U.S. patent number 3,913,565 [Application Number 05/464,141] was granted by the patent office on 1975-10-21 for guide tube for a treating instrument to be inserted into body cavity.
This patent grant is currently assigned to Olympus Optical Co., Ltd.. Invention is credited to Ichizo Kawahara.
United States Patent |
3,913,565 |
Kawahara |
October 21, 1975 |
Guide tube for a treating instrument to be inserted into body
cavity
Abstract
There is provided a guide tube for guiding a tubular treating
instrument to be inserted into a patient's body cavity. Said guide
tube includes a tubular, flexible main body. A cuff is attached to
said main body in the proximity of the forward end thereof, and is
so adapted as to be expanded by the operation of air or liquid feed
from the base end portion of the main body. The main body is
further extended forwardly from the cuff-attached portion, and said
extended portion is formed more flexible than the main body. The
guide tube is fixed within the body cavity by the expansion of the
cuff, and the treating instrument is inserted up to a predetermined
position in the interior of the body cavity with the guide tube
taken as a guide.
Inventors: |
Kawahara; Ichizo (Kokubunji,
JA) |
Assignee: |
Olympus Optical Co., Ltd.
(Tokyo, JA)
|
Family
ID: |
12992626 |
Appl.
No.: |
05/464,141 |
Filed: |
April 25, 1974 |
Foreign Application Priority Data
|
|
|
|
|
May 18, 1973 [JA] |
|
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48-55224 |
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Current U.S.
Class: |
600/585;
128/207.15; 604/915; 604/96.01; 600/114; 600/581 |
Current CPC
Class: |
A61M
25/10 (20130101); A61M 25/0116 (20130101); A61B
1/00082 (20130101); A61B 1/00154 (20130101); A61B
1/2736 (20130101); A61M 25/0108 (20130101) |
Current International
Class: |
A61B
1/12 (20060101); A61M 25/10 (20060101); A61M
25/01 (20060101); A61B 1/273 (20060101); A61M
025/00 (); A61B 001/26 () |
Field of
Search: |
;128/2M,3-8,343,276,348-357,DIG.9 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
What is claimed is:
1. A guide tube for guiding a body cavity-treating instrument up to
a predetermined position in a body cavity comprising:
a. a flexible tubular main body having a forward end and a base end
at which the treating instrument is inserted into the main body,
said main body including an inner tube, an outer tube having an
aperture and a helical winding wound between the inner and outer
tubes around the outer periphery of the inner tube;
b. a cuff mounted on said main body in the proximity of the forward
end thereof and adapted to be expanded by the entry thereinto of
fluid from the base end of the main body first through a space
defined by said helical winding with the inner and outer tubes and
then through said aperture thereby to be pressed against inner
walls of the body cavity to fix the forward end of the guide tube
to the interior of the body cavity; and
c. a flexible tube section further extended forwardly from the
forward end of the main body and formed more flexible than the main
body, whereby the forward end of the treating instrument inserted
from the base end into the main body is sent forth from said
flexible tube section and carried up to the predetermined position
in the body cavity.
2. A guide tube for guiding a body cavity-treating instrument up to
a predetermined position in a body cavity comprising:
a. a flexible tubular main body having a forward end and a base end
at which the treating instrument is inserted into the main body,
said main body including an inner tube, an outer tube having an
aperture and a net-like member wound between the inner and outer
tubes around the outer periphery of the inner tube for preventing
said inner and outer tubes from being buckled,
b. a cuff mounted on said main body in the proximity of the forward
end thereof and adapted to be expanded by the entry thereinto of
fluid from the base end of the main body first through the meshes
of said net-like member and then through said aperture thereby to
be pressed against inner walls of the body cavity to fix the
forward end of the guide tube to the interior of the body cavity;
and
c. a flexible tube section further extended forwardly from the
forward end of the main body and formed more flexible than the main
body, whereby the forward end of the treating instrument inserted
from the base end into the main body is sent forth from said
flexible tube section and carried up to the predetermined position
in the body cavity.
