U.S. patent number 3,885,567 [Application Number 05/333,871] was granted by the patent office on 1975-05-27 for gastrointestinal aspirator pump.
Invention is credited to John R. Ross.
United States Patent |
3,885,567 |
Ross |
May 27, 1975 |
Gastrointestinal aspirator pump
Abstract
The gastrointestinal pump, preferably an aspirator, includes
means for creating positive and negative pressures. A timer
circuit, in conjunction with an arrangement of valves, activates
the positive and negative pressure outputs of the pump in a
selectable, alternately timed sequence. A double lumen tube
transmits the pressures to the gastrointestinal tract. The negative
pressure lumen withdraws the gastric fluids, while the positive
pressure lumen exerts force at the opening of the negative pressure
lumen to prevent blockage of the opening. A collecting vessel is
connected in the negative pressure line. The lumens of the tube may
be eccentrically or concentrically located. Openings may also be
formed along the length of the double lumen tube.
Inventors: |
Ross; John R. (Brookline,
MA) |
Family
ID: |
23304613 |
Appl.
No.: |
05/333,871 |
Filed: |
February 20, 1973 |
Current U.S.
Class: |
604/120;
604/151 |
Current CPC
Class: |
A61M
1/0062 (20130101) |
Current International
Class: |
A61M
1/00 (20060101); A61m 001/00 () |
Field of
Search: |
;128/240,276-278,348-350 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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150,667 |
|
Apr 1904 |
|
DD |
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191,092 |
|
May 1937 |
|
CH |
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Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Claims
I claim:
1. An aspirator-pump and tube combination for evacuating liquid
from an intestinal cavity wherein debris or tissue can block the
evacuating means comprising:
a. air pump means with connections to supply both positive and
negative pressure (relative to atmospheric) air;
b. a multi-lumen tube adapted to be inserted into said cavity
having a positive air pressure lumen connected to the positive air
connection of said pump and a negative pressure lumen connected to
the negative pressure connection of said pump;
c. means including valves and a timer for supplying positive
pressure air from said pump to said positive air pressure lumen for
a measured period of time;
d. means for withdrawing liquids from said cavity comprising walls
forming a negative pressure opening in said negative pressure lumen
communicating with said cavity, and
e. means for moving debris or tissue away from said negative
pressure opening comprising walls in said positive air pressure
lumen forming a positive air pressure opening, and additional walls
supporting said positive air pressure opening in position to
project air against said debris or tissue blocking the negative
pressure opening during said period.
2. The aspirator-pump and tube combination according to claim 1
including additional negative and positive pressure openings spaced
along said tube.
3. The aspirator-pump and tube combination, according to claim 1
wherein said positive and negative pressure lumens are parallel
tubes.
4. The aspirator-pump and tube combination of claim 1 wherein said
positive pressure lumen is within said negative pressure lumen.
Description
BACKGROUND OF THE INVENTION
This invention relates to a gastrointestinal pump and, more
particularly, to an aspirator that avoids blockage of the negative
pressure tube in the gastrointestinal tract.
Gastrointestinal aspirators are commonly used for withdrawing the
fluid contents of the gastrointestinal tract.
One type of a known aspirator utilizes a single lumen tube for
transmitting a negative pressure from the aspirator to the
gastrointestinal tract. The negative pressure in the tube withdraws
the contents.
One drawback with this type of aspirator resides in the tendency of
the tube opening to become blocked by gastrointestinal membranes
and debris. The blockage not only impedes effective aspiration but
also may cause severe pain and discomfort to the patient. In cases
where the intestinal wall becomes drawn to or into the suction
opening, the tube cannot be moved within the digestion tract
without release of the vacuum.
Known attempts to solve the problem have either not been successful
or have been only partially effective and with the loss of other
desirable features. In one conventional aspirator, the tube has a
plurality of holes along its length so that if some openings are
blocked, others may remain open. However, such an aspirator does
not entirely prevent the undesirable blockage or attachment to the
intestine. Additionally, it may be impossible with such a tube to
reach certain parts of the gastrointestinal tract, or to identify
the exact location in the tract from which a sample was taken.
Another known arrangement utilizes a hood at the end of the tube,
the hood having a plurality of openings to permit gastrointestinal
fluids to enter the hood, from which they are drawn into the tube.
The hood also is provided with an air-tight compartment connected
to another tube in such a way that air may be pumped into the
compartment to extend the hood to keep the hood erect. Such an
aspirator, however, does not entirely prevent blockage and is
difficult to position in certain parts of the gastrointestinal
tract.
