Pressure conditioning systems for supplying insufflation gas to an open-ended body conduit such as a rectal cavity during a transanal minimally invasive surgery (TAMIS) procedure can reduce billowing of walls of the body conduit. A pressure conditioning system can include a pressure storage component, an accumulator, and a flow restrictor. The pressure storage component can include a variable volume reservoir that is biased to a relatively low volume state. The flow restrictor can include insufflation tubing with a restrictor plate having a relatively low diameter orifice. The pressure storage component, accumulator, and flow restrictor can be fluidly connected in various orders in series or as side branches from a gas flow conduit. Despite a pulsed or otherwise discontinuous insufflation gas flow and leakage and absorption from the body conduit, the pressure conditioning system can maintain a constant pressure within the body conduit.

A patient interface structure includes a cushion configured to sealingly engage the patient's face and a front that is more rigid than the cushion. The cushion includes a forward opening, a rearward opening that is opposite the forward opening and a continuous sealing surface. The continuous sealing surface has a mouth sealing portion configured to seal around the patient's mouth and a nasal sealing portion configured to seal around both of the patient's nasal airways. The front plate includes an air inlet configured to both receive the pressurized respiratory gas and secure headgear to the patient interface structure. In addition, the nasal sealing portion includes at least one aperture that is separate from the rearward opening. Also, the front plate, the mouth sealing portion and the nasal sealing portion together form a common chamber.

A patient interface structure includes a cushion configured to sealingly engage the patient's face and a front that is more rigid than the cushion. The cushion includes a forward opening, a rearward opening that is opposite the forward opening and a continuous sealing surface. The continuous sealing surface has a mouth sealing portion configured to seal around the patient's mouth and a nasal sealing portion configured to seal around both of the patient's nasal airways. The front plate includes an air inlet configured to both receive the pressurized respiratory gas and secure headgear to the patient interface structure. In addition, the nasal sealing portion includes at least one aperture that is separate from the rearward opening. Also, the front plate, the mouth sealing portion and the nasal sealing portion together form a common chamber.

A mechanical insufflation-exsufflation device including an air source to provide positive airway pressure (PAP); a patient interface; at least one sensor to sense air pressure and flow at the patient interface; and a controller to control the air source to deliver at least one mechanically assisted cough to the patient in response to at least one of a target breathing flow and a target inhalation time period being sensed by the at least one sensor, and when the at least one of a target breathing flow and a target inhalation time period is not sensed, the controller is configured to control the air source to deliver each in a series of high-level PAP provided over a duration being followed by a low-level PAP provided over a duration, the series of high-level PAP increasing in pressure level and duration from a prior one in the series of high-level PAP.

A mechanical insufflation-exsufflation device including an air source to provide positive airway pressure (PAP); a patient interface; at least one sensor to sense air pressure and flow at the patient interface; and a controller to control the air source to deliver at least one mechanically assisted cough to the patient in response to at least one of a target breathing flow and a target inhalation time period being sensed by the at least one sensor, and when the at least one of a target breathing flow and a target inhalation time period is not sensed, the controller is configured to control the air source to deliver each in a series of high-level PAP provided over a duration being followed by a low-level PAP provided over a duration, the series of high-level PAP increasing in pressure level and duration from a prior one in the series of high-level PAP.

A nasal respiratory mask for a high flow oxygen therapy apparatus, comprising: a mask frame; and a mask cushion on the mask frame for contacting and substantially sealing against a face of a patient, the mask frame and mask cushion defining a nasal breathing cavity, wherein the mask frame comprises: a hose attachment portion for attaching a hose for delivering a supply of oxygen enriched air to the patient; and a mask aperture for restricting the flow of gas from the nasal breathing cavity directly to ambient, wherein the mask aperture maintains a positive end-expiratory pressure (PEEP) in the nasal breathing cavity of between 0.2 kPa and 1 kPa during the administering of high flow oxygen therapy to the patient.

A nasal respiratory mask for a high flow oxygen therapy apparatus, comprising: a mask frame; and a mask cushion on the mask frame for contacting and substantially sealing against a face of a patient, the mask frame and mask cushion defining a nasal breathing cavity, wherein the mask frame comprises: a hose attachment portion for attaching a hose for delivering a supply of oxygen enriched air to the patient; and a mask aperture for restricting the flow of gas from the nasal breathing cavity directly to ambient, wherein the mask aperture maintains a positive end-expiratory pressure (PEEP) in the nasal breathing cavity of between 0.2 kPa and 1 kPa during the administering of high flow oxygen therapy to the patient.

A a nasal airway interface apparatus includes a body section having a gas delivery connector for receiving a gas from a source of gas, two nasal interfaces, and strap connectors for attaching a head strap. Each nasal interface of the two nasal interfaces extends from the body section, has an insertion tip that has an opening that is distal from the body section, and a flattened side for sealing against a septum of a nose. Two exhalation manifolds are provided for exhausts, each of the two exhalation manifolds have a plurality of holes for expelling exhalation gases. Gas flows in a substantially linear path from the gas delivery connector, through the body section, through the two nasal interfaces and out the openings.

A a nasal airway interface apparatus includes a body section having a gas delivery connector for receiving a gas from a source of gas, two nasal interfaces, and strap connectors for attaching a head strap. Each nasal interface of the two nasal interfaces extends from the body section, has an insertion tip that has an opening that is distal from the body section, and a flattened side for sealing against a septum of a nose. Two exhalation manifolds are provided for exhausts, each of the two exhalation manifolds have a plurality of holes for expelling exhalation gases. Gas flows in a substantially linear path from the gas delivery connector, through the body section, through the two nasal interfaces and out the openings.

A shroud for a mask system includes a retaining portion structured to retain a frame, a pair of upper headgear connectors each including an elongated arm and a slot at the free end of the arm adapted to receive a headgear strap, and a pair of lower headgear connectors each adapted to attach to a headgear strap. The retaining portion, the upper headgear connectors, and the lower headgear connectors are integrally formed as a one piece structure.