U.S. patent number 3,703,899 [Application Number 05/110,469] was granted by the patent office on 1972-11-28 for surgical drainage instrument.
Invention is credited to Teodora A. Calinog.
United States Patent |
3,703,899 |
Calinog |
November 28, 1972 |
**Please see images for:
( Certificate of Correction ) ** |
SURGICAL DRAINAGE INSTRUMENT
Abstract
A trocar is slidably mounted in a main tube and normally is
disposed at its front end. Connected to the rear end of the trocar
is a rod that extends back through the tube and out of its rear
end. A tubular bellows encircles the rod and has a front end sealed
to the trocar, while the rear end of the bellows is sealingly
connected to the rear end of the tube. After the tube is inserted
in an incision the trocar is pulled back into a position near the
rear end of the tube. Directly in front of this rear portion the
tube is provided with a lateral outlet opening and a discharge tube
so that drainage can occur back through the two tubes.
Inventors: |
Calinog; Teodora A.
(Pittsburgh, PA) |
Family
ID: |
22333177 |
Appl.
No.: |
05/110,469 |
Filed: |
January 28, 1971 |
Current U.S.
Class: |
604/264;
604/170.01; 604/267 |
Current CPC
Class: |
A61M
25/0606 (20130101); A61M 1/84 (20210501) |
Current International
Class: |
A61M
25/06 (20060101); A61M 1/00 (20060101); A61b
017/34 (); A61b 027/00 () |
Field of
Search: |
;128/347,348,349R,35R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
|
|
142,879 |
|
Nov 1953 |
|
SW |
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1,035,273 |
|
Jul 1966 |
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GB |
|
Primary Examiner: Pace; Channing L.
Claims
I claim:
1. A surgical drainage instrument comprising a main tube having
front and rear ends, a trocar slidably mounted in the tube and
normally disposed in the front end thereof, a rod in the tube
connected to the rear end of the trocar and extending therefrom
back through the tube and out of its rear end, the diameter of the
rod being considerably less than the inner diameter of the tube, a
tubular bellows encircling the rod inside the tube and having a
front end sealed to the trocar, means sealingly connecting the rear
end of the bellows to the rear end of the tube to isolate the rod
from the inside of the tube around and in front of the bellows,
said rod being designed for pulling the trocar rearwardly in the
tube to a position near the rear end of the tube, the tube being
provided with a lateral outlet opening near its rear end between
the front and rear positions of the trocar, and a discharge tube
joined to the main tube around said opening and extending outwardly
away from it.
2. A surgical drainage instrument according to claim 1, in which
said trocar is provided in its side with a drain groove extending
from end to end, and the front end of the main tube is provided
with a lip engaged by the trocar and closing the front end of the
groove and with a side opening beside said groove, whereby fluid
entering said side opening can pass the trocar and leave said main
tube through said discharge tube.
3. A surgical drainage instrument according to claim 1, in which
said connecting means includes a plug fitting tightly in the rear
end of the main tube and provided with an axial passage for said
rod, the rear end of said bellows encircling said plug inside the
main tube and being compressed between them.
4. A surgical drainage instrument according to claim 1, in which
said rod is detachably connected to the trocar and is completely
removable from said tube.
Description
Following surgical operations it often is necessary to insert a
drainage tube in the incision. For example, after lung or heart
surgery a tube is inserted in order to draw off blood clots and air
and also to reestablish the negative pressure within the pleural
cavity. Such tubes are likewise used in the drainage of empyema and
other abnormal fluid accumulations. Sometimes such a tube is used
for instillation of drugs into the pleural cavity for treating
infection or for chemotherapy of cancer. One of the most common
problems that is encountered is maintaining the drainage path
through the tube open, especially when thick fluid-like blood clots
and pus are encountered. The customary way of keeping a drainage
tube open is by milking it frequently, but this is not
satisfactory. Another less common, but important, problem is the
instillation of drugs through the chest tubes without the danger of
letting air into the pleural cavity, which is an obvious danger to
the lift of the patient. Finally, there is the problem of insertion
of the most commonly used tubes, that needs many different
ancillary instruments.
It is among the objects of this invention to provide a surgical
drainage instrument which is easy to insert in an incision, which
can be freed of any obstructions quickly and in a simple manner,
and which permits the instillation of drugs without admitting air
to the chest cavity.
The preferred embodiment of the invention is illustrated in the
accompanying drawings, in which
FIG. 1 is a side view with parts broken away in longitudinal
section;
FIG. 2 is an enlarged front end view;
FIGS. 3 and 4 are enlarged cross sections taken on the lines
III--III and IV--IV, respectively, of FIG. 1;
FIG. 5 is an enlarged fragmentary side view, with parts shown in
longitudinal section; and
FIG. 6 is a reduced perspective view, again partly in section, of
the instrument in operating position.
Referring to the drawings, a flexible main tube 1 made of rubber or
a plastic and more or less transparent has a bevelled front end
provided with a central inlet opening 2 encircled by a lip 3.
