WO1998004200A1

WO1998004200A1 - Surgical smoke evacuator

Info

Publication number: WO1998004200A1
Application number: PCT/SE1997/001233
Authority: WO
Inventors: Sven-Olof Nyman
Original assignee: Nyman Sven Olof
Priority date: 1996-07-25
Filing date: 1997-07-07
Publication date: 1998-02-05
Also published as: AU3711997A; SE9602856L; SE9602856D0; SE518424C2

Abstract

The present invention relates to a smoke suction device and to a smoke extraction method for use together with smoke-generating surgical equipment. More specifically, the invention relates to a smoke suction device comprising a pump, a filter means, at least one suction nozzle, and sensing means for automatically activating the device. It is characteristic of the smoke suction device that the pump is a pneumatically operated ejector having no movable parts. The method for smoke extraction in connection with the use of smoke-generating surgical equipment is characterised in that a suction flow of at least some magnitude is established already before the surgical equipment is used and thereby generates smoke, and in that at least a reduced flow is established throughout most of the time when that same equipment is not active.

Description

SURGICAL SMOKE EVACUATOR

Technical Field

The present invention relates to a smoke suction device and to a smoke suction method for use together with smoke-generating surgical equipment. More specifically, the invention relates to a smoke suction device comprising a pump, a filter means, at least one suction nozzle, and sensor for automatically activating the device.

Background

In the use of surgical equipment, such as diathermy appliances, lasers and cauterising apparatuses, smoke develops. Such smoke is undesirable, since it obstructs the surgeon's vision and has an unpleasant odour. A more serious problem is, however, the potential contamination of the smoke and the consequential dangers to the patient as well as to the nursing staff. For preventive purposes smoke suction devices are used together with smoke- generating surgical equipment of this type, such devices typically comprising a suction pump and a number of filters .

This kind of smoke suction devices are already known. The problem encountered with these devices is, however, that in order to offer satisfactory protection against infection, they must be active also during the interim periods of non-use of the smoke-generating equipment, which leads to rapid wear on the device with consequential early breakdown, to impaired working environment on account of the constant high noise level from the pump and to premature clogging of the filters which therefore are in need of more frequent cleaning/ replacements, which in turn leads to the work having to be interrupted and to infection hazards. In order to solve these problems smoke suction devices have been suggested that are activated simultaneously with the surgical equipment, for example with the aid of control via current-intensity sensors. Smoke evacuators of this kind are described in e.g. US-A-5 160 334 and US-A-5 336 218. The disadvantage of this kind of smoke evacuators is, however, that the pumps are not activated until concurrently with the start of use of the surgical equipment and thus at the same time as smoke starts to develop. In an initial stage, the smoke thus will not be taken care of in a manner that is satisfactory from the viewpoint of infection hazards. The problem is aggravated further when the pumps used are of a mechanical type, utilizing pistons, fans or similar means and typically have a start-up time of some second or seconds. In the case of surgery involving particularly serious infection hazards (hepatitis, HIV, and so on), it is of particular importance that all smoke be taken care of. Another problem encountered in the above-mentioned mechanical pumps is that they are comparatively voluminous and awkward, produce high-level noise and generate much heat, features which in turn often are dissuasive to use as the pumps are felt to be a cause of discomfort, which obviously is not favourable from an infection preventive point of view.

A further problem encountered in the above-mentioned smoke suction devices is that because of the intermittent flow, suction nozzles and connecting hoses may be fouled or contamined and consequently are potential sources of infection when the equipment, following a standstill, is restarted. A particular danger is extracted cancer cells and similar substances that may be dispersed in this manner and be re-implanted into the body, thus generating new tumours. Object of the Invention

The object of the present invention is to provide a smoke suction device that completely or at least partially elminates the problems connected with prior-art smoke suction devices.

This object is achieved in a smoke suction device according to claim 1. Advantageous embodiments are defined in the dependent claims.

Brief Description of the Drawings

For exemplifying purposes the invention will be described in closer detail in the following with reference to the accompanying drawings, wherein: Fig. 1 is a schematic view of the structure of an embodiment of a smoke suction device in accordance with the invention;

Fig. 2a is a time diagram illustrating parallel activation of a diathermy apparatus and activation of the suction device, respectively, in a first operational mode of the suction device;

Fig. 2b is a time diagram similar to that of Fig. 2a, in a second operational mode of the suction device; Fig. 2c is a time diagram similar to that of Fig. 2a, in a third opperational mode of the suction device; Fig. 2d is a time diagram similar to that of Fig, 2a, in a fourth operational mode of the suction device;

Fig. 2e is a time diagram similar to that of Fig. 2a, in a fifth and sixth operational mode of the suction device;

Fig. 2f is a time diagram similar to that of Fig. 2a, in a seventh operational mode of the suction device;

Fig. 3 is a circuit diagram of the control unit used in the device of Fig. 1; Figs 4a and b are schematical views illustrating magnets provided to sense position changes of the handle of the smoke-generating equipment; and Figs. 5 a-c are schematical views illustrating various types of nozzles for use together with the suction device in accordance with the invention.