Also known is an aspirator that sequentially supplies a positive
and negative pressure to the tube, the gastrointestinal contents
being withdrawn during the negative cycle, with the positive
pressure intended to prevent blockage of the tube opening. With
such a device, however, the blockage is removed only during the
positive cycle with variable and irretrievable loss of fluids that
are being forced back into the gastrointestinal tract, and blockage
can occur before new fluid has been withdrawn. Therefore, the
return of fluids to the gastrointestinal tract prevents accurate
analysis. Important diagnostic information can be obtained from
knowledge of the exact location in the tract from which a given
sample is taken. However, if the tube contents are alternately
pushed forward and backward in the tube, the identity of the
location of a given portion of the sample can become confused or
lost.
Thus, it is an object of the present invention to provide a
gastrointestinal aspirator that prevents tube blockage, that
operates efficiently and safely, that requires a minimum of time on
the part of attendant personnel, and that accurately permits
physicians to determine the location in the gastrointestinal tract
from which samples are removed. Additional objects will appear as
the description proceeds.
SUMMARY OF THE INVENTION
There is provided in accordance with the present invention, a
gastrointestinal aspirator that accomplishes the above objects. In
the aspirator of the present invention, means are provided for
withdrawing gastrointestinal fluids through a suction tube and for
preventing blockage of the opening of the suction tube in a manner
independent of the passage of the contents through the suction
tube. Thus, continuous operation and change of position are
possible without attachment to the intestinal wall and the exact
location in the gastrointestinal tract from which the fluids are
withdrawn can be identified. Blockage of the tube inlet is
prevented by injecting air into the intestine through a separate
tube, having its opening positioned near to the opening of the
suction tube. In this way, an air bubble is formed so as to lift
blocking membranes or debris adjacent to the tube and thereby free
the suction tube opening. Preferably, the positive and negative
pressure cycles occur alternately.
In one form of the present invention, a single pump provides both
the positive and negative pressures. The pump may be controlled by
a timer that causes the pump to supply positive and negative
pressures alternately. The duration of each pressure cycle is
variable and may range from 10 to 0.1 seconds.
The two tubes are preferably joined to form a double lumen tube
which permits the aspirator to operate more efficiently and
facilitates insertion and positioning. The lumens may be either
eccentrically or concentrically arranged, and may also be formed
with openings along their lengths to provide a plurality of
openings for withdrawing the fluids and for air injection.
Pressure, temperature, and/or pH sensing elements may be provided
in the tube, for diagnostic purposes or to monitor and control the
positive and negative pressures. Thus, if the pressure tends to
exceed a safe limit, control elements can be activated to maintain
the pressure within the safe range.
A vessel for collecting the gastric fluids may be inserted in the
negative pressure line.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view of the gastrointestinal aspirator
according to the present invention;
FIG. 2 is a sectional view of the double lumen tube taken along the
lines 2--2 of FIG. 1;
FIG. 3 is a view of an alternate form of a double lumen tube;
FIG. 4 is a sectional view of a triple lumen tube;
FIG. 5 is a schematic diagram of the aspirator.
DESCRIPTION OF PREFERRED EMBODIMENTS
In an exemplary embodiment of a gastrointestinal aspirator
according to the present invention, as shown in FIG. 1, the
aspirator includes a control mechanism indicated generally at 10, a
positive pressure line 12, negative pressure lines 14 and 16, a
vessel 18 for gastrointestinal fluids, and a double lumen tube 20.
The control mechanism 10 operates to provide a negative pressure or
suction to cause the gastrointestinal fluids to be withdrawn
through line 16 and collected in the vessel 18. Positive pressure
is provided in the line 12 for blockage prevention as will be
described.
In the double lumen embodiment of FIG. 2, a tube 20 is provided
with a lumen 22 for positive pressure and a lumen 24 for negative
pressure. The tube 20 may be made of rubber, PVC, polyethylene, or
other similar flexible materials. A wall 26 in the tube 20 forms a
barrier between the two lumens 22 and 24. Openings 28 are provided
in lumen 22 for supplying air under positive pressure to the
gastrointestinal tract. Openings 32 are provided in the negative
pressure lumen 24, to permit the fluids to be withdrawn through
lumen 24 to the vessel 18. The emission of air under positive
pressure adjacent to the negative lumen openings 32 prevents
blockage by lifting the adjacent membranes. In this way a bubble of
air is formed, and during the negative cycle, it will enter the
negative lumen 24, but such air in the negative lumen does no harm
and merely passes along to the vessel 18 and thence to exhaust. The
openings 28 and 32 may be arranged in closely spaced pairs along a
substantial length of the tube 20, or a single pair may be located
at the end of the tube adjacent to a metallic slug to permit
location identification by X-ray. The holes can be on opposite
sides of the tube as shown in FIG. 2, but in that case, a solid
object caught in the negative opening 32 may not be freed by the
bubble. For this reason, placing the holes side-by-side as
indicated by arrows 29 and 33 with the holes occupying the position
shown in dotted lines, may be preferred. In FIG. 3 a form of
multi-lumen tube is shown in cross-section, with a positive
pressure tube 36 inside a negative pressure tube 38 and with webs
40 and 42 maintaining the concentric spacing, but in this case the
positive pressure openings 28 are inside of and in alignment with
the negative pressure openings 32. By this arrangement, when air is
ejected, during the positive cycle, it passes outwardly through the
negative opening 32 into the gastrointestinal tract so as to
relieve blockage in the negative openings 32. Fluid back-pressure
in the negative pressure lumen 24 prevents the air from following
the negative lumen rather than passing out into the tract. In this
way, blockage even by a loose particle is prevented. A fourth lumen
92 (see FIG. 4) can be provided to house filaments connected to
pressure, pH, and temperature sensing instruments positioned
appropriately in the tube.
