22, the waste management system may include a separate module for the waste collection container 202, such as a floor pod 190'. In this embodiment, the floor pod 190 'may include a separate compartment 192' for each of the waste collection containers 202. However, it should be understood that the floor pod 190 'may alternatively include a single compartment to hold all of the waste collection containers or a single disposable waste bag 196', as shown in fig. 23. The floor pod 190' may include wheels so that the collection container may be rolled as needed to clear the surgical suite.

To optimize the ergonomics, accessibility, and functionality of the fluid management system 10, the major subsystems, components, and modules of the fluid management system 10 may be arranged in various configurations according to a program. For example, the location of the pump, saline bag, touch screen, etc. may be arranged in any desired configuration to optimize the access of the surgeon or those assisting the procedure, depending on the procedure to be performed. In an exemplary embodiment, as shown in fig. 24-34, the fluid management system 10 is configured as a modular option and vertical stacking of major components on a vertical IV pole 106 with a rolling base 108. This vertical stacking of components reduces the width of the fluid management system 10 (i.e., the fluid management system 10 is narrower), making the system 10 more compact so that it can be positioned in a confined area, such as in an operating room. In these embodiments, the rod 106 may include a bend 602 at a lower portion thereof, such that each of the components and modular options may be coupled to the front of the rod 106 without interfering with the weight distribution of the system 10.

In this embodiment, the collection container 202 is positioned around the bottom of the stem 106 in a compact configuration. In the exemplary embodiment shown in fig. 24, the collection container is weighed by a hanging weight mechanism 604. The hanging weight mechanism 604 may be coupled to the pole 106 and include a plurality of individual compartments 606 for loading the collection container 202. In the embodiment of fig. 24 and 26, the hanging weight mechanism 604 includes five compartments 606. However, it should be understood that any number of collection container compartments 606 may be used depending on the procedure and fluid waste level. Each compartment 606 includes an aperture (not shown) in which the collection container 202 is placed. The suspended weight mechanism 604 may include a weight sensor (not shown). In another embodiment, each compartment 604 may include a weight sensor (not shown) for detecting a change in weight of the containers 202 loaded in the respective compartment. In other embodiments, as shown in fig. 26-27, the collection containers 202 may be loaded onto individual substrates 610. The substrates 610 may each include a weight sensor (not shown) that detects a change in weight of the collection container 202 loaded on the corresponding substrate 610. In another exemplary embodiment, a collection container may be loaded into a swivel mount 612 as shown in fig. 28. The cartridge receptacle 612 may be manually or automatically pivoted. Additional supports 614 may be added to stabilize cartridge receptacle 612 and collection container 202. In this embodiment, the collection containers may be weighed as a group or individually. Alternatively, an optical level sensor (not shown) may be used to monitor changes in the fluid level within the collection container.

The display unit 616 may or may not be integrated with vertically stacked components, depending on user preference or limitations of available space. For example, it may be preferable to have the display unit 616 positioned on a table at a different viewing angle than any viewing angle that could be provided if the display were coupled to the pole 106. Alternatively, in another example, integrating the display unit 616 with the stacked components may increase the height of the vertical stack such that it cannot fit within the designated space in the surgical suite. In these cases, such as the embodiment shown in fig. 24 and 27, the display unit 616 is not integrated with the IV pole and the overlying components, but is a separate display unit, so as to be placed in the desired location. However, in other embodiments, the display unit 616 may be coupled to the top of the bent IV pole 106, for example as seen in fig. 25, 28. This location of the display unit 616 at the top of the IV pole 106 allows greater visibility for the user while preventing the display unit 161 from being blocked by other components of the system 10. In some embodiments, multiple display screens may be used to implement multiple imaging modalities. For example, in the embodiment shown in fig. 31 and 34, system 10 may include an operator display 618 and a procedure display 620. In this embodiment, the display screens 618, 620 may be positioned to facilitate visibility within the surgical suite. The display screens 618, 620 may be coupled to the system 10 by a swing hinge 617 as shown in fig. 31, 34 to allow a user and/or support personnel to be able to move the screens to a desired angle to improve visibility. In another embodiment (shown in fig. 32), operator display screen 618 may be coupled to system 10 via a swivel hinge 619. The swivel hinge 619 is a multi-directional hinge that provides greater mobility to the screen to allow a user to more easily position the screen 618.

