U.S. patent application number 16/900614 was filed with the patent office on 2020-09-24 for material removal from a lung or bronchial tree.
This patent application is currently assigned to Piranha Medical, LLC. The applicant listed for this patent is Piranha Medical, LLC. Invention is credited to Robert A. Ganz, Mark Anders Rydell.
Application Number | 20200297386 16/900614 |
Document ID | / |
Family ID | 1000004885873 |
Filed Date | 2020-09-24 |
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United States Patent
Application |
20200297386 |
Kind Code |
A1 |
Ganz; Robert A. ; et
al. |
September 24, 2020 |
MATERIAL REMOVAL FROM A LUNG OR BRONCHIAL TREE
Abstract
A method can include introducing a device into a lung of a
patient to a site of a material lodged in the lung. The device can
include a distal end configured to core the material, a proximal
end, and a tube that includes a hollow interior. The method can
further include coring from the material a piece that is sized to
pass through the hollow interior of the tube using the distal end
of the device. The method can further include applying suction to
the proximal end of the device to pass the piece through the hollow
interior of the tube and out of the device through the proximal
end. Other and further methods are also disclosed.
Inventors: |
Ganz; Robert A.;
(Minnetonka, MN) ; Rydell; Mark Anders; (Golden
Valley, MN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Piranha Medical, LLC |
Salt Lake City |
UT |
US |
|
|
Assignee: |
Piranha Medical, LLC
Salt Lake City
UT
|
Family ID: |
1000004885873 |
Appl. No.: |
16/900614 |
Filed: |
June 12, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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15356975 |
Nov 21, 2016 |
10722267 |
|
|
16900614 |
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62260873 |
Nov 30, 2015 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/00818
20130101; A61B 17/22 20130101; A61B 2217/005 20130101; A61B
2218/007 20130101; A61B 17/50 20130101; A61B 2017/22079 20130101;
A61B 17/32053 20130101 |
International
Class: |
A61B 17/50 20060101
A61B017/50; A61B 17/22 20060101 A61B017/22 |
Claims
1. A method comprising: introducing a device into a lung of a
patient to a site of a material lodged in the lung, the device
comprising a distal end configured to core the material, a proximal
end, and a tube that comprises a hollow interior; coring from the
material a piece that is sized to pass through the hollow interior
of the tube using the distal end of the device; and applying
suction to the proximal end of the device to pass the piece through
the hollow interior of the tube and out of the device through the
proximal end.
2. The method of claim 1, further comprising introducing a
bronchoscope into the lung to the site of the material, the
bronchoscope defining a channel, wherein said introducing the
device into the lung comprises delivering the device through the
channel of the bronchoscope.
3. The method of claim 2, further comprising visualizing the site
of the material.
4. The method of claim 3, wherein said applying suction to the
proximal end of the device to pass the piece through the hollow
interior of the tube and out of the device through the proximal end
preserves visualization of the site of the material.
5. (canceled)
6. (canceled)
7. The method of claim 2, wherein said introducing the device into
the lung further comprises deploying the device past a distal end
of the bronchoscope into contact with the material.
8. The method of claim 2, further comprising maintaining the
bronchoscope in place within the lung during said coring from the
material and during said applying suction to the proximal end of
the device.
9. The method of claim 1, wherein the tube comprises the distal end
of the device.
10. The method of claim 9, wherein the tube further comprises the
proximal end of the device.
11. The method of claim 1, further comprising using the distal end
of the device to repetitively core pieces from the material,
wherein said applying suction to the proximal end of the device
further passes the pieces through the hollow interior of the tube
and out of the device through the proximal end.
12. The method of claim 1, further comprising coupling the proximal
end of the device to a collection cannister and a source of
suction.
13. The method of claim 12, further comprising collecting the piece
in the collection cannister.
14. The method of claim 1, wherein the material comprises
mucous.
15. (canceled)
16. A method comprising: introducing a device into the bronchial
tree of a patient to a site of a material lodged in the bronchial
tree, the device comprising a distal end configured to core the
material, a proximal end, and a tube that comprises a hollow
interior; coring from the material a piece that is sized to pass
through the hollow interior of the tube using the distal end of the
device; and applying suction to the proximal end of the device to
pass the piece through the hollow interior of the tube and out of
the device through the proximal end.