3. A guide tube for guiding a body cavity-treating instrument up to
a predetermined position in a body cavity comprising:
a. a flexible tubular main body having a forward end and a base end
at which the treating instrument is inserted into the main
body;
b. a cuff mounted on said main body in the proximity of the forward
end thereof and adapted to be exapnded by the entry thereinto of
fluid from the base end of the main body, so as to be pressed
against inner walls of the body cavity thereby to fix the forward
end of the guide tube to the interior of the body cavity;
c. a flexible tube section further extended forwardly from the
forward end of the main body and formed more flexible than the main
body, whereby the forward end of the treating instrument inserted
from the base end into the main body is sent forth from said
flexible tube section and carried up to the predetermined position
in the body cavity; and
d. a metallic cap mounted on the base end of the main body and
formed with a tube insertion hole for allowing a treating
instrument to be inserted into the main body.
4. A guide tube for a body cavity-treating instrument as described
in claim 3 wherein said metallic cap is formed with a passage for
allowing fluid to be sent from outside into the interior of the
cuff.
Description
BACKGROUND OF THE INVENTION
This invention relates to the construction of a guide tube for
guiding up to a predetermined position of within the body cavity a
tubular treating instrument to be inserted into the body cavity,
such as an intestinal tube used to sample the intestinal juice or a
Miller Abott tube used for the intestinal obstruction.
In the case of using an intestinal tube for sampling intestinal
juice or a Miller Abott tube, it is generally required for these
tubes to be inserted up to the interior of the ileum.
For example, as shown in FIG. 1, a tube 1 such as an intestinal
tube can be relatively easily inserted without using guide means up
to the interior of the stomach 2. However, the insertion of the
forward end of the tube 1 into the pars pylorica 3 constituting the
connecting section of the stomach 2 with the duodenum is
accompanied with an extreme operational difficulty and therefore
requires a higher level of technique and a longer time. Indeed, if
the forward end of the tube 1 has only to be able to be inserted
into the pars pylorica 3, it will be possible to feed the tube 1
into the ileum with the aid of the vermicular movement. But the
insertion of the tube 1 into the pars pylorica, as above described,
requires a higher level of technique and a longer time, and in some
cases it is necesary to carry out the insertion while it is being
observed by the X ray-radiation. Further, even if the vermicular
movement is utilized and even if, for example, medicines are used
to promote the vermicular movement, the utilization of the
vermicular movement alone will require several hours for passing
the forward end of the tube 1 through the pars pylorica. For this
reason, the patient must endure a long restraint and pain until the
tube insertion is completed. Particularly, in the case of a patient
suffering from the intestinal obstruction, unless he is subjected
to urgent treatment, another disease, for example, the peritonitis
is accompanied, giving rise to a serious situation to him.
The passage extending from the duodenal cap 4 immediately
succeeding the pars pylorica 3 to the downward extending section 5
of the duodenum is in a sharply curved state and said curve does
not take place on the same plane but in a three dimensional form.
Usually, therefore, the tube 1 conflicts with the inner walls of
the downward extending section 5 of the duodenum and thereby is
interrupted from advancing. Furthermore, since the interior of the
downward extending section 5 is relatively large, the direction in
which the forward end of the tube 1 is advanced is not determined,
so that the tube 1 becomes liable to conflict with the inner walls
of said section 5 and therefore becomes difficult to advance. Even
under these circumstances, the tube 1 was conventionally obliged to
be subjected to the natural advancement by the vermicular movement
to some extent, giving rise to the waste of a large length of time
and a patient's pain in inserting the tube up to the ileum.
SUMMARY OF THE INVENTION
The general object of the invention is to provide a guide tube for
a treating instrument which is designed to eliminate the
difficulties accompanying the above-mentioned operations in the
case of inserting a tubular treating instrument into the body
cavity.
The guide tube of the invention comprises an elongate, flexible
main body which has an inner diameter enough to admit of the
insertion of an endoscope, celoscope and body cavity-treating
instrument, a cuff (or termed "balloon") attached to said main body
in the proximity of the forward end thereof and expanded by the
operation of air or liquid feed from the base end portion of the
main body, and a flexible tube section further extended forwardly
from the cuff-attached portion and integrally with the forward end
of the main body and formed more flexible than the main body.
Accordingly, a primary object of the invention is to provide a
guide tube for permitting a body cavity-treating instrument to be
readily inserted for an extremely short time up to a predetermined
position in the interior of the body cavity.
