U.S. patent application number 09/769095 was filed with the patent office on 2001-06-28 for bladder dialysis urinary catheter.
Invention is credited to McGuckin, James F. JR..
Application Number | 20010005788 09/769095 |
Document ID | / |
Family ID | 21985091 |
Filed Date | 2001-06-28 |
United States Patent
Application |
20010005788 |
Kind Code |
A1 |
McGuckin, James F. JR. |
June 28, 2001 |
Bladder dialysis urinary catheter
Abstract
An irrigating bladder dethrombulator for removing blood clots in
the urine. The device includes a housing having an outflow conduit
insertable into the bladder through the urethra for transporting
bodily fluid from the bladder and a bladder pressurization conduit
for transporting fluid into the bladder to increase the internal
pressure of the bladder. Connected to the housing is a structure
for mechanically reducing the size of the blood clots in the urine.
The mechanism for driving the reducing structure can be a magnetic
drive or a fluid drive.
Inventors: |
McGuckin, James F. JR.;
(Radnor, PA) |
Correspondence
Address: |
Rex Medical, L.P.
585 County Line Road
Radnor
PA
19087
US
|
Family ID: |
21985091 |
Appl. No.: |
09/769095 |
Filed: |
January 25, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09769095 |
Jan 25, 2001 |
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09122480 |
Jul 23, 1998 |
|
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60053557 |
Jul 24, 1997 |
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Current U.S.
Class: |
606/167 ; 604/22;
604/27; 604/96.01; 606/180 |
Current CPC
Class: |
A61B 17/320783 20130101;
A61B 17/320758 20130101; A61B 2017/22069 20130101; A61B 2017/00553
20130101; A61B 2017/00685 20130101; A61B 17/22 20130101 |
Class at
Publication: |
606/167 ; 604/22;
604/27; 604/96.01; 606/180 |
International
Class: |
A61B 017/20 |
Claims
I claim the following:
1. An irrigating bladder dethrombulator comprising: a. a housing
insertable into a human bladder via the urethra, including: i. an
outflow conduit formed therein for transporting bodily fluid out of
the human bladder, having a closed distal end; ii. a bladder
pressurization conduit for transporting fluid into a human bladder
to increase bladder internal pressure; b. mechanical means within
said outflow conduit for reducing size of clots in bodily fluid
traversing said outflow conduit; c. means rotatably driven by fluid
passage through said pressurization conduit for driving said clot
size reducing means; d. said housing including at least one
aperture proximate said clot size reducing means for influx of
bodily fluid from within said bladder into said outflow conduit for
dethrombosis of the same fluid in the course of fluid passage
through said outflow conduit to exit said bladder.
2. The irrigating bladder dethrombulator of claim 1 wherein said
housing includes a balloon control conduit for passage therethrough
of fluid for internally pressurizing a balloon within said human
bladder.
3. The irrigating bladder dethrombulator of claim 2 further
comprising a balloon in fluid communication with said balloon
control conduit and connected to the exterior of said housing, for
retaining a distal end of said housing within said human bladder to
be irrigated and dethrombulated.
4. The irrigating bladder dethrombulator of claim 1 wherein said
clot size reducing means is rotatably mounted within said outflow
conduit.
5. The irrigating bladder dethrombulator of claim 4 wherein said
clot size reducing means is rotatably mounted within said outflow
conduit proximate the distal end thereof.
6. The irrigating bladder dethrombulator of claim 1 wherein said
clot size reducing means further comprises means for cutting clots
traversing an interior wall of said outflow conduit.
7. The irrigating bladder dethrombulator of claim 1 wherein said
driving means is rotatably mounted on a common shaft with said clot
cutting means within said outflow conduit and is rotatably driven
by fluid passage through said pressurization conduit.
8. The irrigating bladder dethrombulator of claim 1 wherein said
clot size reducing means is a rotating wire.
9. The irrigating bladder dethrombulator of claim 8 wherein said
wire is looped.
10. The irrigating bladder dethrombulator of claim 1 wherein said
clot size reducing means is a rotatable spiral vane-shaped
blade.
