U.S. patent number 3,780,740 [Application Number 05/302,808] was granted by the patent office on 1973-12-25 for intubation device and method of advancing a tube past the pylorus.
Invention is credited to James W. Rhea.
United States Patent |
3,780,740 |
Rhea |
December 25, 1973 |
INTUBATION DEVICE AND METHOD OF ADVANCING A TUBE PAST THE
PYLORUS
Abstract
An intubation device providing communication into a patient's
intestine. The device is formed of a soft flexible tube having a
weighted front end, a soft flexible sleeve slidably mounted on the
tube, and a collar mounted on the front end of the tube in registry
with the sleeve. The front end of the device is inserted through a
nasal passage of the patient and is advanced, by the coaction of
the weighted plug and the advancement of the sleeve against the
collar, to bring the plug and the front of the tube into the
patient's stomach up to the pylorus. The sleeve is then withdrawn
with respect to the collar and tube, then readvanced carrying the
tube so as to provide slack in the front of the tube so that the
coaction of peristalsis and the weighted plug will effect a
transpyloric passage of the plug and the leading end of the tube. A
passage extends between the interior and exterior of the tube at or
near the front of the tube to permit fluid to flow between the tube
and the intestine.
Inventors: |
Rhea; James W. (Bristol,
TN) |
Family
ID: |
23169292 |
Appl.
No.: |
05/302,808 |
Filed: |
November 1, 1972 |
Current U.S.
Class: |
604/270 |
Current CPC
Class: |
A61J
15/0026 (20130101); A61J 15/0003 (20130101); A61J
15/0069 (20130101); A61J 15/0023 (20130101) |
Current International
Class: |
A61J
15/00 (20060101); A61m 025/00 () |
Field of
Search: |
;128/276-278,240,241,239,343,348-351 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. An intubation device comprising:
a soft flexible tube having a weighted plug secured to its front
end; a soft, flexible sleeve, of shorter length than the tube,
slidably mounted on the tube; passage means between the interior of
the tube proximate to its front end and the exterior of the tube;
and a collar mounted on the front end of the tube in registry with
the sleeve.
2. The device of claim 1 wherein said passage means comprises:
at least one radial passage extending through the tube.
3. The device of claim 1 wherein said passage means comprises:
an axial passage extending through the plug and communicating with
the interior of the tube.
4. The device of claim 1 wherein the plug has a rearwardly
extending threaded tail that is received in the front of the
tube.
5. The device of claim 4 wherein said collar extends about the
threaded tail.
6. The device of claim 1 further comprising:
a funnel-shaped connector mounted to the back end of the tube.
7. A method of advancing the leading end of a soft, flexible tube
having a weighted plug at its front end past the pylorus of a
patient comprising:
slidably mounting a soft, flexible sleeve on the tube; providing a
collar, mounted on the front end of the tube, that is in registry
with the sleeve; inserting the front end of the tube, together with
the plug and the front end of the sleeve, into a body passage of
the patient; advancing the sleeve against the collar so that this
advancement, in conjunction with the effect of the weighted plug,
will cause the plug and the front of the tube to advance into the
patient's stomach up to the pylorus; and withdrawing the sleeve
with respect to the collar so as to provide slack in the front of
the tube; whereby the coaction of the weighted plug and
persistalsis will effect passage of the plug and the front of the
tube past the pylorus.
Description
BACKGROUND OF THE INVENTION
U. S. Pat. Nos. 1,736,182, 2,356,659, 2,596,947, and 3,189,031 show
tubes which can be inserted into a patient's stomach or intestine
to provide communication with the stomach or intestine for feeding
or aspirating purposes. However, particularly with infants,
difficulties arise in enabling the tube to be placed in the
duodenum or jejunum, such placement being desirable for the
following reasons:
A. Liquid deposited in the stomachs of certain infants is likely to
be vomited or regurgitated which puts the infant at risk of
aspirating or inhaling the liquid, such aspiration having a
tendency to cause choking, asphyxia, pneumonia or other disease in
a weak or ill infant;
B. The pyloric valve between the stomach and the duodenum provides
a substantial barrier to reflux of liquid delivered
transpylorically into the duodenum or the jejunum;
C. The jejunum is capable of rapidly absorbing certain liquids in
contrast to the stomach which acts more as a reservoir and absorbs
very little except alcohol.
SUMMARY OF THE INVENTION
This invention is concerned with an intubation device which enables
a feeding or aspirating tube to be readily inserted past the
pyloric valve into the intestine and with a method of advancing the
leading end of the tube into the intestine. The tube, which is made
of a soft flexible material, has a weighted leading end and a
sleeve, also made of a soft flexible material, is slidably mounted
on the tube. A collar is mounted on the front of the tube in
registry with the sleeve. At least one passage extends between the
interior and exterior of the tube at or near the front of the tube
to provide communication between the tube and the lumen of the
intestine. The leading ends of the tube and the sleeve, and the
plug, are inserted into a patient's body passage, such as a nasal
passage, and the sleeve is advanced against the collar to thus, in
coaction with the weight of the plug, bring the plug and the front
of the tube into the patient's stomach up to the pylorus. The
sleeve is then withdrawn with respect to the collar and tube, and
then is readvanced carrying the tube to provide slack at the front
of the tube so that the coaction of the weighted plug and
peristalsis will effect a transpyloric passage of the plug and the
leading end of the tube into the intestine.