The positioning of the fluid saline bag 104 may also vary depending on loading, height, visualization, and access preferences. In some cases, it may be preferable that the fluid pouch 104 be easily visible to a user. For example, a physician may wish to see the rate at which saline is used or the level of saline remaining in each fluid bag 104 in order to know when the fluid bag 104 should be replaced. In another example, the process may require top or rear access of a Y-pinch valve in the tube. In these embodiments shown in fig. 24-28 and 34, a fluid bag 104 may be mounted to the top of the IV pole. This high mounting allows the user or support personnel to easily see the fluid bag 104 while also allowing the tube 136 to hang down to facilitate fluid flow. In one embodiment, as shown in fig. 28, where an external display is mounted on top of the IV pole, the fluid bag 104 may be positioned behind the display. This rear accessibility allows support personnel to access the fluid bag 104 from behind the system 10 without interfering with user access to the modular components of the system 10. In another exemplary embodiment, the fluid bag 104 may be mounted to the bottom of a modular component of the system 10. For example, as shown in fig. 35, the fluid bag 104 may be mounted to the bottom of the pump 126. This embodiment includes optimal loading accessibility for the user/physician while also allowing good visibility of the fluid pouch 104. In another exemplary embodiment shown in fig. 36, the fluid pouch 104 may be corner mounted. That is, each of the fluid bags 104 may be mounted at an angle behind the modular system. This configuration provides good loading height and rear accessibility for the bag to be set or replaced by support personnel. In another exemplary embodiment shown in fig. 37, the fluid pouch 104 may also be corner mounted. However, unlike the fluid bag 104 mounted at an angle as shown in fig. 36, the fluid bag 104 is mounted coaxially behind the modular system. As with the embodiment of fig. 36, this configuration provides support personnel with good loading height and rear access for easy setup and saline bag replacement. In some exemplary embodiments, the saline bag hanger may be a retractable hanger. For example, the arms of the hanger may be able to rotate/pivot inwardly, thereby pulling the bag closer to the body. In another example, the arm itself may be telescopic. Such a retractable hanger allows easy loading (especially if multiple bags are hung) and space minimization.

In vertically stacked embodiments, the pumps 126 may be grouped in vertical or horizontal groups, or combinations thereof, as can be seen in fig. 24-34. That is, in a system 10 in which the fluid management unit 100 includes multiple input and/or output pumps, the pumps 126 may be grouped into different groups to facilitate better fluid flow and provide different fluid flow paths and efficiencies. For example, the high/low flow output pumps 622 may be vertically grouped, or as shown in fig. 24-26 and 28, the high/low flow output pumps 622 may be horizontally grouped. Similarly, the high/low output pumps 622 may be vertically grouped with the input pumps 624 or may be horizontally aligned with the input pumps 624 as shown in fig. 27. Further, in some embodiments (shown in fig. 27-28), the input pump 624/output pump 622 may have a symmetrical layout with respect to the overall system 10, wherein the input pump 624 is spaced apart from the output pump. Alternatively, the input pump 624 and the output pump 622 may be positioned adjacent to each other, as shown in fig. 24 and 26. In the exemplary embodiment of fig. 24, the input pump 624 may be disposed in a different plane than the remaining output components (including the output pump 622). For example, the high/low output pump may be positioned on a front or first side of the system, while the input pump is positioned on the opposite side of the system. In an exemplary embodiment, the high/low output pump is retractable or covered for proper setup. In each of the various configurations of the pump, connections between other modular components of the system 10 and the pump are made in groups with input and output pumps.

In some embodiments of the vertically stacked fluid management system 10, various additional features may be integrated. For example, in one embodiment (shown in fig. 29-30), the system 10 may include a filter nest for an irrigation tube extending from a patient. The filter nest is used to hold a cylindrical filter that filters fluid returning from the patient so that it can be reused and pumped back into the patient. In other exemplary embodiments (shown in fig. 30-31), the system 10 may include a pinch valve to allow a user to stop the flow of saline from the fluid bag 104. In these embodiments, the fluid bag 104 is positioned directly above the rest of the system 10 to create a direct flow route from the fluid bag to, for example, the pump system 126. In the embodiment of fig. 30, the fluid bag hanger 102 may be angled forward from the stem 106 so that the fluid bag 104 hangs in front of the unit, allowing for easier fluid flow, and greater visibility and accessibility by the user.