17. The method of claim 16, wherein the tube comprises the distal
end of the device.
18. The method of claim 17, wherein the tube further comprises the
proximal end of the device.
19. The method of claim 16, further comprising using the distal end
of the device to repetitively core pieces from the material,
wherein said applying suction to the proximal end of the device
further passes the pieces through the hollow interior of the tube
and out of the device through the proximal end.
20. The method of claim 16, further comprising coupling the
proximal end of the device to a collection cannister and a source
of suction.
21. The method of claim 20, further comprising collecting the piece
in the collection cannister.
22. The method of claim 16, wherein the material comprises
mucous.
23. (canceled)
24. A method comprising: advancing a bronchoscope through the
bronchial tree of a patient to a site of a material trapped in the
bronchial tree, the bronchoscope defining a channel; deploying a
device through the channel of the bronchoscope to the site of the
material, the device comprising a distal end configured to core the
material, a proximal end, and a tube that comprises a hollow
interior; coring from the material a piece that is sized to pass
through the hollow interior of the tube using the distal end of the
device; and applying suction to the device to pass the piece
through the hollow interior of the tube and to move the piece out
of the device.
25. The method of claim 24, wherein the material is trapped within
a lung of the patient.
26. The method of claim 24, wherein the material comprises
mucous.
27. The method of claim 26, wherein the mucous causes mucous
plugging.
28. (canceled)
29. The method of claim 24, further comprising visualizing the site
of the material.
30. The method of claim 29, wherein said applying suction to the
proximal end of the device to pass the piece through the hollow
interior of the tube and out of the device through the proximal end
preserves visualization of the site of the material.
31. (canceled)
32. (canceled)
33. The method of claim 24, wherein said deploying the device
through the channel of the bronchoscope to the site of the material
further comprises deploying the device past a distal end of the
bronchoscope into contact with the material.
34. The method of claim 24, further comprising maintaining the
bronchoscope in place within the bronchial tree during said coring
from the material and during said applying suction to the
device.
35. The method of claim 24, wherein the tube comprises the distal
end of the device.
36. The method of claim 35, wherein the tube further comprises the
proximal end of the device.
37. The method of claim 24, further comprising using the distal end
of the device to repetitively core pieces from the material,
wherein said applying suction to the proximal end of the device
further passes the pieces through the hollow interior of the tube
and out of the device through the proximal end.
38. The method of claim 24, further comprising coupling the
proximal end of the device to a collection cannister and a source
of suction.
39. The method of claim 38, further comprising collecting the piece
in the collection cannister.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 15/356,975, titled BLOCKAGE REMOVAL, filed on
Nov. 21, 2016, which claims the benefit under 35 U.S.C. .sctn.
119(e) of U.S. Provisional Patent Application No. 62/260,873,
titled Treating Esophageal Food Impactions, filed on Nov. 30, 2015;
the entire contents of each of the foregoing applications are
hereby incorporated by reference herein.
BACKGROUND
[0002] Blockages within the body can take various forms. For
example, esophageal food impactions are one of the most common and
dangerous emergencies in gastroenterology, with an annual incidence
rate of at least 13/100,000 population (Longstreth, GIE; 2001);
moreover, the incidence has been increasing in recent years due to
the recent rise in eosinophilic esophagitis (Desai, GIE; 2005).
Food impactions can occur when a bolus of swallowed food becomes
lodged in the esophagus and is unable to pass spontaneously into
the stomach. This occurs either when the swallowed bolus is too
large or when there are diseases of the esophagus that narrow the
esophageal lumen, such as GE reflux with a stricture or ring, an
esophageal food allergy such as eosinophilic esophagitis with
stricture or stenosis of the esophagus, a Schatzki's ring,
esophageal webs or esophageal cancer. Motility disorders of the
esophagus typically do not cause impactions.
