DE1958561A1 - Medical instrument - Google Patents

Description

AMERICAN HOSPITAL SUPPLY CORPORATION, PHARJVIASEAL DIVISION Glendale, California, USA

Medical instrument

The invention relates to a medical instrument for everting an elongated sack or catheter and Introducing the same through an opening and into a body cavity, for example the ureter. The instrument is suitable is particularly suitable for taking samples of microorganisms from different areas of the ureter or for Insertion of a tube into the urinary bladder without transferring microorganisms from the meatus and distal ureters to other areas of the urinary tract.

Devices ^ for rolling out catheters that take these measures Allow to carry out already belong to the state of the art «, a very simple example of such a device is in an article, "A New Method for the Prevention of Intraurethal Spreading of Germas Caused by the Insertion of Catheter and Irrigation of the Urethra "by Georg Baller

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in ^ ermat. Magazine (. now Dermatologica) Volume 32, page 39-46 (1921) described and illustrated. Similar work was done by Henry P. Helmholz, Sr. and called "Determination of Bacterial Content of the Urethra: A iiew Method, with Results of a Study of 82 Ken, "in Journal of Urology, Volume 64, pages 158-166 (1950) reported.

The known devices according to Baller and Helmholz included one rigid metal insertion tube and one rigid Disc with a central hole that was slidably fitted over the insertion tube. A flexible rubber sak was made connected at one end to the disc. The other end was telescoped into a hole in the metal insert tube inserted. When the disk was near the front end of the insert tube, it was generally the flexible sack completely within the insert tube. When in use, a sister or started Doctor the disc against the urinary meatus. The insert tube was then pushed through the disc and into the ureter. When the insert tube was advanced, the rubber seal went out the .pipe bore pulled out, turned inside out, when it extends over the front end of the insert- tube unrolled and laid out along the ureter.

When viewing how this unrolling the catheter device is going on, it can be seen that the sac or catheter is everted during insertion. this is important because it has been found that the first centimeter of the distal area of the ureter is often a high one Has bacterial count. Areas of the ureter near the bladder usually contain fewer or less bacteria even be sterile. With a sterile roll-out catheter device, it is possible to run the catheter over the entire length of the Insert the urethra or the ureter into the bladder,

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without the transmission of bacteria coming from the distal area to the proximal area of the ureteral tract Infections.

The flexible structure of this device can be used either for urine drainage in the manner described above, but also for taking bacteria samples at various points along the ureter or the urethra. In the latter case they find; ^J the bacteria samples for culture tests in the diagnosis of urological oesonderen Iroblems the patient using · "Trn second 7all vyeist of,] ac-c a Üugfaden on which at one; imde of the iac: ε is attached inside the insert tube. ^ "After inserting the flexible sack into the urethra, the pigtail is bent to invert the sack and pull it back into the insert tube; en points along the Har;: fvhre and a doctor .-: an: i iie ira _: -: identify teries u: ad their r.er »~ e :: tration" ceiepiels.veise ir. 1, 2, 3 u ^ d 4 eil distance from the Hariix ^ -Λ * uz schü.t :: er :.

? ei the known devices .vuräe a rigid Γ-.e'all tube for inserting the flexible. Jack? use--. lir. s ⁺ arres metal tube can, however, for a latient. very sc ::: r. to be excruciating, especially when it moves, and the stiff tube in its urethra is stretched to one side. Metal pipes are, however, used for the patient despite the pain because they have sufficient column or rod strength to penetrate the urethra and turn the flexible bag over,! Can has also proposed flexible plastic tubes, but these do not have the columns - or high rigidity of xetallic tubes, and one runs the risk of them advancing into the urethra

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to kink and bend.

The present invention overcomes these difficulties with known roll-out catheter devices through use a flexible plastic insert tube to reduce patient discomfort, a flexible sack for insertion into the urethra and a rigid guide sleeve that surrounds the flexible insertion tube. The rigid guide sleeve provides the necessary longitudinal rigidity for the flexible insert tube, but does not penetrate the urethra itself.

The drawings show three exemplary embodiments for a device according to the invention, namely in

Pig. 1 is a view of the medical instrument for inserting a flexible bag and for deployment into a body cavity;

FIG. 2 is a partially sectioned side view of the medical instrument; FIG.

iif. 3 is a section along the line 3-3 of FIG. 2; Figure 4 is a section along line 4-4 of Figure 2; Figure 5 is a section along line 5-5 of Figure 2;

6 is a partially sectioned view of the front part of an embodiment of the medical Instruments when used for urinary drainage;

7 shows a partially sectioned view of a second embodiment of the medical instrument

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t> e ± used for taking bacterial samples from the urethra; and in

Pig. 8 is a side view of the front part of a third embodiment with a preformed curve in FIG an insertion tube.

Figures 1 to 6 show a first embodiment in particular for inserting a flexible sack into the urethra of a patient without the risk of bacteria entering from the meatus to the urinary bladder. After the device once is inserted, the sack has a flexible insert tube inside through which the urine can drain. It is important to the invention that the insertion tube is laterally flexible so that it can be any natural contour of the Urethra and not causing unnecessary pain to the patient if it moves while moving the insertion tube or bag is in the urethra.