Description of Preferred Embodiments

Fig. 1 illustrates a smoke suction device in accordance with the invention, comprising a suction pump 1 the suction part of which, i.e. the vaccum connection lc, is connected to a suction nozzle 3 via a filter unit 2.

Preferably, a pneumatic vacuum pump, a so called pneumatically operated ejector, is used as the suction pump, said ejector operating on the principle of allowing a large gas flow to pass a restriction, whereby a nega- tive sucking pressure forms immediately after the point of restriction, which is where the vacuum connection lc is placed. The advantage of using a suction pump of this nature is the absence of moving parts, a feature which reduces wear and consequently the maintenance need, and the rapid response upon activation. A further advantage is that a pump of this kind may be made to small dimensions, which facilitates the positioning thereof, as it need not necessarily be placed on the floor but could be supported from the wall or the ceiling, be positioned outside the operating room, etcetera. Another advantage is that the pump requires less energy and creates less noise and vibration than previously used types of pumps.

The suction pump 1 has an input connection la for the inflow of pressurized air, an output connection lb for air evacuation and, as already mentioned, a suction vacuum connection lc. The output air-evacuation connection advantageously may be directed away from the infection-sensitive area via an evacuation hose or evacuation channel 6. Such evacuation is also recommended by the Swedish Board of Occupational Safety and Health ("Report of 0 S & H Board 1994:1"). For example, the evacuation channel may debouch externally of the building. In this manner, re-entry into the operating room of infectious particles not trapped by the filter unit is avoided. The filter unit 2 comprises at least one smoke- purifying part 2a which advantageously may consist of an ordinary and previously known smoke filter, and a liquid- blood separator part 2b. The latter part advantageously comprises a suction vessel, also of a prior-art kind. The filter unit connection arrangement is such that the vacuum connection lc of the suction pump is coupled to the ouput connection of the smoke filter 2a, the input connection of the smoke filter is coupled to the output connection of the suction vessel 2b, and the input connection of the suction vessel is coupled to the suction nozzzle 3 via a sterile surgery suction hose 4. Prefer- ably, the suction vessel has non-confusable connections, this non-confusion safety feature being achieved e.g. by differentiating diameter sizes, in order to prevent erroneous coupling of connections with consequential infection hazards. The sterile surgery suction hose 4 preferably is of a disposable nature.

In addition, the filter unit 2 preferably is a separate unit and it is positioned for instance on a separate support and integration stand 5 in order to permit convenient connection and disconnection of the unit. This feature is of great importance, since it allows the filter unit 2 to be removed from the operating room, which is the most sensitive space from an infection protection point of view. Owing to this feature the filter unit may be conveniently moved to an adjoining room for filter changes, emptying and cleaning of the suction vessel, and so on.

The nozzle 3 may be a prior-art so called smoke extraction tube which is applied on the hand-held tool of the smoke-generating equipment, such as a diathermy tool which may be of various designs and which in turn is connected to a diathermy appliance. The sterile surgery suction hose 4 likewise could be coupled to various kinds of specula, monopolar and bipolar diathermy handles or hand-held suction implements. Examples of designs of the suction nozzles will be described in more detail in the following. The flow of pressured air is carried to the suction pump 1 via one of several valves 7, 8, coupled in parallel. Preferably, the valves are electrically controlled valves operated by one or several control units 9. One example of a control unit 9 for this purpose is shown in Fig. 3.

The control unit comprises a mode selector 11, allowing the device to be set to operate in accordance with various operational modes. In addition, the control unit comprises inputs 12, 13 for input of sensed data signals or other external signals, generators 14, 15 for producing square impulses and outputs 16, 17 for output of control data signals for control of the above- mentioned electrically controlled valves 7, 8.

In the following, the various operational modes in which the control unit of Fig. 3 is capable of operating will be described in closer detail.

