U.S. patent number 3,892,226 [Application Number 05/410,716] was granted by the patent office on 1975-07-01 for urological irrigation-evacuator.
Invention is credited to Irwin Charles Rosen.
United States Patent |
3,892,226 |
Rosen |
July 1, 1975 |
Urological irrigation-evacuator
Abstract
A urinary bladder irrigation-evacuator includes means for
selectively introducing a sterile fluid into a urinary bladder and
thereafter withdrawing fluid including tissue, and other
particulate matter from the bladder and of depositing said material
into a specimen collecting receptacle in which the tissue and other
particles of particulate matter, stones, and the like, are
accumulated. The withdrawn fluid is filtered and then recirculated
to the first mentioned means for subsequent reinjection into the
bladder.
Inventors: |
Rosen; Irwin Charles
(Connersville, IN) |
Family
ID: |
23625936 |
Appl.
No.: |
05/410,716 |
Filed: |
October 29, 1973 |
Current U.S.
Class: |
600/563; 604/190;
604/37 |
Current CPC
Class: |
A61M
3/0229 (20130101); A61M 1/82 (20210501); A61M
2210/1085 (20130101); A61M 2205/7545 (20130101) |
Current International
Class: |
A61M
3/00 (20060101); A61M 3/02 (20060101); A61M
007/00 () |
Field of
Search: |
;128/2F,241,248,249,250,273,278,276,231,232,230,328,214B,235,251,240
;166/105.1,105.3,105.4 ;417/472,437 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Layton; Henry S.
Claims
What is claimed is:
1. A urological irrigation-evacuator for alternately introducing
fluid into and withdrawing fluid from a body cavity through a
resectoscope, comprising a fluid-receptive, manually compressible
bulb; a specimen collecting receptacle; a first fluid conduit one
end of which is in open communication with the interior of said
receptacle, and the other end of which includes means providing
connection to and establishing communication with a resectoscope; a
second fluid conduit in substantial parallelism with said first
fluid conduit, the upper end of said second conduit having means
providing connection to and establishing open communication with
said bulb; valve controlled means establishing communication
between the upper portions of said conduits; valve controlled means
establishing a fluid connection between the lower portions of said
first and second conduits; said valving means being constucted and
arranged whereby to preclude transportation of fluid from said bulb
to said receptacle via said first conduit during those periods of
time when fluid is being transported from said bulb into a body
cavity, and to preclude transportation of fluid withdrawn from the
body cavity directly into said bulb and second conduit during those
periods of time when fluid withdrawn from the body cavity is being
transported into said first conduit; and means for filtering
particulate matter from fluid transported from the first conduit
into said second conduit.
2. A device as called for in claim 1, wherein the specimen
collecting receptacle comprises a base or support member for the
device.
3. A device as called for in claim 1, wherein the fluid conduits
are formed of rigid material, are secured and to and extend
upwardly in parallelism from the specimen collecting
receptacle.
4. A device as called for in claim 1, wherein the said fluid
conduits are elongate, parallel and rigid whereby to collectively
define a handgrip portion adapted to be grasped by a surgeon using
the device.
5. A device as called for in claim 4, wherein the fluid conduits
are detachably secured to the specimen collecting receptacle.
6. A device as called for in claim 5, which includes a closure
member adapted to seal the contents of the receptacle therein.
7. A device as called for in claim 4, wherein the fluid conduits
are fixed to the specimen collecting receptacle.
8. A device as called for in claim 1, wherein the first conduit
includes means providing connection to and establishing open
communication with a resectoscope or the like, and wherein the
second conduit includes means providing connection to and
establishing open communication with said fluidreceptive, manually
compressible bulb.
9. A device as called for in claim 1, wherein the specimen
collecting receptacle includes a relief valve for the discharge of
fluid from said receptacle.
10. A device as called for in claim 9, wherein said relief valve
includes means operable for rendering said valve selectively
inoperable.
11. A device as called for in claim 1, wherein the specimen
collecting receptacle includes a normally closed access port.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
In the field of urological surgery, the need frequently arises to
evacuate, by flushing, pieces of solid or semi-solid material from
the urinary bladder, such as stones, blood clots, particulate
particles such as pieces of tissue, and the like.
The subject invention is directed to an improved device which will
enable a surgeon to initially introduce sterile fluid into a body
cavity and thereafter withdraw fluid containing foreign matter from
the body cavity in such a manner that the foreign matter is
deposited within a specimen collection chamber, and wherein the
withdrawn fluid is filtered for recirculation or reintroduction
into the body cavity free of foreign matter, thereby greatly
enhancing the efficiency and utility of the device.