[0003] Most impactions clear spontaneously, but a significant
fraction (20%) will not and will require emergent endoscopic
intervention to clear the blocked food. This can be dangerous,
since emergency endoscopy with removal of food can result in
serious complications including aspiration pneumonia, laceration of
the esophagus with bleeding, or esophageal perforation which can
result in sepsis and death. The complication rate of endoscopic
clearance of a food impaction is approximately 3-5% and the
mortality rate is unknown but several deaths have been reported
(Simic, Am J Forensic Med Path; 1988).
[0004] Food impactions present acutely and dramatically, with
patients noting chest pain or pressure, inability to swallow,
painful swallowing, a sensation of choking, and neck or throat
pain. Retching and vomiting are also common, and patients can also
experience breathing problems due to tracheal or airway
compression, with stridor, coughing or wheezing being noted.
[0005] There are various endoscopic tools used to clear impactions
but all have flaws and there is no current technique that is
demonstrably better than any other. Food can sometimes be pushed
blindly through the esophagus and into the stomach using the tip of
the endoscope, but this technique is performed without vision of
the more distal esophagus, so the endoscopist has no way of knowing
what the esophagus looks like distal to the obstruction or what
abnormalities exist. This technique can work well (Vicari, GIE;
2001), but because the technique is blind, can often result in
esophageal laceration or perforation. Many endoscopists avoid blind
pushing for this reason. Forceps including "rat-tooth" type
designs, snares and variable wire basket designs can be used to
break up food into smaller pieces for extraction, but these
techniques are laborious, time-consuming and often fail.
[0006] Other extraction techniques can also be tried, particularly
when the food bolus is not tightly wedged and is firm, or if the
food contains bone or sharp surfaces. In this regard, baskets,
snares, graspers, "pelican" forceps with longer arms, nets etc.,
can be used to remove food in whole or in pieces, but these
techniques also frequently fail, and the patient is at risk for
aspiration pneumonia if the pieces fall into the hypopharynx or
mouth during the extraction attempts. If the food bolus is lodged
proximally, then most of the above techniques will fail or are too
dangerous to try. Endoscopic suction cannot be used for impactions,
since chunks of food cannot be effectively suctioned through an
endoscope, and also if suction fails to hold a bolus against the
tip of the scope then a patient would be at high-risk for
aspiration as the scope is withdrawn through the hypopharynx or
mouth. Overtubes can be used if repeated endoscopic intubation is
needed, but overtubes are uncomfortable, require deeper sedation
and are dangerous in of themselves with risk of esophageal
laceration and perforation.
[0007] Thus, it is important to provide mechanisms to clear
blockages within the body. For example, within the field of
esophageal food impaction, there is a need for effective and safer
mechanisms to remove food stuck in the esophagus.
SUMMARY
[0008] Systems and methods are provided to address blockages within
the body.
[0009] In one example, a device is configured to clear a bolus of
food impacted within an esophagus, the device including a catheter
tube having a hollow interior and a distal end configured to core
the bolus of food and a proximal end configured to be coupled to a
source of suction to clear the core.
DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 shows an example catheter for removing a blockage
within a body of a person.
[0011] FIG. 2 shows an example system for removing a bolus of food
or other debris lodged within an esophagus including the catheter
of FIG. 1.
[0012] FIG. 3 shows a portion of the system of FIG. 2 with the
bolus of food or other debris being partially cored.
[0013] FIG. 4 shows an example distal end of the catheter for
coring the bolus of food or other debris shown in FIG. 1.
[0014] FIG. 5 shows another example distal end of the catheter for
coring the bolus of food or other debris shown in FIG. 1.
[0015] FIG. 6 shows a portion of an example catheter tube of FIG. 1
coupled to a syringe.
[0016] FIG. 7 shows an example stylet of the system of FIG. 2.
[0017] FIG. 8 shows the stylet of FIG. 7 positioned with the
catheter of FIG. 1.
[0018] FIG. 9 shows another example catheter having a Y-fitting for
removing a bolus of food or other debris lodged within an
esophagus.
[0019] FIG. 10 shows another view of the catheter of FIG. 9.
[0020] FIG. 11 shows a proximal portion of the catheter of FIG. 9
with a stylet advanced fully therethrough.