Fitting snugly within the tube, but slidable therein, is a trocar 4
which can be formed of the same material as the tube. The front end
of the trocar is bevelled to the same extent as the front end of
the tube and normally engages lip 3. The trocar has a forwardly
projecting reduced extension 5 that plugs the inlet 2 of the tube.
The side of the trocar is provided with one or more, preferably
three, grooves 6 extending from end to end. The front ends of these
grooves are closed by lip 3. Beside the front end of each of the
grooves there is an inlet port 7 in the side of the tube.
To help in inserting the front end of the tube in an incision and
also to enable the trocar to be retracted in the tube, the front
end of a rod 10 is screwed into the rear end of the trocar. The
diameter of the rod is considerably smaller than the inside of the
tube so that there is a substantial space between them. The rod
extends rearwardly through the tube and out of its rear end. The
outer end of the rod may be provided with a pull ring 11. The rod
is slidably mounted in an axial passage through a plug 12 fitting
tightly in the rear end of the tube. The trocar and rod stiffen the
tube for insertion in an incision. Thereafter, by pulling on the
rod the trocar can be pulled back in the tube to an out-of-the-way
position near its rear end. Directly in front of the trocar in its
rear position, the main tube is provided with a lateral outlet
opening 13, from which a discharge tube 14 extends laterally and
rearwardly away from the main tube. The outer end of the discharge
tube normally is closed by a removable plastic or rubber stopper
15.
Another feature of this invention is that the trocar can be moved
back and forth in the main tube by means of the rod without the
inside of the tube being contaminated by the rod. Accordingly, the
rod is surrounded by a tubular bellows 17 of plastic or rubber that
extends from the trocar to the plug 12 in the rear end of the tube.
The front end of the bellows is sealed to the rear end of the
trocar in any suitable manner, and the rear end of the bellows is
either sealed to the plug or is clamped tightly between the plug
and the encircling tube. When the trocar is in its forward position
shown in FIG. 1, the bellows, of course, is extended but when the
trocar is retracted to its rear position shown in FIG. 5, the
bellows is compressed or folded in the space between the trocar and
the plug. The proper rear position for the trocar can be indicated
by providing the rod with a mark, or providing the inside of the
main tube with a bump or restriction that the rear end of the
trocar will engage. The rod then can be removed by unscrewing it
from the trocar and later reinserted in order to move the trocar
forward again. Since the rod is isolated by the bellows from the
passage through the tube, there is no necessity for maintaining the
rod sterile. Moving the trocar forward in the main tube, followed
by retracting it to its rear position again, is for the purpose of
loosening any blood clots or the like that may form in the tube and
obstruct the passage through it.
OPERATION
After the stopper in the end of the discharge tube has been
removed, that tube is connected by a flexible tube 20 with a water
bottle 21 into which fluid is to drain, as shown in FIG. 6. The
front end of the main tube, by means of the trocar, then is pushed
into the incision 22 in a patient's chest and between his ribs into
the chest cavity. The surgeon can tell when the main tube is in the
correct position because the expected fluid will enter the lateral
inlets 7 in the front of the tube, flow back through the grooves 6
in the side of the trocar and then be seen between the bellows and
the inside of the tube before it enters discharge tube 14 and
finally enters the bottle. If air is expected, the bottle is
observed for bubbling. The main tube can be fastened in place in
the usual way. The rod is retracted to pull the trocar back in the
main tube to its rear position directly behind the entrance to the
discharge tube, and then the rod is disconnected from the trocar
and laid aside for future use. The inside of the main tube now is
unobstructed so that blood or any other liquid from the chest
cavity can flow freely through it and into the bottle. However, as
mentioned before, if the tube starts to become obstructed, the rod
can be screwed back into the trocar and the latter pushed forward
in the main tube to clear the passage and then retracted again. The
fact that the rod is not sterile is immaterial, because it is
enclosed in the bellows.
This instrument likewise can be used for instillation of drugs into
the pleural cavity. After adequate drainage has occurred, the
discharge tube 14 is disconnected from the bottle tube 20 and a
sterile rubber stopper is inserted in the outlet of the discharge
tube. This stopper is punctured with the needle of a syringe
containing the drug. The syringe then can force the drug through
the discharge tube into the main tube and from there into the
chest. This can be repeated at intervals if necessary. This is most
useful for chemotherapeutic agents for cancer therapy and
antibiotics for specific type infections.
It will be seen that the instrument described herein is a
multipurpose item. It can be used for both drainage and
instillation of drugs. The passage through the main tube can be
maintained open by moving the trocar back and forth in it. The
trocar also aids in inserting the tube in the chest cavity. The
danger of producing more pneumothorax in the process of inserting
the tube is avoided by the plug and stopper that seal the outer
ends of the tubes. When used for instilling drugs, the danger of
introducing more air into the pleural cavity is avoided by
injecting the drugs through the stopper in the outer end of the
discharge tube.
According to the provisions of the patent statutes, I have
explained the principle of my invention and have illustrated and
described what I now consider to represent its best embodiment.
However, I desire to have it understood that, within the scope of
the appended claims, the invention may be practiced otherwise than
as specifically illustrated and described.
* * * * *