2. Description of the Prior Art
Heretofore, the medical profession has utilized a device known in
the art as the ELLIK evacuator for effecting irrigation of the
urinary bladder. The Ellik evacuator comprises a pair of integrally
formed glass chambers disposed in vertical alignment and having a
restricted, centrally disposed passageway in open communication
between the chambers. The upper chamber is provided with two ports
each of which are defined by an outwardly extending hollow
projection, one of which is adapted for communication with a
manually compressible bulb, the other of which is adapted to be
suitably connected to a resectoscope, or the like, to be introduced
into the bladder, or other body cavity, to be irrigated.
In use, the upper and lower chambers of the Ellik evacuator and the
compressible bulb are initially completely filled with a sterile
fluid which is introduced into a body cavity incident to
compression of the bulb. Release of the bulb produces a negative
pressure resulting in withdrawal of fluid from the body cavity into
the upper chamber, the lower chamber and the bulb. Tissue and other
particulate particles in the fluid withdrawn from the body cavity
which have a specific gravity greater than that of water will tend
to settle or gravitate through the opening between the chambers
into the lower chamber. However, since actuation of the bulb
produces a pronounced swirling action to the fluid in the upper
chamber a certain percentage of the evacuated tissue and other
foreign material remain in suspension in the fluid of the upper
chamber and in the bulb with the result that tissue and other
particulate particles are reinjected into the body cavity each time
the bulb is compressed after its first or initial compression.
When the evacuation process has been concluded and/or in those
instances in which it becomes necessary or desirable to empty and
refill the Ellik evacuator during an evacuation procedure, the
upper chamber is disconnected from the resectoscope and the bulb is
removed after which the fluid within the upper and lower chambers
is poured into a cloth or other filtering agent on which tissue and
other particulate particles which have been flushed from the
bladder will be deposited for examination by the surgeon,
pathologist and/or laboratory. Thereafter the bulb is reattached
and the entire device refilled with a sterile solution, after which
the other port is reconnected to the resectoscope in order that the
irrigating-evacuating process may be resumed.
It should be understood that the aforesaid procedure of irrigation,
emptying and refilling the evacuator is repeated several times
until the bladder or body cavity has been washed free of all loose
tissue, stones, and other particulate particles. It will be noted
that the tissue, stones and other particulate matter, per se,
evacuated from the Ellik device are almost invariably submitted for
a laboratory examination, whereby it becomes necessary to transfer
such matter to another receptacle in the process of which some can
be lost.
U.S. Pat. No. 1,643,631 discloses a device for irrigating the
urinary bladder for removing fragments of stones therefrom, said
device including a fluid receptacle from which fluid is introduced
into and thereafter collected after being withdrawn from the
bladder.
U.S. Pat. No. 1,925,230 discloses a syringe apparatus having means
for introducing fluid from a closed container through a
compressible bulb thence through a passageway, and of withdrawing
fluid from a body cavity through another conduit which discharges
into a wire mesh filter in which particulate matter is strained
from the withdrawn fluid which, having passed through the filter,
is adapted to be recirculated through the body cavity incident to
manipulation of the bulb.
Other prior art U.S. patents disclosing apparatus for introducing
and withdrawing fluids into and from a body cavity are Nos.
3,411,502; 2,044,912; 3,233,609; 3,527,203; 2,188,190; 3,106,204;
3,398,743; 3,626,928; 3,513,849 and 523,345.
None of the aforesaid prior art devices suggest or disclose a
urinary bladder irrigation-evacuator as contemplated by the subject
invention.
SUMMARY OF THE INVENTION
The subject invention is directed to a unique urological bladder
irrigation-evacuator of the type which includes a specimen
collection chamber in the form of a normally closed, transparent
compartment which is constructed and arranged in such a manner as
to provide a base or support member for the device per se, and
which is adapted to receive and retain tissue and other particles
of particulate matter including stones, or the like, in fluid
withdrawn from a body cavity, to wit, the bladder, or the like. The
specimen collection chamber is constructed in such a manner as to
enable it to be forwarded directly to a laboratory for examination
of the material housed therein; said chamber, in one aspect of the
invention, being formed integral with an upstanding handgrip
portion, and in another aspect of the invention being selectively
removable from an upstanding handgrip portion in which event the
contents of the chamber are sealed within the chamber by means of
an auxiliary closure member.