[0021] FIG. 12 shows another view of the proximal portion of the
catheter of FIG. 11.
[0022] FIG. 13 shows another view of the proximal portion of the
catheter of FIG. 11 with the stylet partially removed
therefrom.
[0023] FIG. 14 shows an enlarged view of a portion of the proximal
portion of the catheter of FIG. 13.
[0024] FIG. 15 shows another view of the portion of the proximal
portion of the catheter of FIG. 14 with a cap of the suction port
removed.
[0025] FIG. 16 shows a distal end of the catheter of FIG. 15.
[0026] FIG. 17 shows a distal end of the catheter of FIG. 10.
[0027] FIG. 18 shows another example embodiment of a stylet for
removing a bolus of food or other debris lodged within an
esophagus.
[0028] FIG. 19 shows an end portion of the stylet of FIG. 18.
[0029] FIG. 20 shows another example embodiment of a system for
removing a bolus of food or other debris lodged within an
esophagus.
[0030] FIG. 21 shows a portion of the device of FIG. 20.
[0031] FIG. 22 shows another example embodiment of a system for
removing a bolus of food or other debris lodged within an
esophagus.
[0032] FIG. 23 shows a cross-sectional view of a portion of the
device of FIG. 22.
[0033] FIG. 24 shows another cross-sectional view of a portion of
the device of FIG. 22.
DETAILED DESCRIPTION
[0034] Example devices and methods described herein address the
removal of blockages within the body. Although some of the examples
depicted herein relate to the removal of impactions within the
esophagus, the inventions are not so limited. For example, the
inventions described herein can also be used to remove or otherwise
break-up other blockages within the body, such as those in the
lungs.
[0035] Some of the systems described herein assist in resolving the
buildup of pieces of food in the esophagus while minimizing the
risk of aspiration. The systems are further designed in an
atraumatic manner, helping to avoid esophageal laceration and
perforation. One such approach consistent with the embodiments
disclosed involves coring out the center of a food impaction.
[0036] For example, in one embodiment, the system includes a
catheter (e.g., hollow) with a distal end that is delivered to the
site of the blockage. The distal end is used to core out portions
of the blockage until the blockage is reduced in volume in a
piecemeal manner. The smaller volume blockage can then pass through
the esophagus spontaneously and/or be more easily removed. In some
examples, the catheter can be delivered to the blockage site
through an endoscope or other similar device.
[0037] In certain examples, suction can be provided to remove the
cored portions of the blockage. The suction can be provided at the
proximal end of the catheter to cause the cored portions to be
suctioned from the site of the blockage and passed through the
catheter and discarded, thus minimizing a risk of food aspiration
and preserving visualization.
[0038] Certain embodiments include aspects that allow cored
portions of the food to be cleared should the portions become
caught in the catheter while being suctioned away from the blockage
site. In one example, a source of compressed air, such as a
syringe, can be placed at the proximal end of the catheter, and air
can be passed through the catheter to clear any portions caught in
the catheter, via the distal end.
[0039] In addition, a stylet can be passed through the interior of
the catheter to clear any portions of food caught therein. The
stylet can also perform other functions, such as providing
stiffness for the catheter during delivery of the catheter to the
blockage site. Further, the stylet can be configured to assist in
the manipulation of the blockage, such as by advancing the stylet
into the blockage one or multiple times to create a nidus for
coring and suctioning.
[0040] Referring now to FIG. 1, an example catheter 100 is shown.
The catheter 100 includes a hollow catheter tube 102 that generally
can be used to core out a portion of a blockage. Specifically, the
catheter tube 102 includes a distal end 104 that is configured to
contact and core the blockage one or more times. As the blockage is
cored by the distal end 104 of the catheter tube 102, the volume of
the blockage is reduced until the blockage is reduced to a
sufficient level to be passed through the esophagus spontaneously
and/or removed.
[0041] The catheter tube 102 includes a proximal end 106 configured
to be coupled to various devices. For example, as described further
below, the proximal end 106 of the catheter tube 102 is configured
to be coupled to a source of suction to allow the cored food
portions to be suctioned and/or removed through the catheter tube
102. In another example, the proximal end 106 of the catheter tube
102 is configured to be coupled to a source of pressurized air,
such as a syringe, to allow any cored food stuck within the
catheter tube 102 to be cleared. Other configurations are
possible.