When the mode selector 11 is set in the position activating output 11a, mode position "sensing" appears. In this position, a sensing signal is sensed via input 12. This signal could be generated e.g. by a power-sensor sensing the power consumed by the smoke-generating equipment. If desired, the signal may be used to start a delay circuit 18, activating a time-selectable connection-delay function Tl (see Figs 2a, b) . If desired, a delay circuit 19 is started, which produces a time-selectable disconnection-delay function T2 (see Figs, 2a, b) . The duration span of the two circuits could be wide. The signal is immediately gated to the output 16 via AND-condition 20 which condition is satisfied via the mode selector 11 and thereafter via OR-condition 21. In addition, a drive step 22 preferably is located ahead of the output 16. As a result, the magnetic valve 8 opens and the vacuum pump 1 is supplied with pressurized air and is immediately activated. A time diagram showing the activation of a diathermy appliance in parallel with the activation of the suction device is illustrated in Fig. 2a. The suction device is activated substantially simultaneously with the diathermy appliance or possibly after said delay TI. When the diathermy appliance is shut off, the suction appliance continues to be in an activated state during said time period T2, and consequently the suction device is already in an active state, should the diathermy appliance be re-activated shortly after the first use thereof. This arrangement is advantageous, since a smoke- generating diathermy sequence often involves a prolonged activation lasting for a number of seconds, followed by a number of correction cauterisations that vary in time and duration. When a cauterisation, an activation, has been performed, it is therefore likely that supplementary burning operations will be made shortly.

In a second mode, "probability -t-sensing", the output lib of the mode selector 11 is activated. In this situation, the device is auto-activated in brief intermittent suction pulses for a predetermined period following activation of the device as a result of the sensing action. This is effected by sensing the power consumed by the smoke-generating equipment, as mentioned earlier, and activating the suction device. When the smoke extraction activity stops, a time-selectable time delay circuit 23 is started for a time period T3. For a selected period, brief time-selectable astable signal pulses emitted from the pulse-generating generator 14 will be transmitted to the magnetic valve 8 via the AND-condition 24, which condition is satisfied by means of the mode-selector 11 and via the OR-condition 21. Thus, the vacuum pump 1 is supplied with pressurized air and is activated. Should a renewed cauterisation be performed at this time, this action is sensed as previously mentioned, producing a new activation signal. In this mode it is likely that an astable pulse, and consequently also a suction flow, exist at the time of the renewed cauterisation, which in principle means that the smoke extraction activity is established before the surgeon has had time to cauterise while at the same time the suction hose is kept clean and an efficient protection against contagious infection is obtained. A time diagram illustrating one example of this mode is shown in Fig. 2b.

A third mode, referred to as "intermittent", is activated by selection of output llf on the mode selector 11. In this situation, the suction device is activated and emits brief suction pulses, keeping the device clean, diverting coagel away from the suction hose, and so on. This is effected by brief time-selectable astable pulse signals emitted from the pulse generator 15 being transmitted to the magnetic valve 8 via the AND-condition 25 which is satisfied by mode selector 11 and thereafter via OR-condition 21. Fig. 2c shows one exemplifying time diagram relative to this mode. A fourth mode, referred to as "intermittent

+sensing", relates as implied by the designation to a combination of intermittent suction pulses and sensing of the power consumption of the diathermy appliance. Because in this case the suction device assumes a standby state in intermittently pulsing mode there is a comparatively great probability that the device will be active when the activation is performed via sensing, while at the same time the device is kept clean. This state is set by selection of output lie on the mode selector 11. In this situation the device is activated either by the sensed signal via an AND-condition 26 or OR-condition 28 or by a pulse emitted by the pulse generator 15 via AND-condition 27 and OR-condition 28. One example of how the suction device operates in association with a diathermy appliance is shown in this case by means of a time diagram illustrated in Fig. 2d. A fifth mode, referred to as "basic flow", is activated by selection of the output llg on the mode selector 11. This situation means that a continuous reduced basic flow exists at all times, which is achieved by the signal actuating the magnetic valve 7 via a drive step 29. The basic flow is constrained vis a vis the ordinary suction flow by means of a regulating means 30 (see Fig. 1) . The existence of such a basic flow ensures that the suction device is maintained in a clean con- dition while at the same time some suction activity goes on already prior to use of the smoke-generating equipment. Advantageously, this mode is combined for instance with the "sensing" mode. One exemplifying time diagram relative to the "basic flow" combined with "sensing" is shown in Fig. 2e.

A sixth mode, referred to as "continuous", is obtained if output llh is selected on the mode selector 11. This situation means that the suction device is activated at all times, which may be desirable under certain conditions. This mode is also exemplified by a time diagram in Fig. 2e.

A seventh mode, referred to as "external signal", is obtained by selection of output lie on the mode selector 11. In principle, this mode operates in the same manner as the "sensing" mode. An external signal arrives via an input 31, a conditionally controlled insulating step 32, and a time delay circuit 33 for connection and disconnection delay at the OR-condition 21. The external signal could for instance be derived from a signal generator incorporated in the smoke-generating equipment, from a motion-sensor (acceleration detector) located in the handle of the smoke-generating equipment, or a magnetic breaker connected to the same handle. By sensing when the handle is being moved, the suction device may be activated before the actual smoke-generating activation of the equipment takes place. The magnetic breaker may be provided with magnet-field sensing means located in the diathermy handle for sensing of magnets positioned for instance in the storage holder in which the diathermy handle is positioned while not in use. Such a storage holder 35 including a magnet 36 associated therewith is shown in Fig. 4a. Alternatively, a magnet may be attached directly on the patient by means of a strip of tape or the like, or anywhere else where the surgeon habitually lays down the handle. Such a magnet 37 taped in position is shown in Fig. 4b. In fig. 2b is shown one exemplifying time diagram relating to the mode of s.ensing via the handle.