Preferably the device includes means to enable a surgeon to have
quick and easy access to the foreign or particulate matter housed
within the specimen collection chamber, in the event the surgeon
should desire to inspect such matter or material during the
evacuation procedure.
Likewise, means in the form of an adjustable check valve are
provided for enabling the surgeon to accurately control the
discharge of excess fluid, blood, and the like, from the specimen
collection chamber without necessitating cessation of an
irrigation-evacuating operation, and without losing any of the
particulate material entrained in the chamber.
In the preferred embodiment of the invention, the device is
fabricated from a suitable plastic material capable of being gas
sterilized for providing an inexpensive, sterile, yet highly
efficient device which may be discarded after use. The subject
device embodies simple and highly effective means for positively
circulating fluid from a manually operable bulb into a body cavity
and of then withdrawing fluid from the body cavity through a
conduit which is in open communication with the specimen collection
chamber in which tissue and other particulate particles, including
stones, are deposited and retained. The fluid thus withdrawn from
the body cavity is filtered before being recirculated to the
compression bulb, whereby the fluid introduced into the body cavity
will, at all times, be substantially, if not completely devoid of
tissue and other particulate particles.
The subject device is constructed in such a manner as to facilitate
its use by lefthanded and/or righthanded surgeons, with equal
facility, thereby enhancing its utility.
A primary object of the present invention is to provide in a
urological irrigation-evacuator, means to provide foolproof,
positive filtering of the recirculated fluid and to reliably
extract foreign matter from the urinary bladder in as short a time,
and with as little effort, and as completely as practical.
A further object of the invention is to provide a device which is
capable of efficiently collecting the foreign matter evacuated from
the urinary bladder in a specimen collection chamber or receptacle
which per se can be sent directly to the laboratory, thus
eliminating the possiblity of loss of such matter incident to
transfer from one receptacle to another.
BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. 1 and 2 are perspective views of the subject device
illustrating the matter in which it may be used by right and/or
left handed persons.
FIG. 3 is a view, partly in vertical section, of the device
illustrating its use for introducing fluid into a body cavity.
FIGS. 4 and 5 are exploded views illustrating the structural
details of valving members as embodied in the device of FIG. 3.
FIG. 6 is a view somewhat similar to FIG. 3 illustrating its use
for withdrawing fluid from a body cavity into the specimen
collecting receptacle portion of the device.
FIG. 7 is a perspective view illustrating the manner in which the
combination handgrip-fluid conduit portion of the device are
releasably secured to the specimen collecting receptacle.
FIG. 8 is a view similar to FIG. 7 illustrating the manner in which
a plug is utilized for sealing the contents of the specimen
collecting receptacle.
FIG. 9 is a perspective view of a closed or sealed specimen
collecting receptacle as delivered in a sterile condition for
association with the fluid conduits of the device as in FIGS. 6 and
7, and further illustrating the manner in which the specimens
collected in said receptacle are made available to the laboratory
or pathologist.
FIG. 10 is a sectional view illustrating the details of the check
valve-drain assembly of the device.
FIG. 11 is a side view, partly in section, of a modified form of
the device of FIG. 1.
PREFERRED EMBODIMENTS OF THE INVENTION
With particular reference to the drawings, the numeral 18
designates generally a urinary bladder irrigation-evacuation device
which includes a compressible, fluid reservoir 20; a specimen
collecting receptacle 30 and a pair of fluid conduits 40 and 50
which, in FIGS. 1 and 2 collectively constitute a handgrip portion
or member 25.
Uniformly satisfactory results have been obtained in those
instances in which the fluid reservoir 20 comprises a conventional,
fluid-receptive manually-compressible bulb, or the like. The
specimen collecting receptacle 30 and the fluid conduits 40 and 50
are preferably fabricated of an unbreakable, transparent material,
such as, by way of example, high impact plastic, or the like.
With particular reference to FIG. 7, it will be noted that conduits
40 and 50 are housed within the single, elongate, stem or conduit
member 60, the interior of which is subdivided by a transverse
panel 27 into individual conduit 40 and 50.