[0042] Referring now to FIGS. 2-3, the catheter 100 is shown within
an example system 200 configured to remove a blockage 202
positioned within an esophagus 204 of a person. In this example,
the blockage 202 (generally food or other debris, but could also be
other blockages like blood or blood clots, mucus, etc.) has become
caught within the esophagus 204.
[0043] In the embodiment shown, the catheter 100 is delivered to
the blockage 202 using an endoscope 210. The endoscope 210 contains
a channel that is generally hollow and allows the catheter 100 to
be delivered through the endoscope 210 to the blockage 202. Once
the distal end 104 of the catheter tube 102 is in position, the
endoscope 210 can be withdrawn or can remain in place as the
blockage 202 is manipulated.
[0044] The catheter tube 102 of the catheter 100 is configured to
be advanced so that the distal end 104 impacts the blockage 202 so
as to reduce the volume of the blockage 202, such as by
repetitively coring the food. As the volume is reduced (such as is
shown in FIG. 3), the blockage 202 can be naturally passed through
the esophagus 204 and into a stomach 206 of the person.
[0045] In example embodiments, the catheter tube 102 is at least
semi-rigid but flexible, which allows the catheter tube to flex
and/or bend during delivery through the endoscope, as the endoscope
flexes and bends. This allows the catheter tube 102 to be directed
more precisely as it is inserted to a desired location.
[0046] In some examples, the distal end 104 of the catheter tube
102 is configured to assist in the coring of the blockage 202. For
example, as shown in FIG. 4, the distal end 104 of the catheter
tube 102 is tapered. Specifically, the distal end 104 includes an
inner diameter 402 that is smaller than an inner diameter 404 of a
portion 406 of the catheter tube 102. In one example, the
difference in diameters can be less than one-hundredth of a
millimeter. Other sizes are possible. In addition, the walls of the
catheter tube 102 can be thinned as the walls extend to the distal
end 104, as depicted.
[0047] This tapering of the distal end 104 can allow a core 410 of
the blockage 202 that is formed by the distal end 104 to be more
easily suctioned through the catheter tube 102. Since the cores
formed by the distal end 104 will typically have a diameter smaller
than that of the portion 406, the cores can be more easily
suctioned through the catheter tube 102 for evacuation, as is
illustrated by Poiseuille's law.
[0048] In another depiction shown in FIG. 5, the catheter tube 102
is formed of a first portion 502 at the distal end 104 having a
smaller diameter, and a second portion 504 extending along a
remainder of the catheter tube 102 having a larger diameter. This
again allows the cores of the blockage 202 that are created by the
first portion 502 to be smaller in diameter so that the cores can
more easily pass through the remainder of the catheter tube 102
(i.e., the second portion 504).
[0049] In some examples, a tip 508 of the distal end 104 of the
catheter tube 102 can be beveled and/or serrated. The tip 508 can
take multiple forms, including a serrated edge, to shave bits of
the blockage 202 off of the bolus to better aid suctioning. The tip
508 can help core the blockage.
[0050] For example, referring again to the system 200 depicted in
FIG. 2, a source of suction can be applied to the proximal end 106
of the catheter 100 to allow the cores of the blockage 202 to be
removed through the catheter tube 102. Specifically, in the example
provided, a vacuum line 220 can be coupled to the proximal end 106
of the catheter tube 102. The vacuum line 220 can be coupled to a
collection canister 222, and the collection canister 222 is coupled
to a suction line 224. The suction line 224 is coupled to a source
of suction, such as a hospital vacuum source. In this
configuration, pieces of the blockage 202 that are cored or
otherwise dislodged by the catheter tube 102 can thereupon be
sucked up the catheter tube 102, through the vacuum line 220, and
collected in the collection canister 222.
[0051] As described previously, it is possible for one or more
cores of the blockage 202 to become stuck within the catheter tube
102. In such a scenario, various devices can be used to clear the
stuck cores.