11. The irrigating bladder dethrombulator of claim 1 wherein said
pressurization conduit, said outflow conduit and said balloon
control conduit are parallel.
12. The irrigating bladder dethrombulator of claim 11 wherein
internal walls of said housing defining said pressurization and
balloon conduits are connected to an exterior wall of said housing
and are axially immovable with respect thereto.
13. A method for irrigatingly dethrombulating bladder fluid
comprising the steps of: a. inserting an outflow conduit into a
human bladder; b. internally pressurizing said bladder; c. turning
a clot cutter mounted within said outflow conduit proximate the
distal end thereof to reduce size of clots in bodily fluid passing
out of said bladder via said conduit; d. positioning a vane
rotatably mounted on a common shaft with said clot cutter for
rotation thereof responsively to influx of pressurizing fluid into
said bladder; e. permitting bodily fluid flow from within said
bladder into said outflow conduit via at least one aperture in the
wall thereof proximate said cutter for dethrombosis as said fluid
passes said cutter in the course of passage through said outflow
conduit to exit said bladder.
14. The method of claim 13 wherein turning said clot cutter within
said outflow conduit to reduce size of clots in bodily fluid
passing out of said bladder via said conduit is performed by
turning a wire at a speed sufficient to create a standing wave in
said wire.
15. The method of claim 13 wherein turning said clot cutter within
said outflow conduit to reduce size of clots in bodily fluid
passing out of said bladder via said conduit is performed by
turning spiral shaped blade.
16. The method of claim 13 wherein turning said clot cutter within
said outflow conduit to reduce size of clots in bodily fluid
passing out of said bladder via said conduit is performed by
turning a looped wire.
17. The method of claim 13 further comprising pressurizing said
bladder by introducing fluid thereinto.
18. The method of claim 13 further comprising inflating a balloon
within said bladder to increase pressure therewithin and retain
said conduit within said bladder.
19. The method of claim 13 further comprising cutting clots passing
along the interior wall of said outflow conduit.
20. The method for irrigatingly dethrombulating bladder fluid of
claim 13 wherein said step of inserting said outflow conduit distal
end into a human bladder is performed by inserting said outflow
conduit distal end into said bladder via the urethra.
21. The method of claim 18 further comprising maintaining said
balloon about the exterior of said outflow conduit thereby
retaining a distal end of said irrigating bladder dethrombulator
within said human bladder to be irrigated and dethrombulated.
22. A method for irrigatingly dethrombulating bladder fluid
comprising the steps of: a. inserting an outflow conduit into a
human bladder; b. internally pressurizing said bladder; c. powering
clot reducing means mounted said outflow conduit to reduce size of
clots in bodily fluid passing out of said bladder via said conduit
responsively to influx of pressurizing fluid into said bladder.
23. An irrigating bladder dethrombulator comprising: a. a housing
insertable into a human bladder via the urethra, including: i. an
outflow conduit therein for transporting bodily fluid from said
human bladder, having a closed distal end positioned within said
bladder upon housing insertion thereinto; ii. a bladder
pressurization conduit for transporting fluid into said bladder to
increase bladder internal pressure; b. clot reducing means
connected to said housing, located within said outflow conduit and
rotatable with respect thereto for mechanically reducing size of
clots in said bodily fluid passing through said outflow conduit; c.
means connected to the exterior of said housing and magnetically
coupled with said clot reducing means for magnetically driving said
clot cutting means; d. said housing including at least one aperture
proximate said clot size reducing means for influx of bodily fluid
from within said bladder into said outflow conduit for dethrombosis
of the same as said fluid passes through said outflow conduit to
exit said bladder and said housing.
24. The irrigating bladder dethrombulator of claim 23 wherein said
driving means further comprises means for generating a magnetic
field circumferentially enveloping said clot size reducing
means.
25. The irrigating bladder dethrombulator of claim 23 wherein said
clot size reducing means rotates upon coaxial rotary motion of said
magnetic drive means about said housing.
26. The irrigating bladder dethrombulator of claim 23 wherein said
housing further comprises a balloon control conduit for passage
therethrough of fluid for inflating a balloon within said bladder
and said dethrombulator further comprises: a. a balloon
communicating with said balloon control conduit and connected to
the exterior of said housing, for retaining said housing within
said bladder and optionally further pressurizing said bladder.