The control mechanism 10 has indicators and controls for operation
of the gastrointestinal aspirator. A positive pressure gauge 44
provides a visual indication of the positive pressure. Similarly, a
pressure gauge 46 provides an indication of the negative pressure.
These gauges are each provided with an adjustable maximum safe
pressure switch controlling an alarm (not shown) which will be rung
if the safe pressure is exceeded. A switch 48 activates power to
the control mechanism. An "Activate-Standby" control 50 operates to
control the supply of pressures to the lumens of tube 20. A
pressure control 52 determines whether positive and negative
pressures are applied alternately through the lumens of tube 20 or
only negative pressure is applied through lumen 24. A switch 54,
designated as "manual purge", permits a constant positive pressure
to be provided through lumen 22 into the gastrointestinal tract. A
positive pressure time duration switch 56 is provided to select the
time duration of the positive pressure cycle. Similarly, a negative
pressure time duration switch 58 is provided to control the
duration of the negative pressure cycle.
FIG. 5 diagramatically illustrates the operation of the control
mechanism 10. Power to operate the aspirator is provided through
the power switch 48 from a source 59, which may be a standard
outlet power of 120 volts, 60 hz. The power switch 48, when
activated, provides electrical power to operate a pump 60, a timer
control 62, solenoids for valve control, lights, warning buzzers,
etc. The pump 60 is preferably a positive displacement pump of the
piston or rotary types. A negative pressure line 62 and a positive
pressure line 64 are provided for pump 60. When the pump 60 is of
the piston type, both lines 62 and 64 may be provided on the same
side of the piston with appropriate check valves. Lines 62 and 64
can also be arranged on either side of the piston with slight
modification to the arrangement of FIG. 5. When the pump 60 is of
the rotary type, the outputs are preferably arranged on either side
of the rotating members.
The following description relates to the arrangement of the
elements connected to lines 62 and 64. The negative pressure line
62 passes through a check valve 66 that only permits air to pass
into the pump 60. Line 62 then leads to a valve 68, shown as a
cylinder valve. Various forms of valves suitable for this purpose
are available commercially. Similarly, the positive pressure line
64 leads to valve 68 through a check valve 76 that only permits air
to pass out of the pump. The valve 68 includes portions for
separately valving the positive and negative lines. Valve 68 is
controlled by solenoid mechanism (not shown), energized by
operation of the "Standby-Activate" switch 50 in the control
mechanism 10. In operation, with the standby-activate switch on,
both positive and negative pressures are permitted to pass through
the valve 68. This is the position of the valve depicted in FIG. 5.
When the "standby-activate" switch is off, or in the "standby"
position, the valve 68 is positioned to connect the positive and
negative outputs to the atmosphere and the pump will then operate
without load.
The negative pressure line 62 then leads from the valve 68 to a
pressure reducing valve 72 and also branches off to a pressure
relief valve 74. Similarly, the positive pressure line 64 leads to
a pressure reducing valve 76 and a pressure relief valve 78. The
pressure relief valves are adjustable and provide a bleed-off to
prevent the pressure from exceeding a selectable limit. The
pressure reducing valves, also adjustable, may provide a means for
setting the amount of positive and negative pressures. In the
present context, I employ only 1 p.s.i. maximum pressure on each
line.
The positive and negative lines next pass to a valve 80 that is
controlled through a solenoid 82 by the timer 62. Valve 80 has two
positions. In the position shown in FIG. 5, the negative pressure
is being transmitted to lumen 24 of the tube 20, while the positive
pressure is being transmitted to the atmosphere. When the valve 80
is in its alternate position, the negative pressure line is
connected to the atmosphere and the positive pressure line to lumen
22 of the tube 20. The valve 80 is shown being controlled by
solenoid 82 which in turn is controlled by either a signal from the
timer 62 or by a signal from the manual purge switch 54.