As best illustrated in FIG. 4, the upper portion of transverse
panel 27 is provided with an opening 29 which is disposed centrally
of a plurality of through ports 31. A first flap valve or valving
member 70, fabricated from a suitable resilient material, such as,
by way of example, rubber or the like, is disposed in overlying
relationship with one side surface of ports 31 by means of a
mounting stem 72 which terminates in an enlarged headed portion 74
which is adapted to be compressed incident to insertion into the
through opening 29 for disposing stem portion 72 within opening 29
and with the enlarged under-surface of headed portion 74 engaging
the hole-adjacent portion of transverse panel 27 for securely,
though releasably, securing the flap valve 70 in operable
relationship with ports 31.
As illustrated in FIG. 5, the lower portion of transverse panel 27
is provided with a plurality of through portholes 80, wherein the
diameter or cross-sectional areas of each of the holes is
sufficiently small whereby to effectively and efficiently strain or
filter tissue and/or other particles of particulate matter from
fluid passing through said holes. A flap valve anchoring aperture
82 is provided through panel 27 centrally of port openings 80 for
receiving the mounting stem 72 of a second flap valve or valving
member 71. Mounting stem 72 of valving member 71 terminates in an
enlarged head portion 74.
With reference now to FIG. 3, it will be noted that the first valve
member 70 is constructed and arranged in such a manner as to permit
the flow of fluid from reservoir 20, incident to the application of
a compressive force on bulb 20, which produces a positive pressure
on the fluid within the device, through the upper end of conduit
50, through ports 31 into the upper end of conduit 40 and thence
through the outlet-inlet nozzle 42, which is integral with and in
open communication with the upper portion of conduit 40. It will be
understood that a length of tubing 44 is adapted to telescopically
engage nozzle 42 for thereby establishing a suitable fluid
connection between the subject device and a resectoscope (not
illustrated), or the like, which is inserted into the interior of a
urinary bladder (not illustrated), hereinafter referred to as a
body cavity. During those periods of time when fluid is thus being
introduced from reservoir 20 into a body cavity the second flap
valve 71 is closed for effectively preventing the introduction of
fluid from conduit 50 into the lower portion of conduit 40 and/or
into receptacle 30.
When a negative pressure is induced on the fluid incident to
release of compressive forces on bulb 20, fluid will be withdrawn
from a body cavity, through the resectoscope, tubing 44, nozzle 42
into the upper end of conduit 40, downwardly into and through
conduit 40 and thence into receptacle 30, as illustrated in FIG. 6.
It will be noted that flap valve 70 is closed for precluding the
entry of fluid, via ports 31, from the upper end of conduit 40 into
the upper end of conduit 50, whereas flap valve 71 is open for
permitting fluid which has been filtered through portholes 80 from
the lower portion of conduit 40 and/or the receptacle 30 to enter
the lower portion of conduit 50, thence up conduit 50 into bulb
20.
With particular reference to FIG. 6, the letters A indicate
generally foreign substances in the fluid which have been washed
from the body cavity, such as, by way of example, particles of
tissue, particulate matter, stones, and the like, which are
positively drawn and flushed downwardly through conduit 40 and
deposited in the specimen collecting receptacle 30.
It should be understood that when using the subject device all
portions thereof will be initially completely filled with a sterile
fluid. In the event that manipulation of the device should effect
the release of additional fluids from the body cavity, in excess of
the volumetric capacity of the device, I have provided simple yet
highly effective means, in the form of an adjustable,
check-discharge valve indicated generally by the numeral 90 through
which excess fluids may be drained or discharged without
necessitating cessation of the evacuating procedure. Said valve,
see FIG. 10, includes a nozzle 91 having an inlet port 92 in open
communication with an outlet port 94 of receptacle 30. In the
preferred embodiment of the invention, outlet port 94 is defined by
a plurality of portholes each having a diameter or cross-sectional
area such as to effectively and efficiently strain or filter tissue
or other particles of particulate matter from fluid passing through
said holes into port 92. By rotating sleeve 96, the force by which
check ball 98 is urged against its seat 97 by spring 100 may be
varied for thereby enabling the surgeon to dissipate any excess
fluid through discharge port 102 of the check-discharge valve.
Sleeve 96 may threadably engage nozzle 91, as illustrated.
In the preferred embodiment of the invention the combination
handgrip-fluid conduit portion 25 is adapted to be securely, though
releasably, associated with the specimen collecting receptacle 30
via port 41 in the upper wall 43 of said receptacle. As clearly
illustrated in each of FIGS. 3, 6, and 7, the lower end of member
60 is provided with outwardly projecting tongues 45 which are
receptive within apertures 47 of a plurality of bayonet-slot
sockets 49 provided in upstanding boss 51 which circumscribes port
41. Suitable sealing means, such as, by way of example, an O-ring
53, note FIGS. 3 and 6, may be utilized for effecting a fluid tight
seal between the interlocked portions of the combination
handgrip-fluid conduit portion 25 and boss 51 of the specimen
collecting receptacle 30.