27. The irrigating bladder dethrombulator of claim 26 wherein said
inflow conduit, said outflow conduit and said balloon control
conduit are parallel.
28. The irrigating bladder dethrombulator of claim 27 wherein
internal walls of said housing defining said inflow and balloon
conduits are connected to an exterior wall of said housing and are
axially immovable with respect thereto.
29. The irrigating bladder dethrombulator of claim 23 wherein said
clot size reducing means is proximate the distal end of said
outflow conduit.
30. The irrigating bladder dethrombulator of claim 23 wherein said
clot size reducing means cuts clots traveling along an interior
wall of said outlet conduit.
31. The irrigating bladder dethrombulator of claim 23 wherein said
clot size reducing means is a rotating wire.
32. The irrigating bladder dethrombulator of claim 31 wherein said
wire is looped.
33. The irrigating bladder dethrombulator of claim 23 wherein said
clot size reducing means is a rotatable spiral vane-shaped
blade.
34. A method for irrigatingly dethrombulating bladder fluid
comprising the steps of: a. inserting an outflow conduit into a
human bladder; b. internally pressurizing said bladder; c. turning
mechanical clot size reducing means within said outflow conduit to
reduce size of clots in bodily fluid passing out of said bladder
via said conduit by rotating magnetically coupled drive means
located externally of said outflow conduit.
35. The method of claim 34 wherein said rotating is performed
manually.
36. The method of claim 34 further comprising inflating a balloon
within said bladder to increase pressure therewithin and retain
said conduit within said bladder.
37. The method of claim 34 further comprising internally
pressurizing said bladder by introducing fluid thereinto.
38. The method of claim 34 wherein said turning mechanical clot
size reducing means within said outflow conduit to reduce size of
clots in bodily fluid passing out of said bladder via said conduit
is performed by turning a wire at a speed sufficient to create a
standing wave in said wire.
39. The method of claim 34 wherein said turning mechanical clot
size reducing means within said outflow conduit to reduce size of
clots in bodily fluid passing out of said bladder via said conduit
is performed by turning a spiral shaped blade.
40. The method of claim 34 wherein said turning mechanical clot
size reducing means within said outflow conduit to reduce size of
clots in bodily fluid passing out of said bladder via said conduit
is performed by turning a looped wire.
Description
CROSS-REFERENCE TO RELATED PATENT APPLICATION
[0001] This patent application is based on and claims the benefit
of the filing date of U.S. provisional patent application
60/053,557 filed Jul. 24, 1997 by James F. McGuckin, Jr., M.D. and
entitled "Method and Apparatus for Bladder Irrigation Mechanical
Thrombolysis".
BACKGROUND OF THE INVENTION AND DESCRIPTION OF THE PRIOR ART
[0002] One of the side effects of many urological procedures is
formation of blood clots in the urine within the bladder. Typically
after urological procedures the patient will be fitted with a
catheter to facilitate bladder drainage. Clots forming in the urine
within the bladder tend to clog the inlet orifice for a catheter
thereby preventing effective voiding of the bladder. This is a
particular problem subsequent to urological procedures such as
transectional prostatectomies, radial prostatectomies and
nephrolithotomies.
[0003] Magnetic coupling in surgical devices is known, being
disclosed in U.S. Pat. No. 5,609,602. However, '602 is concerned
with a magnetic couple which limits rotation of one element when
driven by a second element, incorporating a mechanical stop for the
first element allegedly to produce high frequency oscillations in
one of the magnetically coupled pair of elements.
SUMMARY OF THE INVENTION
[0004] In one of its aspects, this invention provides an irrigating
bladder dethrombulator including a housing insertable into the
human bladder via the urethra with an outflow conduit therewithin
for transporting bodily fluid from the human bladder and a bladder
pressurization conduit for transporting fluid into the bladder to
increase bladder internal pressure. The dethrombulator preferably
includes means connected to the housing located within the outflow
conduit and rotatable with respect thereto for mechanically
reducing size of clots in the bodily fluid passing through the
outflow conduit. The mechanical clot size reducing means is
preferably driven by means connected to the exterior of the housing
which drives the clot size reducing means via a magnetic coupling
upon manual or powered rotation of the drive means. The housing
preferably includes at least one aperture proximate the clot size
reducing means for influx of bodily fluid from within the bladder
into the outflow conduit for dethrombosis of the same as the fluid
passes through the outflow conduit to exit the bladder and the
housing.