[0052] For example, referring now to FIG. 6, an example syringe 602
is coupled to the proximal end 106 of the catheter 100 using, for
example, a suction line fitting or Luer-lock style connection. In
this embodiment, the syringe 602 can be a typical 60 cc syringe
that is used to deliver air into the catheter tube 102 during
coring of the blockage 202 to dislodge and/or remove portions of
the blockage 202 that are in the catheter tube 102.
[0053] In this instance, a plunger of the syringe 602 is actuated
to displace air within the syringe 602 into and through the
catheter tube 102. This air can be used to dislodge obstructions
within the tube. Other configurations are possible. For example,
other types of fluids, such as a jet spray of water, could be used
to help clear the tube or break up food.
[0054] In other instances, different devices can be used to clear
the catheter 100. For example, referring now to FIGS. 7-8, a stylet
700 is shown that is sized to fit through the hollow interior of
the catheter tube 102. Generally, the stylet 700 can be used to
perform various functions.
[0055] For example, the stylet 700 can be used to stiffen the
catheter 100 during delivery to the blockage 202. Further, the
stylet 700 can be introduced through the catheter tube 102 to clear
the catheter tube 102 when one or more cores get stuck, performing
a function of a pusher rod. Finally, the stylet 700 can also be
used to pierce the blockage 202 to start a nidus for coring and
suctioning. In some examples, the stylet 700 can also be solid or
hollow.
[0056] In this example, the stylet 700 further includes a stylet
knob 702 that is configured to be engaged with the proximal end 106
of the catheter 100. The proximal end 106 can be configured to
include a Luer taper that allows the proximal end 106 to engage the
stylet knob 702 of the stylet 700. Other coupling arrangements,
such as a threaded engagement, can be used.
[0057] As shown in FIG. 8, the stylet knob 702 is coupled to the
proximal end 106 of the catheter tube 102. In this configuration,
the catheter 100 can be delivered to the desired location within
the esophagus 204. At that time, the stylet knob 702 can be
disengaged from the proximal end 106 to free the stylet 700 for
movement. This movement can include the caregiver pushing the
stylet 700 into and out of the catheter tube 102 to generally
disrupt the blockage 202 and/or removal of the stylet 700
completely from the catheter tube 102.
[0058] When the stylet 700 is removed from the catheter tube 102,
the vacuum line 220 can be connected to the proximal end 106 of the
catheter tube 102 for suctioning, as described previously.
[0059] In this example shown in FIG. 8, the catheter tube 102 is
approximately 80.5 inches in length and the stylet 700 is
approximately 84 inches in length, although many different lengths
can be provided such as, for example, shorter lengths for children
and longer lengths for adults or to accommodate different length
endoscopes, bronchoscopes or colonoscopes. The example catheter
tube 102 has an outer diameter of 0.135 inches and an inner
diameter of 0.115 inches. The stylet 700 has an outer diameter of
0.105 inches. Other sizes can be used.
[0060] In other embodiments, the catheter tube 102 can be variable
in length and diameter. For example, another embodiment of the
catheter tube 102 measures 0.093 inches in outer diameter and 0.082
for the inner diameter, allowing for easy introduction and sliding
within the working channel of any endoscope. The catheter tube 102
is long enough to extend through an endoscope, at least 120 cm in
length but can be longer.
[0061] The stylet 700 can vary in diameter, but in the preferred
embodiment measures 0.070 inches in outer diameter to allow easy
introduction and sliding within the catheter tube 102, and is
slightly longer than the catheter tube 102 to allow the stylet 700
to extend beyond the distal end 104 of the catheter tube 102 to
clear the catheter tube 102 and extend further into the blockage
202, if necessary.
[0062] The catheter tube 102 can be made from a thin-walled
extruded tube sized to fit the working channel (biopsy channel) of
any commercially available endoscope. One example material is Pebax
7233 SA. Another possible material would be an extrusion grade of
PETG. Other possibilities would be Polyamide or extrusion grade
Nylon or Delrin, such as Nylon 10 or Nylon 12.