In other exemplary embodiments shown in fig. 39-42, the fluid management system 10 may be positioned on a modular cart 630 that includes a rolling base 608. Modular cart 630 includes a pole 632 coupled to the side of modular cart 630 and a flat clean top surface 634 for arranging the individual modular units. In one embodiment, as shown in fig. 39, the individual modular units may be stacked vertically. Specifically, collection container 202 may be positioned at the bottom of modular cart 630 below planar surface 634. The collection container 202 may be snapped into a covered container compartment 636 having an exposed coupler (hookup) (not shown) for connecting the collection container to the patient and the rest of the fluid management system 10. The folding touch screen 638 and the input and output pumps 624, 622 may be positioned on the cleaning top surface 634 with the input and output pumps 624, 622 separated by the touch screen 638. This arrangement is optimal for a compact modular cart and fluid management system 10. In this embodiment, the display unit 616 may be integrated with the modular cart 630 and coupled to the top of the pole 632, with the fluid bag 104 suspended from the bottom of the display unit 616 for easy access by a user or support personnel. Suspending the fluid bag 104 from the display unit 616 positions the bag 104 at a preferred loading height. For example, the saline bag may be positioned approximately 48 inches from the ground.

In another exemplary embodiment of the modular cart based system shown in fig. 40, the individual modular functional units may be horizontally stacked on the clean top surface 634. In this embodiment, the rod 632 may also be coupled to the side of the modular cart 630, with the fluid bag 104 suspended from the top of the rod 632. A second side bar 640 is positioned on the opposite side of cart 634 for display unit 616. The fluid bag 104 and the display unit 616 are positioned on opposite sides of the modular cart 630 to balance each other, providing greater stability to the modular cart 630. The input and output pumps 624, 622 may be arranged in vertical banks on a flat top surface 634 with mechanical covers (not shown) or retractable mechanisms (not shown) for proper setup. Connections (not shown) are grouped with sets of input and output pumps 624 and 622. The touch screen 638 may also be placed on the flat top surface 634. In this embodiment, the collection containers 202 may be grouped in covered compartments 642 disposed on the flat top surface 634, as shown in fig. 40. This elevated positioning of collection container 202 on flat top surface 634 allows for easier viewing and replacement of collection container 202 within compartment 642.

In some cases, it may be beneficial to have a more compact modular cart arrangement. For example, when the space available in a surgical suite is very small, a compact cart may be required. In the exemplary embodiment of fig. 41, a very simple modular cart arrangement can be seen, which includes a flat top surface 634 and a cart bar 632. In this embodiment, the flat top surface 634 may be positioned approximately 16 inches above the ground to provide just enough space below it for the collection container 202. The collection containers 202 may be grouped in a front compartment 636 having an exposed coupling (not shown) for connecting the collection containers 202 to the rest of the fluid management system 10. The bar 632 in this embodiment is centrally located at the rear of the cart 630, with the fluid bag 104 suspended from the fluid bag hanger 102 at the top portion of the fluid bag hanger 102, for balancing and increasing stability of the cart 630. All functional modular components (i.e., pump, touch screen, and connections) are positioned in a compact arrangement on the flat top surface 634. Specifically, the input pump 624 and the output pump 622 are positioned horizontally, and the touch screen 638 is a folding touch screen to facilitate a small cart layout. In order to make the cart layout as compact as possible, this embodiment uses a separate external display unit 616, which may be placed elsewhere in the room.

In another exemplary embodiment according to fig. 42, the modular cart arrangement may include a plurality of stacked modules 644, which may be added or removed depending on the application. In this embodiment, the modular cart 630 includes a pole 632 for hanging the fluid bags 104 and a collection container compartment 636 located at the bottom of the cart 630. Each of the modular devices or systems may be positioned on separate flat top surfaces 634 similar to shelves, which flat top surfaces 634 are configured to be coupled to the rods 632. For example, the touch screen 638 may be positioned on one removable planar top surface 634, the input pump 624 and the output pump 622 may be positioned on a second planar top surface 634, and the heater may be positioned on a third planar top surface 634. This removability of the flat top surface 634 increases the flexibility of the system 10, allowing the components of the system 10 to be replaced according to the patient or procedure. Furthermore, because fluids can be managed on the cart 630 separately from the modular components of the system, accessibility is increased for support personnel. The flat top surface may be connected to the rod via any suitable coupling mechanism. For example, the flat top surface may be mounted to the rod with screws or mounting hardware.