[0005] In another embodiment of the invention, the means for
mechanically reducing size of clots in bodily fluid traversing the
outflow conduit is powered by fluid passage through the
pressurization conduit.
[0006] In another of its aspects, this invention provides a
rotating mechanical thrombectomy device, preferably incorporating a
turbine, driven by a hydrostatic, pneumatic or other power source,
with rotating or torquing blades to break down and shred clots into
smaller clots enabling easier passage of the shredded clots out of
the patient, thereby preventing occlusion of the outflow port or
ports of a drainage catheter.
[0007] In yet another of its aspects this invention provides an
irrigating bladder dethrombulator having a housing including an
outflow conduit adapted for transporting urine and other bodily
fluids out of the human bladder with the outflow conduit having a
closed distal end. The dethrombulator thus provided preferably
further includes a bladder pressurization fluid conduit for
transporting fluid into a human bladder and releasing the fluid
thereinto to raise internal pressure within the bladder. The
dethrombulator preferably further comprises a balloon control
conduit adapted for passage therethrough of air or other gaseous
fluid for pressurizing a balloon within the human bladder. The
pressurization conduit, the outflow conduit and the balloon control
conduit are preferably parallel, with walls of the pressurization
and balloon conduits preferably being connected to or even formed
in an exterior wall of the outflow conduit.
[0008] The dethrombulator preferably further includes at least one
clot cutting device such as a blade, vane or wire, rotatably
mounted within the outflow conduit proximate the distal end
thereof, for reducing size of clots in urine by cutting any clots
encountered in the course of rotatably passing in close proximity
along the interior wall of the outflow conduit.
[0009] The dethrombulator may further preferably include a turbine
or vane rotatably mounted on a common shaft with said clot cutting
device where the turbine or vane is located within the outflow
conduit remote from the distal end of the outflow conduit relative
to said cutting blade. The turbine or vane, even though largely
positioned within the outflow conduit, preferably has at least tip
extremities in fluid communication with the pressurization conduit
interior, to rotate responsively to fluid passage through said
pressurization conduit and driving said clot cutting device.
[0010] The dethrombulator yet further preferably includes a balloon
adapted to be in fluid communication with the balloon control
conduit and connected to the exterior of the outflow conduit for
retaining a distal end of the irrigating bladder dethrombulator
within the human bladder to be irrigated and dethrombulated.
[0011] The outflow conduit preferably includes at least one
aperture in the wall thereof at the location of the clot cutting
device for influx of urine and other bodily fluid from within the
bladder into the outflow conduit for dethrombosis of the same as
the fluid passes the cutting blade in the course of passage through
the outflow conduit to exit said bladder.
[0012] In another of its aspects, this invention provides a method
for irritatingly dethrombulating bladder fluid by inserting an
outflow conduit into a human bladder through the urethra,
internally pressurizing the bladder and turning mechanical clot
size reducing means within the outflow conduit to reduce size of
clots in bodily fluid passing out of the bladder via the conduit by
rotating magnetically coupled drive means located externally of the
outflow conduit. Preferably the rotating is performed manually. The
method may further include inflating a balloon within the bladder
to increase pressure therewithin and retain the conduit within the
bladder and may further yet include internally pressurizing the
bladder by introducing fluid thereinto.
[0013] In yet another of its aspects, this invention provides a
method for irritatingly dethrombulating bladder fluid by inserting
an outflow conduit into a human bladder through the urethra,
internally pressurizing the bladder, turning a clot cutter mounted
within the outflow conduit to reduce size of clots and bodily fluid
passing out of the bladder via the conduit, responsive to influx of
pressurizing fluid into said bladder.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 is a schematic vertical section of one embodiment of
an irrigating bladder dethrombulator in accordance with the
invention.