[0063] The stylet 700 could be made of the same or similar
material. For example, the catheter tube 102 and the stylet 700 can
be made of the same material to allow the stylet 700 to fit within
the catheter tube 102 while minimizing friction. However, other
materials and different materials for each can be used.
[0064] The above materials would clear food, but would not
seriously damage the walls of the esophagus should they
inadvertently contact the walls of the esophagus.
[0065] Referring now to FIGS. 9-17, another example device 900 is
shown. The device 900 includes the catheter tube 102 with a suction
port 902 at the proximal end 106 and with the distal end 104 that
is designed (e.g., beveled) to be advanced through the biopsy
channel of any commercial endoscope and that can accommodate the
stylet 700 to clear food that sticks in the catheter tube 102 after
removal from the esophagus.
[0066] As shown in FIG. 9, the catheter tube 102 is designed to fit
through the biopsy channel of an endoscope positioned within the
esophagus to reach a food blockage, but can also be advanced
adjacent to an endoscope and can also be advanced orally without
the aid of an endoscope. The catheter tube 102 is also bendable and
maneuverable as the endoscope bends and maneuvers, yet is rigid
enough to withstand kinking.
[0067] In this example (see FIGS. 9 and 15), there is a Y-fitting
904 wherein one arm 906 of the Y is attached to and forms the
suction port 902, and another arm 908 of the Y accommodates the
stylet 700.
[0068] There is also a compression seal 910, or rubber stopper, at
the proximal end of the arm 908 that accommodates the stylet 700,
so that any air escaping the proximal end is minimized when the
stylet 700 is in the catheter tube 102, so that suction and stylet
clearance of the vacuum tube can occur simultaneously. When the
compression seal 910 is loosened, the stylet 700 can be easily
advanced into and out of the catheter tube 102 using a handle 912
of the stylet 700. The compression seal 910 can also secure the
stylet 700 in any location along the shaft of the catheter tube
102.
[0069] In this example, a cap 914 is threaded onto the proximal end
916 of the arm 908 to retain the compression seal 910 in place.
Upon removal of the stylet 700 from the catheter tube 102, the
compression seal 910 is configured, in some embodiments, to close
the proximal end 916 so that suction can be performed through the
catheter tube 102 and the suction port 902.
[0070] In the example shown, the catheter tube 102 can work with
the stylet 700 completely removed; the stylet 700 can also be
introduced as needed, and advanced any distance in the catheter
tube 102.
[0071] As with previous embodiments, the distal end 104 of the
catheter tube 102 can disrupt food, core food, shave food and
suction food. The catheter tube 102 wall could be thin and rigid to
better accommodate a larger lumen of the tube. The stylet 700 can
help support the catheter tube 102 to help prevent kinking if
necessary. Thus the stylet 700 can both help clear the suction tube
and act as a stylet to stiffen the catheter tube 102.
[0072] Many alternative designs are possible. For example, in
another design shown in FIGS. 18-19, a stylet 1800 could have a
spline shape 1802 with splines 1804 formed along the stylet to
better accommodate suction when the stylet in is the catheter tube.
In other words, spaces 1806 are formed between the splines 1804 to
allow suction to be provided through the catheter tube 102 even
with the stylet 1800 in place within the catheter tube 102. Other
configurations are possible.
[0073] Referring now to FIGS. 20-21, another example of a stylet
2000 is shown. In this example, the stylet 2000 is a wire 2002 with
a piston 2004 positioned at an end 2006 thereof. The piston 2004
can be automatically (and/or manually) actuated intermittently or
at regularly intervals (such as by a motor) to drive the stylet
2000 through the catheter tube 102 to engage the blockage in the
esophagus. Other configurations are possible.
[0074] Referring now to FIGS. 22-24, another example device 2200 is
shown. The device 2200 is similar to the embodiment of FIGS. 20-21,
except that the device 2200 does not necessarily need suction.
Instead, the device 2200 includes a handle 2202 and a tube 2204.
The handle 2202 includes an actuator member 2206 that can be moved
(e.g., by the caregiver's finger or thumb) in a direction 2208 in
or out.