The fluid management system 10 may be an open loop system or a closed loop system. As previously mentioned, the fluid management system 10 is a modular system that allows for the addition, replacement, or suspension of various modular components within the system 10. For example, the system 10 may be configured to include the heater assembly 138 for one application, and subsequently, the heater assembly 138 may be removed for a different application. The touch screen interface 112 allows for the addition and removal of various modular items such that feedback and alerts related to each modular item are displayed to the user on the display screen 113.

The fluid management system 10 may be supplied with power by any known method (e.g., via a removable cord). In an embodiment, some components may receive power from more than one power source. For example, one or more power supply units may provide appropriate voltages and currents to various electrical loads. The primary processing device 124 may be protected by battery backup in the event of a power failure or accidental disconnection.

In an exemplary method of operating the fluid management system 10, a user may hang one or more fluid bags 104 on one or more of the weight sensor hooks 134 extending from the weight sensor 132. The fluid bag 104 is connected to the peristaltic pump 126 via a tube 136. The pump 126 may be connected to a fluid inlet port 146 of the heater assembly 138 via another tube 136. Another tube 136 may connect a fluid outlet port 148 of the heater assembly 138 to the mirror device 20. The operator may then utilize the touch screen interface 112 to set up the fluid management system 10, which may include selecting a surgical rule (mode), a procedure type, a modular system being used, and setting fluid pressure, temperature and flow set points, and/or other parameters (e.g., alarm set points, display content, and/or placement). When inserting the scope 20 into a target passageway (i.e., bladder, ureter) within a patient, the user may begin a fluid cycle using the fluid flow on/off button 176 on the scope 20 or a touch button on the touch screen interface 112. Sensors positioned on the mirror 20 provide feedback regarding the condition of the target anatomy in which the mirror is positioned, which is then displayed on the display screen 113. If the user has selected to place the system 10 in an automatic mode, changes in pressure, temperature, or visual feedback detected by the sensors may automatically trigger a change in pump/flow if the change exceeds or falls below a particular set point. For example, such changes may occur to improve visualization, to flush blood, urine, blood clots, or debris, or in the case of a tool that has been inserted through the scope to compensate for the reduced flow space within the working channel. At the same time, the user and/or the entire surgical team may be alerted of the change by an audible or visual alert. Once the sensors detect that the conditions have been standardized (i.e., the obstruction or tool has been removed), the system 10 will decrease the pump/flow. At any time during the procedure, the user may toggle the system 10 via the touch screen interface 112 or other physical switch so that its components (such as the pump 126) may be manually adjusted. The adjustment may be made manually by using a foot pedal 117 or by touching a button on the display 113.

Also, various other modular devices and systems (e.g., heater assembly 138, pump 126, and fluid deficiency monitoring system 130) may provide information to a user on display screen 113 regarding the operating conditions of each system. For example, the heater assembly may display the fluid flowing through the heater assembly 138 and the internal temperature of the heater. In another example, the pump 126 may provide a pump rate to a display screen, and the fluid starvation system may provide the amount of time remaining before the existing fluid bag 104 should be replaced, as previously discussed. The user may switch the system 10 to manual mode at any time to manually control each of the modular systems.

Those skilled in the art will appreciate that the present apparatus and methods are not limited to the disclosed embodiments. For example, the disclosed fluid management system 10 may be used for various other procedures, such as, for example, hysteroscopy, cystoscopy, TURP, and the like. Thus, the system 10 is not limited to use with a ureteroscope, but may be used with other devices, such as a cystoscope, hysteroscope, or any other device having sensors and image capabilities.

It will be appreciated by those skilled in the art that changes could be made to the embodiments described above without departing from the inventive concepts thereof. It is also to be understood that structural features and methods associated with one of the embodiments may be incorporated into other embodiments. Therefore, it is to be understood that the invention is not to be limited to the specific embodiments disclosed and that modifications are intended to be included within the scope of the invention as defined by the appended claims.