[0015] FIG. 2 is a more detailed vertical section of a second
embodiment of an irrigating bladder dethrombulator in accordance
with the invention.
[0016] FIG. 3 is a schematic vertical section of a preferred
embodiment of an irrigating bladder dethrombulator in accordance
with the invention.
[0017] FIG. 4 is a sectional view taken at lines and arrows 4-4 in
FIG. 3.
[0018] FIG. 5 is a partially broken schematic vertical section
taken at the same position as FIG. 3, showing a second preferred
embodiment of an irrigating bladder dethrombulator in accordance
with the invention.
[0019] FIG. 6 is a sectional view taken at lines and arrows 6-6 in
FIG. 5.
[0020] FIG. 7 is a partially broken schematic vertical section
taken at the same position as FIG. 3, showing a third preferred
embodiment of an irrigating bladder dethrombulator in accordance
with the invention.
[0021] FIG. 8 is a sectional view taken at lines and arrows 8-8 in
FIG. 7.
[0022] The same reference numerals denote corresponding or
functionally equivalent parts in the drawing figures.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0023] Referring to FIGS. 1 and 2, irrigating bladder
dethrombulators manifesting aspects of the invention and embodying
one approach to practice of the invention are illustrated in FIGS.
1 and 2 and generally 10. Dethrombulator 10 generally has a housing
11 which includes an inflow bladder pressurization fluid conduit 12
which is axially elongated as illustrated in FIGS. 1 and 2. Housing
11 further includes a central outflow conduit 14, which is also
axially elongated as illustrated in FIGS. 1 and 2, and optimally
but preferably a balloon control conduit 16 which is yet
additionally axially elongated in the same manner as conduits 12
and 14, all as illustrated in FIGS. 1 and 2.
[0024] FIG. 1 illustrates the irrigating bladder dethrombulator in
position within a human bladder where the bladder has been
designated generally 18 and is illustrated in dotted lines for
drawing clarity. In FIG. 2 only a portion of the bladder wall is
depicted, without sectioning.
[0025] A balloon 20 is preferably attached to the exterior surface
of housing 11 as illustrated schematically in FIG. 1 and in FIG. 2.
When inflated in place once dethrombulator 10 is within the
bladder, balloon 10 helps to retain irrigating bladder
dethrombulator 10 in position within bladder 18.
[0026] Balloon 20 is in fluid communication with the interior of
balloon control conduit 16 so that pressurized air or other gas may
be provided to inflate balloon 20 within bladder 18, once the
irrigating bladder dethrombulator 10 has been positioned protruding
into the bladder via the urethra or, less desirably, through the
bladder wall, with pressurized air or other gas being supplied to
pressurize balloon 20 via balloon control conduit inlet/exhaust
port 50 as illustrated in FIGS. 1 and 2.
[0027] Preferably bladder pressurization fluid conduit 12, outflow
conduit 14 and balloon control conduit 16 are all parallel one with
another. Further preferably walls of the pressurization fluid and
balloon conduits are desirably connected to an exterior wall of
housing 11 having outflow conduit 14 therewithin in a manner to be
immovable with respect thereto.
[0028] Pressurization fluid is supplied to the bladder interior via
inflow conduit 12, with the fluid entering conduit 12 via bladder
pressurization fluid inlet orifice 42 and exiting conduit 12 into
bladder 18 via bladder pressurization fluid outlet 44.
[0029] In the embodiment of the apparatus illustrated in FIGS. 1
and 2, the dethrombulating function is preferably performed by at
least one clot cutting or dethrombulating blade 36, two of which
have been illustrated in the drawings. Blades 36 are preferably
rotatably mounted within outflow conduit 14 proximate a distal,
closed end of outflow conduit 14. The distal, closed end of outflow
conduit 14 is designated 34 in the drawings. Clot cutting blades
reduce size of clots 82 in urine and other bodily fluid within
bladder 18 by slicing any clots 82 which are encountered by blades
36 as those blades rotatably pass in close proximity along the
interior wall 52 of outflow conduit 14 in housing 11.