An eighth mode of operating the suction device, which is set by choice of the output lid of the mode selector 11, is a shut-off position. In this position the suction device remains inactivated during the cauterisation process, which may be a desirable function, particularly in the case of sensitive or deep-level surgery during which e.g. brain tissue might be sucked into the device. However, it should be emphasized that the above operational modes of the control unit 9 are but examples of suitable modes and that many similar varieties of course are possible, as are also combinations of the different modes. In order to make it easier for the personnel handling the device to choose the operational modes and to provide information regarding the mode currently in use, a flow meter 10 (see Fig. 1) could advantageously be placed at a point after the vacuum connection lc of the suction pump in order to allow the size of the suction flow to be read directly at all times.

The suction nozzles could be configured in many different ways. However, it is important that they are configured both in a manner allowing them to be posi- tioned close to the area of origin of the smoke and such that they do not constitute a danger to the patient or a hindrance to the surgeon. Some examples of suitable suction nozzle configurations will be described in the following.

As illustrated in Fig. 5a the suction nozzle 41 on e.g. monopolar diathermy handles 40 may be configured to allow it to be attached alongside the handle by means of e.g. an upper and a lower clip 42 and 43, respectively. Preferably, the nozzle is made from a comparatively rigid plastics material and at its upper end it is formed with a connection fitting 44 for connection of the surgery suction hose 4. A suction duct runs from the end of the fitting in the interior of the nozzle and debouches immediately above the cauterising part of the handle.

For bipolar diathermy or other equipment having pince-like handles 45 nozzles 46 preferably are used having an input connection fitting 47 and two suction mouths 49, one in each handle leg member, as shown in Fig. 5b. Otherwise this type of nozzle is on the whole configured like the one mentioned above including upper and lower clips 49 and 59, respectively, for convenient attachment on the handle.

As an alternative, the nozzles 52 may be attached on retractors 51 or the like, as illustrated in Fig. 5c, so that the nozzles are out of the surgeon's way.

One embodiment of the invention has been described in the aforegoing. However, it should be emphasized that several varieties are possible. For instance, other types of filters are conceivable, the control unit could be configured differently and possibly offer also other alternative operational modes, the nozzle could have a different configuration and so on. Such minor modifications must be regarded to be within the scope of the present invention as defined in the appended claims.

The characterising features of the invention reside in its reduced effects on the environment, its efficiency in smoke extraction, the considerable freedom of choice it affords as regards operational modes and its high contamination safety. In addition, it provides ample possibilities of flexible positioning and may easily be adapted to suit all existing smoke-generating surgical appliances and equipment.

Claims

1. A smoke suction device for use together with smoke-generating surgical equipment, comprising a pump (1), a filter means (3), at least one suction nozzle (3), and sensing means for automatically activating the device, c h a r a c t e r i s e d in that the pump (1) has no movable parts, and preferably is a pneumatically operated ejector, and in that the sensing means are adapted to activate the device as the surgical equipment is being prepared for use.

2. A smoke suction device as claimed in claim 1, c h a r a c t e r i s e d in that the device is adapted to produce at least some suction flow already before the surgical equipment is used and thereby generates smoke, and to simultaneously operate at a reduced flow throughout most of the time when that same equipment is in use but is not active.

3. A smoke suction device as claimed in claim 2, c h a r a c t e r i s e d in that the reduced flow continues for a predetermined period of time after deactiva- tion of the surgical equipment.

4. A smoke suction device as claimed in claim 2 or 3, c h a r a c t e r i s e d in that the reduced flow consists of a continuous suction flow having a reduced flow velocity.

5. A smoke suction device as claimed in claim 2 or 3, c h a r a c t e r i s e d in that the reduced flow consists of intermittent suction pulses.

6. A smoke suction device as claimed in any one of the preceding claims, c h a r a c t e r i s e d in that the sensor is arranged on the handle of the surgical equipment for detection of handle movements.

7. A smoke suction device as claimed in any one of the preceding claims, c h a r a c t e r i s e d in that the filter means comprises a liquid and blood separating part (2b) and a smoke-purifying part (2a) .

8. A smoke suction device as claimed in any one of the preceding claims, c h a r a c t e r i s e d in that the filter means is easy to remove.

9. A method for smoke extraction in connection with the use of smoke-generating diathermy equipment, c h a r a c t e r i s e d by establishing a suction flow of at least some magnitude already before the surgical equipment is used and thereby generates smoke, and by establishing at least a reduced flow throughout most of the time when that same equipment is not active.