The output from the timer 62 is provided to the solenoid 82 over a
line 61. The purpose of the timer 62 is to provide a time duration
for the generation of negative and positive pressure cycles. This
is controlled by negative and positive duration switches 58 and 56
respectively. The details of the timers are standard and are not
shown herein. Simple adjustable clock timers are available
commercially to perform the functions described, and they form no
part of the invention in themselves. In the present embodiment, the
time durations are independently selectable on the positive line
from 1 to 10 seconds, and on the negative line from 0.1 to 10
seconds. The switches 56 and 58 are provided with control points
calibrated for these durations. For durations in the range of 1 to
10 seconds, the timer may comprise an electro-mechanical timer. For
shorter durations, such as 0.1 seconds, it is preferable to provide
a digital clock or an adjustable RC timer network. In operation,
the timer provides an energizing signal for solenoid 82
corresponding to the selected duration of the positive pressure
cycle and provides no signal to the solenoid 82 for the time
interval of the negative pressure cycle, the valve 80 being moved
to the negative pressure position by spring action.
The negative pressure line from valve 80 leads to negative pressure
meter 46 and then to the vessel 18. The positive pressure line
leads to a positive pressure control valve 86 and then to the
positive pressure meter 44. The valve 86, when activated by the
positive pressure control switch 52, exhausts the positive pressure
air to atmosphere. Its primary purpose is to provide a quick method
for interrupting positive pressure in the event of failure of the
relief valve 78.
In operation, there is no operation of the aspirator when the
switch 50 is in "standby". In this position, the valve 68 provides
a bleed-off for both the negative and positive pressure lines and
thereby prevents any pressure from being transmitted to the lumens
of tube 20. The pump 60 is then operating under a no-load
condition, and the check valves 66 and 76 permit air to enter and
leave the pump 60.
During the normal operating cycle of the aspirator, an alternate
positive and negative pressure is provided. Here the
activate-standby switch 50 is in the "activate" position which
controls the valve 68 to permit continuous positive and negative
pressures to be supplied to the valve 80. During the positive
pressure cycle determined by the timer 62, the solenoid 82 is
energized and the valve 80 is placed in the position wherein
positive output is provided to lumen 22 of the tube 20 and the
negative line is open to the atmosphere. Air for the pump 60, which
is required to generate the positive pressure, is supplied through
the negative pressure line, which permits the air to pass the valve
80, the pressure reducing valve 72, the valve 68, and the check
valve 66. During the duration of the negative pressure cycle, the
timer 62 deactivates the solenoid 82 and, by spring return action,
places the valve 80 in the position shown in FIG. 5. The pump 60
draws air from lumen 24 of the tube 20 through the vessel 18, the
valve 80, the pressure reducing valve 72, the activate-standby
valve 68 and the check valve 66.
The normal cycle is interrupted when the positive pressure control
switch 52 is selected. Here, the valve 86 causes the positive
pressure output to bleed off so that only negative pressure is
transmitted to the gastrointestinal tract.
In another operational mode, a constant positive pressure may be
provided. The manual purge switch 54 provides a signal to the
solenoid 82 which holds the valve 80 constantly in the second
position. The pressure relief valve 78, prevents positive output
pressure from exceeding a given safe value. This prevents any
undesirable pressures from building up in the gastrointestinal
tract. During operation of this mode, a bubble of air builds up in
the intestine creating positive pressure which forces fluids up
through lumen 24. There is no suction on lumen 24 is this mode
because the negative line is open to the atmosphere at valve 80,
making it a pump not an aspirator.
The primary feature of the present invention is accomplished by
preventing blockage of the openings of the negative pressure line
independently of that line, and without reversing the direction of
flow of fluids in the negative line.
In operation, a small bubble is injected into the digestive tract
adjacent to the negative orifice, and by lifting the surrounding
membranes, frees blockage. During the negative cycle, the bubble is
sucked into the negative line, but with it also comes fluid.
Thereafter, if the negative cycle is continued, intestinal
membranes or debris may plug the openings, but the timing sequence
can be selected to stop the negative cycle at that point, and
reactivate the positive cycle for a short period. Part of the
positive pressure bubble may escape from the area of the negative
pressure opening and rise in the tract, but this causes no problem
because any gas under pressure in the tract can readily be drawn
off into the negative lumen 24 by moving the openings around to
expose them to the gas. Of course, motion of the tube 20 is not
impeded because of the constant "freeing" action of the positive
cycle.
The embodiments of the present invention are intended to be merely
exemplary and those skilled in the art will be able to make
numerous variations of them without departing from the spirit of
the present invention. All such variations and modifications are
intended to be within the scope of the present invention as defined
in the appended claims.
* * * * *