[0030] A vane or drive turbine 22 is positioned within outflow
conduit 14 remote from the distal end 34 of outflow conduit 14
relative to clot cutting blade 36. Drive turbine or vane 22 is in
fluid communication with bladder pressurization fluid conduit 12
and rotates in response to fluid passage through conduit 12. Vane
or drive turbine 22 is mounted on a common central shaft 28 with
blade 36. Mounting of vane or drive turbine blades 24 on central
shaft 28 is accomplished via drive turbine or vane struts 26. While
drive turbine 22 is mounted for rotation about central shaft 28
located within the interior of outflow conduit 14, as illustrated
in the drawing drive turbine blades 24 protrude through a small
aperture 84 formed in wall 52 of outflow conduit 14 so as to be in
fluid communication with the interior of conduit 12. Hence, fluid
flowing into the bladder through conduit 12 turns central shaft 28
via contact with vane 24.
[0031] Dethrombulating blades 36 are mounted via dethrombulating
blade struts 38 on central shaft 28 so that dethrombulating blades
36 turn unitarily with and in response to torque provided by drive
turbine 22. Dethrombulating blades 36 have their cutting edges 54
located in close proximity to the interior wall 52 of outflow
conduit 14, as illustrated. Clots and other debris passing between
cutting edges 54 of dethrombulating blades 36 and interior wall 52
of outflow conduit 14 are cut and thereby reduced in size as the
fluid medium in which such clots reside is transported out of the
bladder through outflow conduit 14, in the direction indicated by
arrow A in FIGS. 1 and 2. The direction of flow of the bladder
pressurization fluid in conduit 12 is indicated by arrow B in FIGS.
1 and 2. The bi-directional flow of air or other pressurized gas,
into or out of bladder 18 through balloon control conduit 16, is
indicated by double-ended arrow C in FIG. 1.
[0032] While it is envisioned that under normal circumstances
sufficient driving torque for operation of dethrombulating blades
36 will be provided via central shaft 28 being rotated by drive
turbine or vane assembly 22 in response to pressure from inflow of
bladder pressurization fluid in conduit 12 in the direction
indicated by arrow B, under certain circumstances it may be
desirable to have an auxiliary drive for dethrombulating blades
36.
[0033] An auxiliary drive for dethrombulating blades 36 has been
illustrated schematically and designated 56 in FIG. 1. Magnetic
induction may be used as the auxiliary drive means; magnetic
induction has the advantage of not requiring any physical contact
and has minimum numbers of moving parts.
[0034] Alternatively, a small motor or gear drive can be provided
as the auxiliary drive means 56 where the motor can be
pneumatically driven, electrically driven or the like.
[0035] In any event, regardless of the type of auxiliary drive
mechanism used and with or without an auxiliary drive mechanism,
the irrigating bladder dethrombulator as illustrated in the
drawings should be small and sufficiently flexible to permit
passage through the urethra and into the bladder. Hence, rigid
structures are desirably to be avoided in the practice of the
invention.
[0036] Various configurations of dethrombulating blades 36 may be
used; it may be desirable to have an auger-type configuration, a
ribbon-type configuration or a straight, axially elongated
configuration as illustrated specifically in FIG. 1. The blade
configuration may depend and may be changed according to the
application and the patient in which the irrigating bladder
dethrombulator is used.
[0037] In one practice of the invention, clot reducing means as
represented generally by dethrombulating blades 36 in FIGS. 1 and 2
is rotatably driven by a magnetic coupling with means for
magnetically driving the clot cutting means, which drive means are
connected to the exterior of the dethrombulator housing as
illustrated generally in FIGS. 3, 5 and 8. Referring specifically
to FIG. 3, the irrigating bladder dethrombulator according to a
preferred embodiment of the invention includes a housing 11
insertable into a human bladder 18. The urethra where the housing
includes a outflow conduit 14 for transporting bodily fluid from
the human bladder 18 where the outflow conduit 14 has a closed
distal end 34 positioned within bladder 18 upon housing 11 being
inserted into the bladder. The housing further includes a bladder
pressurization conduit 12 for transporting fluid into the bladder
interior to increase internal pressure of bladder 18.