The medical device according to the invention contains a flexible insertion tube 1 with a front end 2 and a rear end 3. A thin plastic bag 4 of a flat plastic pipe is telescoped into the bore of the insertion tube is inserted at the front end 2 and an end portion 5 of the sack extends out of the insertion tube and is attached to a rigid guide sleeve 6. The bag can be turned over and down along a side surface of the urethra be guided by holding the guide sleeve 6 and pushing the insertion tube into the urethra.

The instrument contains a rigid guide sleeve 6, which surrounds the flexible insert tube. This guide sleeve is much longer than the diameter of the insert tube.

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speaks and has four parts, namely a front, generally oval-shaped shield 7 for pressing against the area surrounding the meatus; a first tubular part 6; a second tubular part 9 and a rear cap 10. All these parts are connected to one another and form a. laü ^ ge-jtre.iktes rigid member. As can never be seen from FIGS. 1 and 2, the second tubular part 9 has a pair of diametrically opposite slots 11 and 12 which allow access to the insertion tube through the guide sleeve 6. A handle 13 is provided on the flexible inlet tube at these slots in order to push the setting tube in the longitudinal direction along the guide sleeve. The handle includes a rigid G-shaped tubular segment 141 surrounding the insertion tube and a pair of diametrically opposed palatal pads 15 and 16 which are integrally connected to the C-shaped tube segment 14. The tree pads extend outward through the slots 11 and 11. 12th

A nurse or the doctor can easily operate the instrument with one hand by having a pinger flange 17 on the first tubular part δ and a palate pad detected and then the thumb pad in the direction of the iinger flange 17 presses. As a result, the front end of the insertion tube is pushed out of the guide sleeve and the sack 4 inverted and laid out along the inner surface of the urethra. Calibrations 33 show how deep the insertion tube has been inserted into the urethra, the insertion tube swivels into the urethra until the bag 4 is completely is withdrawn from the bore of the insert tube, and the insert tube extends a short distance above the At the end of the sack, as shown in FIG. 6, can be seen. This ensures that the sack does not penetrate the insertion tube blocks and decreases the flow of urine. The thumb pads

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meet the front ends of slots 11 and 12, when the liinsetzrohr, as can be seen from Fig. 6, fully inserted is. Now a line (not shown) leading to a drainage container is connected to an adapter 16 on connected to the rear part of the insert / .pipe and the urine drainage can start. After the urine has been withdrawn from the patient's urinary bladder, the insertion tube and sac are placed pulled out of the urethra and thrown away.

A second exemplary embodiment of the instrument according to the invention is shown in FIG. Here, the medical instrument is used to take samples of the urethra along a female urethra: to determine the type and concentration of bacteria in different depths of the urethra. This instrument is identical to the instrument of Figures 1 to 6, except that a pulling thread 22 is attached to the end 20 of the flexible sack 19 within the bore of the flexible insertion tube 21 and this jade protrudes outward through the rear part of the insertion tube. 7> er. "Aek also has a series of depth marks 2}, 24, 2 ^C and 26 to indicate, for example, the 1 cm, 2 cm, 5 ct and 4 cm positions in the urethra.

When used, this second embodiment of the invention medical instrument used in the same Veise as the instrument according to Figures 1 to c, however the bag 19 is not completely out of the 5 hole of the insertion tube pulled out. Rather, after the sac is up to a given distance it will make contact with the urethra with the inner surface of which is used and for receiving bacterial samples, the sack is withdrawn into the insertion tube 21. If desired, a hole 27 can be made in the sack there be arranged where the thread 22 is attached. This allows

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the urine drainage through the sack so that the sack does not come with it Urine is filled when it is withdrawn into the insertion tube. After the flexible insertion tube and the bag are removed from the Urethra are removed, the sack, which now has the bacterial samples on its inner surface, can be inserted into Pieces of 1 cm in length can be cut. Attempts to establish the bacterial types and concentrations can now be carried out perform at different depths of the urethra.

A third embodiment of the medical according to the invention Instruments is shown in FIG. Again, the instrument is essentially the same as that according to the figures 1 to 6,. However, the flexible insert tube 31 has a preformed curved portion 32 so that it can more naturally conform to the shape of the urethra. Curved around this To maintain shape, the guide sleeve can also be curved. This preformed curved part 32 in the insertion tube can be made '// ground by taking a section of flexible extruded tubing and inserting it into the bending the desired curvature and then heating it in an oven to a temperature below the melting point of the material, from which the pipe consists, so that the pipe is permanent curve or shape. , Venn the insertion tube 31 is puffed out of the rigid guide sleeve, it follows the curved urethra smoothly, as can be seen from FIG. 8. If necessary, the rigid tubular guide sleeve can also be shaped.