It will be noted that the specimen collecting receptacle 30
comprises a stand or support for the device which, when used, is
handled by a surgeon in the manner illustrated in FIGS. 1 and
2.
After an evacuation technique has been completed the handgrip-fluid
conduit portion 25 may be disconnected from the specimen collecting
receptacle 30 after which a closure member 93, note FIGS. 8 and 9,
is associated with boss 51 for securely closing port 41 for thereby
sealing the contents of the specimen collecting receptacle for
transport to a laboratory, or the like. Sleeve 96 of the adjustable
check-valve would, of course, be turned in such a manner as to
firmly urge check ball 98 against its seat for precluding the
accidental or unintentional discharge of fluid from receptacle 30
via port 94.
Access to the interior of the specimen collecting receptacle 30, by
the surgeon, during an evacuating procedure, may be conveniently
effected by means of a removable closure member 101.
In FIG. 11, I have disclosed a modification of the subject device
wherein each of conduits 40 and 50 of FIGS. 3 and 6 constitute
individual tubular members 140 and 150 which are formed integrally
with the specimen collecting receptacle 130.
It will be noted that a first flap valve 170 is located within
conduit 105 opposite ends of which are in free, open communication
with the uppermost ends of conduits 140 and 150. The second flap
valve 171 is disposed in the lower end of conduit 150, as
illustrated.
It will be understood that the operating characteristics of the
device of FIG. 11 is the same as that for the device of FIGS. 3 and
6, the main difference residing in the fact that conduits 140 and
150 are separate, rather than nested, as in FIG. 3 and 6, and,
since the conduits are integral with the specimen collecting
receptacle 130, the device as forwarded to a laboratory would
include a suitable stopper introduced into nozzle 142 for
precluding the accidental or unintentional discharge of fluid from
the device of FIG. 11 while en route to the laboratory.
From the foregoing, it will be noted that flap valves 70 and 170
permit fluid from reservoir 20 to be discharged under positive
pressure via nozzles 42 and 142 into a body cavity during which
time valves 71 and 171 are closed for precluding the introduction
of fluid from the reservoir into the specimen collecting receptacle
30.
When a negative pressure is applied incident to release of bulb 20
fluid containing tissue and other particulate particles is
withdrawn from the body cavity into the upper end of conduits 40
and 140 and particles A which are entrained in the fluid and
thereby propelled into the specimen collecting receptacle.
Concurrently and simultaneously with such withdrawal of fluid from
the body cavity, fluid from conduits 40 and 140 and their
associated receptacles 30 and 130, respectively, is filtered and
then introduced into the lower end of fluid conduits 50 and 150 en
route back into the fluid reservoir 20, thereby completing one
irrigation-evacuating cycle of the device.
It should be understood that irrespective of the rate at which
fluid is introduced into and then withdrawn from a body cavity the
recirculated fluid which is reinjected into the body cavity is, at
all times free of particles of foreign matter, such as tissue,
particulate particles, stones and the like which have been
evacuated from the body cavity as the result of a previous
irrigation-evacuation cycle.
The subject devices are adapted to be individually packaged for
delivery to an operating room in a sterile, ready-for-use
condition, after which they are adapted to be discharged.
The relationship of the specimen collecting receptacle to other
portions of the device is such that literally all of the foreign
matter, such as tissue, particulate particles, stones and the like
which have been flushed from a body cavity being evacuated are
collected and retained in said receptacle where the material is
readily available for examination by the surgeon, pathologist
and/or laboratory. There is no chance for such material to become
lost or misplaced from the time it is initially withdrawn from a
body cavity until it has been examined. The fact that all such
foreign matter is entrained in the fluid means that all such matter
is positively propelled into the specimen receptacle where it is
retained.
It will be noted that in the subject device since the fluid
withdrawn from a body cavity cannot be recirculated until and
unless it is first filtered to remove all foreign particles
therefrom, the device may be actuated to alternately introduce
fluid into and withdraw it from a body cavity for as long a period
of time as desired without the need for draining and replenishing
the device with additional fluid, as in the Ellik evacuator.
* * * * *