[0038] Housing 11 includes an aperture 86 which is proximate to the
clot size reducing means and permits influx of bodily fluid from
within bladder 18 into outflow conduit 14 for dethrombosis of the
bodily fluid as the fluid passes through outflow conduit 14 to exit
bladder 18 and housing 11.
[0039] In the embodiment illustrated in FIG. 3, bladder
pressurization fluid conduit 12 for inflow of bladder
pressurization fluid is not illustrated in housing 11 in order to
assure drawing clarity.
[0040] In the embodiment illustrated in FIG. 3, the clot cutting
means as provided by a wire 90 formed in a loop with the base of
the loop being defined by an annular member 92, which is rotatably
disposed within the central portion of outflow conduit 14. Annular
member 92 includes means for receiving magnetic flux and rotating
annular member 92 in response thereto where the magnetic flux
receiving means is preferably in the form of the annular ring
illustrated in section in FIG. 4. Most preferably, annular ring 94
include one or more magnet portions.
[0041] Annular member 92 resides within a bearing receptacle formed
in an annular interior ring 96 where the bearing receptacle or slot
is specifically defined between two radially inwardly extending
annular step members 98, 100. Annular interior ring 96 preferably
extends circumferentially completely around the inside portion of
outlet passageway 14 as shown generally in FIG. 4.
[0042] Immediately radially outboard of annular interior ring 96 is
an intermediate interior ring 104 which, similarly to annular
interior ring 96, extends annularly completely around the
circumference of the inside surface of the outflow conduit 14, as
also illustrated in FIG. 4. Inner intermediate ring 104 has a pair
of axially extending, diametrically opposed keyways, which have not
been numbered but are illustrated in FIG. 4, formed therein. These
keyways receive corresponding generally rectangular axially
extending keys 106 which are diametrically opposite one from
another and formed on the outer portion of annular interior ring
96. Keys 106 resident in the unnumbered keyways facilitate
longitudinal movement of interior ring 96 and annular magnetic flux
receiving ring 94, having annular member 92 rotatably resident
therewithin, along the longitudinal axis of outlet flow passageway
14.
[0043] Mounted on the exterior surface 108 of housing 11 is an
outer inner ring 110 which is preferably fixedly secured to outer
surface 108 of housing 11 to be axially immoveable therealong.
Similarly to inner intermediate ring 104, outer inner ring 110 has
a pair of rectangular, diametrically opposed, longitudinally
extending keyways formed therein where these keyways have not been
numbered to aid the clarity of the drawing. Annularly disposed
about the exterior of outer inner ring 110 is outer intermediate
ring 112 which, similarly to annular interior ring 96, has a pair
of diametrically opposed longitudinally extending rectangular keys
114 formed therein. Keys 114 fit within corresponding unnumbered
keyways formed in outer inner ring 110. Residences of keys 114 in
the unnumbered keyways facilitates longitudinal movement of outer
intermediate ring 112 along the exterior of housing 11 relative to
outer inner ring 110.
[0044] Due to the action of keys 114 in the unnumbered keyways,
while outer intermediate ring 112 is movably axially respecting
outer inner ring 110, these two rings rotate unitarially one with
another. Outer intermediate ring 112 is preferably fixably secured
to an interior portion of a gripping ring designated generally 66
in FIGS. 3 and 4. Gripping ring 66 has a magnetic member 62 having
at least one magnetic as a part thereof, where the magnetic member
62 preferably extends annularly about the complete inner
circumference of gripping ring 66 as illustrated in FIG. 4.
Gripping ring 66 further includes a plurality of raised portions 72
separated by a plurality of central portions 74 to facilitate hand
gripping and hence turning of gripping ring 66, and hence of
magnetic member 62, by an attending physician or other health
professional. Due to the magnetic coupling provided by close
proximity of magnetic member 62 with annular magnetic flux
receiving ring 94, rotation of gripping ring 66 produces
corresponding rotation of annular magnetic flux receiving ring 95
and hence of annular member 92, resulting in rotation of clot
cutting wire 90 within housing 11. Axial movement of gripping ring
66 and the structures associated therewith and the corresponding
axial movement of the annular magnetic flux receiving ring 94
relative to housing 11 is indicated by double ended arrows L in
FIG. 3.