[0075] The actuator member 2206 is coupled to a wire 2210 that runs
through the tube 2204 to an ejector piston 2402. The ejector piston
2402 is positioned within a cavity 2404 formed in a distal end 2406
of the tube 2204. The distal end 2406 of the tube 2204 forms an
opening 2408 sized to core or otherwise carve the obstruction as
the caregiver moves the handle 2202 and the tube 2204 attached
thereto. This is accomplished, for example, by the pieces of the
obstruction being carved by the distal end 2406 of the tube 2204
and received in the cavity 2404.
[0076] As the cavity 2404 is filled, the caregiver can move the
actuator member 2206 to cause the ejector piston 2402 to be moved
by the wire 2210 through the cavity 2404 towards the distal end
2406 of the tube 2204 to eject food out of the opening 2408. This
process can be done multiple times until the obstruction is
cleared. The actuator member 2206 can be biased to return to the
retracted position and/or simply be moved in the opposite direction
2208 by the caregiver's finger to return the ejector piston 2402 to
the retracted position
[0077] In some examples, the distal end 2406 of the tube 2204 can
be configured to more easily core the obstruction. For example, the
distal end can be thinned or serrated so as to be sharper. In other
examples, additional features, such as a stainless steel tip, can
be added to the distal end 2406 of this (or any other embodiment
disclosed herein) to enhance the coring impact of the device
2200.
[0078] In some examples, the inner surface of the tubes can be
configured to more easily allow cores of the obstruction to pass
therethrough. For example, the inner surface of a tube can be
coated with a low friction or lubricious material to encourage
passage and discourage clumping of the cores. Examples of such low
friction materials include, without limitation, Poly vinyl
pyrolidone and Hyaluronic acid. Such materials can be typically
bonded using heat or ultraviolet light. The external surface of the
catheter 102 can optionally also be coated with low friction
materials to enable passage through the endoscope. Other
mechanisms, such as differing tapers and/or channeling of the inner
surface, can also be used.
[0079] The examples described above refer to impactions in the
esophagus. However, many other similar impactions can be addressed
using the systems and methods described herein.
[0080] For example, a person can choke while eating, and food can
get aspirated and lodge in the trachea, or can also lodge in the
lung, specifically any portion of the bronchial tree. Mucus can
also become trapped anywhere in the bronchial tree, causing mucus
plugging. When this occurs, one or more of the embodiments
described herein can be used to core and suction said food or
mucus, by placing the device through the working channel of a
flexible or rigid bronchoscope as opposed to an endoscope.
[0081] One or more of the embodiments described herein can also be
used to core, suction and remove trapped blood or blood clots
anywhere in the GI tract, specifically the esophagus, stomach,
small intestine or large intestine.
[0082] One or more of the embodiments described herein can also be
used to core, suction and remove trapped food, blood or blood
clots, or mucus or mucus plugs, anywhere in the pulmonary organ
system, i.e., the trachea or lung i.e. anywhere in the bronchial
tree.
[0083] One or more of the embodiments described herein can also be
used to core and remove blood or blood clots, or atheroma or
atheromatous plaque anywhere in the vasculature system, i.e. great
arteries or veins, or peripheral vasculature i.e. the peripheral
arteries or veins. To core harder materials such as calcified
plaque, a stainless steel tip and be attached to the end of the
suction catheter.
[0084] One or more of the embodiments described herein can also be
used to core and remove blood or blood clots, or atheroma or
atheromatous plaque anywhere in the heart or coronary arteries. To
core harder materials such as calcified plaque, a stainless steel
tip can be attached to the end of the suction catheter.
[0085] In another example, One or more of the embodiments described
herein can be used to core and suction kidney stones from the
urinary system, specifically the ureters, bladder and kidneys. To
core harder materials such as calcified, struvite, oxalate or uric
acid kidney stones a stainless steel tip can be attached to the end
of the suction catheter.
[0086] In yet another example, one or more of the embodiments
described herein can be used to core and remove gallstones or
tumors lodged in the biliary tree (common bile duct or peripheral
ducts). Harder materials can be cored by attaching a stainless
steel tip to the end of the suction catheter.
[0087] Although various embodiments are described herein, the
embodiments are only examples and should not be construed as
limiting.
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