BRIEF DESCRIPTION OF THE DRAWING
FIG. 1 is a section of the intubation device;
FIG. 2 is a representation of the intubation device in a
patient;
FIG. 3 is a section of a portion of a variant of the intubation
device; and
FIG. 4 is a view of a variant of a plug of the intubation
device.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Number 10 of the intubation device 11 designates a soft, flexible
limp tube that may be made of silicone rubber or plastic. A plug 12
is secured to the front end of the tube 10 by means of a tapered
threaded tail 14 on the back end of the plug that is inserted into
and distends the front end of the tube 10. The plug 12 has a
tapered blunt nose 16 and is made of a relatively dense non-toxic
material such as gold or platinum. A collar 18, which may be made
of the same material as the plug 12 or, alternatively, may be made
of a plastic similar to that of the sleeve 20 described below, is
fitted over the front end of the tube 10 so as to extend about the
periphery of the front end of the tube 10 outwardly of the back end
14 of the plug 12. A plurality of radial passages 22 extend through
the tube 10 near the front end of the tube. The sleeve 20, which is
made of soft flexible material such as silicone rubber or plastic,
is of shorter length then, and extends about the periphery of the
tube 10 so as to be slidable on the tube 10 and so as to be
registry with the collar 18. A removable plastic funnel-shaped
connector 24 is mounted to the back end of the tube 10.
In use, the tube 10 is dusted with a suitable lubricant, such as
powdered baking soda, to provide lubrication between the tube and
the sleeve. The sleeve 20 is moved along the tube 10 so that the
front end of the sleeve abuts the collar 18. A suitable lubricant,
such as lubricating jelly is applied externally of the plug 12, the
collar 18 and the sleeve 20 to facilitate their movement internally
of the patient and the intubation device 11 is advanced, plug
first, into a nasal passage of a patient 26 (FIG. 2), who is, if
possible, in a 60.degree. sitting position. The intubation device
11 is advanced through the patient's nose, throat and esophagus
until the plug 12 reaches the entrance to the stomach 28, at which
point the patient is put in a horizontal position and turned on his
right side. The intubation device is then further advanced until
the front end 16 of the plug 12 approaches the pylorus 30. This
advance of the intubation device 11 up to the pylorus 30 is
effected due to the weight of the plug 12 at the front end of the
intubation device 11 and also due to the operator manipulating the
portion of the sleeve 20 that projects from the nasal passage by
advancing the sleeve 20 in abutment with the collar 18 which
advances the collar, together with the plug 12 and the tube 10
further into the patient's body.
When the plug 12 has reached a position near the pylorus 30, the
operator alternatively withdraws the sleeve 20 with respect to the
tube 10 and the collar 18 and advances the sleeve 20 and the tube
10 to provide slack at the front end of the tube to thereby enable
the weight of the plug 12 and peristalsis to effect passage of the
plug 12 and the front portion of the tube 10 past the pylorus and
into the duodenum 32.
The passage of the intubation device from the nasal passage up to
the pylorus is facilitated by the tapered blunt end 16 of the
weighted plug 12 and the soft, flexible nature of the tube 10 and
the collar 20. The transpyloric passage of the plug 12 and the
front end of the tube 10 is facilitated by the tapered blunt end 16
of the weighted plug 12 and the soft, flexible nature of the tube
10.
When the intubation device 11 is in position in the body with the
plug 12 and the front end of the tube 10 past the pylorus in either
the duodenum 32 or beyond the duodenum in the jejunum, the
intubation device may be used as a feeding tube for delivering
nutrient liquids and/or gases through the tube 10 and then out of
the tube 10 through the passage 22 into the duodenum or jejunum.
The intubation device 11 may also be used as an aspirator to
extract fluids such as duodenal jucies from the duodenum through
the passage 22 and the tube 10 for diagnostic studies.
Regardless of whether the intubation device 11 is used as a feeding
device or as an aspirator, the removable connector 24 may be used
to connect the tube 10 to either a source of nutrients or to a
receptacle for delivery of the aspirated fluid. After the
intubation device 11 has been inserted in the patient, the
connector 24 may be removed, the sleeve 20 may be completely
withdrawn and the connector may be mounted again to the back end of
the tube 10.
FIG. 3 shows a variant intubation device 34 having a plug 36
identical to the plug 12 except for an axial passage 38 extending
therethrough that is in communication with a tube 40. The tube 40
is identical to the tube 10 except for the omission of the radial
passages 22. The intubation device 34 functions in the same manner
as the intubation device 11 except for the fact that the fluid
flows out of or into the front of the tube 40 by way of the axial
passage 38 in the plug 36 instead of, or in addition to, by way of
the radial passages 22.
FIG. 4 shows a variant plug 42 having a tapered blunt front end 44,
a shank 46 extending rearwardly of the front end 44 and a bill 48
projecting rearwardly of the shank 46 that receives the tube
10.
* * * * *