[0045] As a result of the magnetic coupling, manual rotation of
gripping ring 66 externally of housing 11 results in rotation of
clot cutting wire 64 within housing 11. Clot cutting wire 64 is
preferably configured to pass closely about the inner surface 116
of outflow conduit 14 and especially is configured to pass close to
inner surface 116 in the vicinity of fluid influx aperture 88 in
order to catch and hence slice clots 82 between wire 90 and inner
surface 116.
[0046] FIGS. 5 and 7 illustrate additional preferred embodiments of
the irrigating bladder dethrombulator having the same magnetic
coupling structure facilitating manual rotation of gripping rings
66 to rotate annual magnetic flux receiving ring 94, a illustrated
in FIG. 3 and described above.
[0047] The embodiments illustrated in FIGS. 5 and 7 illustrate
alternative clot cutting means in place of clot cutting wire 90
illustrated in FIG. 3.
[0048] In FIG. 5, clot cutting means is provided by a rotating wire
118. In the embodiment illustrated in FIG. 5, wire 118 is
preferably rotated at a speed sufficient to create a standing wave
in wire 118, with at least one node present in the standing wave.
As wire 118 is rotated to create the standing wave, longitudinal
movement of gripping ring 66 in the direction indicated by arrows L
in FIG. 3 results in rotating wire 118, having the standing wave
therein, moving longitudinally along interior surface of 116 of
outflow passageway 14 in housing 11. This movement of rotating wire
118 permits wire 118 with vibrational nodes therein to move axially
along the interior of outflow conduit 118, rotationally slicing
clots which are encountered and particularly clots which are
trapped between a point of maximum amplitude of rotating wire 118
and interior surface 116 of outflow passageway 14.
[0049] When wire 118 is used as the clot cutting mechanism, wire
118 is preferably rotated at a speed at which wire 118 forms at
least one vibrational node in the portion of wire 118 extending
away from a central hub 120. Wire 118 is preferably hydrophilic, is
preferably braided and is preferably rotated in the direction of
twist of the braid thereby to provide protection against unraveling
of wire 118 when a braided wire is provided.
[0050] Central hub 120 is retained in position by radial spokes 122
illustrated in FIG. 6. Annular magnetic flux receiving ring 94A has
been so designated in FIG. 6 to distinguish it from annular
magnetic flux receiving ring 94 illustrated in FIG. 4. Other than
the presence of central hub 120 and spokes 122, annular magnetic
flux receiving rings 94, 94A are essentially identical.
[0051] In the third preferred embodiment of the invention shown in
FIG. 7, the clot cutting means is provided by a spiral,
auger-shaped cutting blade 124 mounted on a rotatable shaft 126.
Outer edges 128 of spiral clot cutting blade 124 are preferably
sharp and pass in close proximity to interior surface 116 of
outflow passageway 14 and housing 11 to trap and cut clots 82
therebetween.
[0052] As illustrated in FIG. 7, rotatable shaft 126 is preferably
journaled in a thickened portion 130 defining a closed distal end
of passageway 14.
[0053] Similarly to the structure illustrated in FIGS. 3 and 5, a
spiral clot cutting blade 124 is mounted in an annular magnetic
flux receiving ring 94B illustrated in FIG. 8 and extends from a
central hub 130 thereof where central hub 130 is retained in
position by radial spokes 132. The preferred direction of rotation
of spiral clot cutting blade 124 is denoted by arrow R in FIG.
7.
[0054] Similarly to clot cutting wire 90 and wire 118 illustrated
in FIGS. 3 and 5, spiral clot cutting blade 124 is preferably
longitudinally moveable within housing 11 in the direction
indicated by arrows L in FIG. 3, where blade 124 is preferably
fixedly connected to annular magnetic flux receiving ring 94B but
is slidably moveable along and supported by rotatable shaft 126.
Hence blade 124, but not rotatable shaft 126, preferably moves
longitudinally in response to longitudinal movement of gripping
ring 66 by an attending physician or other health professional.
* * * * *