The medical instruments according to the invention according to the various embodiments can be made in a similar manner. It is enough for the description the manufacture according to the reference to the embodiment Figures T to 6 .. The insertion tube 1 consists of a flexible polyvinyl chloride pipe and the sack is a flat

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lying polyethylene sack that is flexible and strong enough to be unwound over the end of the insertion tube. To support the unwinding of the bag over the end of the insert tube, the inner and outer surfaces of the insert tube are coated with a silicone oil. In order to hold the sack on the rigid guide sleeve, one end part of the sack is wedged between the shield and the first tubular part 8. There is no adhesive bond so that the sack can be removed if desired. The removal of the sack is important in the second embodiment where the sack contains bacterial samples.

From the front shield to the rear, the first and second parts 8 and 9 are connected to one another at the connection point 28, which may be a solvent compound. The first part is preferably made of a transparent material, for example polycarbonate, so that the urine flowing through the transparent insert tube part can be observed. The second pipe part 9 has slots 11 and 12 which extend completely to the rear end of this part. A cap 10 with inner and outer edges 29 and 30 fits over the rear end of the tubular member and is sealed there to keep it circular.

As mentioned before, the flexible insertion tube is pushed forward along the rigid guide sleeve with a handle 13, which has a C-shaped pipe segment 14. During the assembly of the instrument, the flexible So the insert tube into a mouthpiece of the C-shaped tube segment 14 squeezed. To ensure that the handle does not slide on the insertion tube, it is through a Solvent or adhesive attached to the insertion tube.

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In the course of the foregoing description of the invention was describes an instrument for inserting a flexible set into a female ureter. The invention is suitable In principle, it can also be used to insert a sack into a male urethra, with only the sack, insertion tube and guide sleeve must be made correspondingly longer.

Patent claims:

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ORIGINAL INSPECTED

Claims (1)

- 11 claims: (1.! Medical instrument with an insertion tube for W. Insertion into a body canal, usually one arranged within the bore of the insertion tube, the sack with an end part aup the front end of the Tube protrudes, and with a tubular guide sleeve, which normally extends around the front end portion of the insert tube, thereby g e k e η η ** shows that the insertion tube (1) is flexible and can be adapted to the curvature of the body canal, in which it is to be used, can be bent so that the tubular guide sleeve (6) is rigid and a stiffener for the flexible insert tube (1) to prevent bending? of the insertion tube the penetration into the body channel and the jack '(4) with the end part on the rigid guide sleeve (6) is attached. ?. Medical instrument according to Claim 1, characterized in that devices (13 " ¹ ) are provided on the insertion tube (1) for pushing it forward along the guide sleeve (6). 3. Medical instrument according to claim 2, characterized characterized in that the guide sleeve (6) has at least one longitudinal slot (11, 12) and the Device for pressing in the insert tube (1) along the guide sleeve (6) from a rigid handle (13) consists, which is attached to the insertion tube (1) and extends outward through the longitudinal slot (11, 12). - 12 - 009824/0154 BATH 4. Medical instrument according to claim 3, characterized in that the handle (13) has a rigid C-shaped pipe segment (q4) which sits over the insert pipe (1). 5. Medical instrument according to one or more of the preceding claims, characterized in that the guide sleeve (6) is a pair diametrically opposite longitudinal slots (11, 12) and the instrument with a handle (13) with a rigid C-shaped pipe segment (14) is provided 'which sits over the insertion tube (1), during the Handle (13) a pair of diametrically opposed thumb plugs (15, 16) fastened to it in one piece which extend outward through the two longitudinal slots (11, 12). 6. Medical instrument according to claim 5, characterized in that the Dauraenpüster (15, 16) hits the front end of the slot (11, 12) when the flexible bag (4) is completely out of the hole of the insert tube (1) is pulled out, and that the front end (2) of the insert tube is slightly over the flexible sack (4) extends. 7. Medical instrument according to one or more of the preceding claims, characterized in that the flexible bag (4) within the bore of the insertion tube (1) a thread link (22) is attached, which extends outward through the rear The end (3) of the insertion tube (1) extends and serves to pull off the sack (4) within the insertion tube (1), after it was inserted into a body canal. - 13 - 009824/01 Si * 1953561 In that the insertion tube (1) has an adapter (18) ■ 8. A medical instrument according to one or more of the preceding claims, characterized in that at the rear end (3) for connection to a 'liquid line. 9. Medical instrument according to one or more of the preceding claims, characterized in that the rigid contact sleeve (6) an enlarged shield portion (7) at the front end to prevent insertion of the sleeve into the body canal having. 10. Medical instrument according to one or more of the preceding claims, characterized in that the rigid guide sleeve (6) has a finger flange (10) which is spaced between the steering slot and the front end of the guide sleeve is arranged. 11. Medical instrument according to one or more of the preceding claims, characterized in that the insert tube (1) and at least part of the guide sleeve (6) are transparent. 12. Medical instrument according to one or more of the preceding claims, characterized in that the flexible insert tube (1) has a preformed curved portion (32) which conforms to the curvature of a body canal and when the part is seated in the rigid guide sleeve (6), it is straightened and under tension. 009824/0154 ORIGINAL INSPECTED Blank page