Another object of the invention is to provide a guide tube for a
treating instrument capable of being made simple in construction
and therefore manufactured inexpensively.
Other objects and advantages of the invention will become apparent
from the hereinafter detailed description of the preferred
embodiment of the invention for which reference is made to the
appended drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a view showing the prior art manner in which an
intestinal tube is inserted into a body cavity;
FIG. 2 is a view showing the manner in which a celoscope is
inserted into the body cavity;
FIG. 3 is a view showing the manner in which a guide tube according
to the invention is inserted into the body cavity by utilizing the
celoscope;
FIG. 4 is a partially broken side view of an embodiment of the
guide tube according to the invention;
FIG. 5 is a partially broken side view of another embodiment of the
guide tube according to the invention; and
FIGS. 6 to 8 are views respectively showing the manner in which the
guide tube according to the invention is used.
DETAILED DESCRIPTION OF THE INVENTION
In FIG. 4, an elongate guide tube 7 according to the invention is
shown partly omitted. Said guide tube 7 has a tubular flexible main
body 8, which is constituted by a flexible inner tube 10 and outer
tube 11 made of, for example, synthetic resin and a helical winding
9 wound between the both tubes 10 and 11 around the outer periphery
of the inner tube 10. Said helical winding 9 is formed of, for
example, metal or tough plastic material, and functions as
reinforcing means for reinforcing the main body 8 so as to prevent
it from being buckled. Further, the inner tube 10 and outer tube 11
are further extended forwardly from the forward end portion 8a (the
right side of FIG. 4) of the main body 8 at which the helical
winding 9 is terminated, and the extended portions of the both
tubes are mutually adhered to constitute a flexible section 12
formed more flexible than the main body 8. Although the main body 8
is elongate as above described, the presence of the helical winding
9 prevents the main body 8 from being deformed in diameter, by the
reinforcing function thereof, thereby causing the main body 8 to
maintain its cross section of a fixed shape, and in spite of this
the main body is maintained flexible. As later described the
flexible tube 14 of the celoscope or endoscope 13 and an intestinal
tube 15 are inserted into the interior of the main body 8 of the
guide tube, and the main body has an inner diameter large enough to
facilitate said insertion.
On the outer periphery of the forward end portion 8a of the main
body 8 is attached an expansible and contractible bag-shaped member
16 termed "cuff" or "balloon" (hereinafter referred to simply as
cuff). In this embodiment, said cuff 16 is secured to the entire
outer periphery of the outer tube 11 so as to surround the same,
but may be provided partially on the outer periphery of the outer
tube 11. The interior of the cuff 16 is designed to be supplied
with air or liquid through an aperture 17 formed in the outer tube
11, and the cuff 16 is usually in a deformed or contracted state
but is designed to be expanded upon the entry of air or liquid.
On the base end portion 8b (the left side of FIG. 4) of the main
body 8 of the guide tube is mounted a metallic cap 18, which is
formed at its center with a tube insertion hole 18a along the axis
of the guide tube 7 and with a passage 19 for passing air or liquid
therethrough. A mouth piece 20 is mounted on the metallic cap 18 at
the opening end portion of said passage 19.
Said passage 19 extends to one end of the helical winding 9 and
communicates with the interior of the cuff 16 through a helical
space 21 formed in the helical winding 9, namely defined by the
inner and outer tubes 10 and 11 with the helical winding 9 and then
through the aperture 17. Accordingly, when air or liquid is
introduced into the passage 19 from the mouth piece 20, the fluid
is helically passed through the helical space 21 and introduced
from the aperture 17 into the interior of the cuff 16 to cause the
cuff 16 to be expanded.
In FIG. 5 a guide tube according to another embodiment of the
invention is shown.
Said guide tube has substantially similar construction to that
shown in FIG. 4 excepting that the helical winding 9 constituting
reinforcing means of the main body 8 of FIG. 4 is replaced with a
net-like member 90 in FIG. 5. Said net-like member 90 may be made
of metal or synthetic resin. Namely said member 90 has only to be
formed at least flexible. Said member 90 is disposed between the
inner tube 10 and the outer tube 11 as in the case of the
reinforcement member of FIG. 4. The air or liquid introduced from
the mouth piece 20 into the passage 19 reaches the aperture 17 by
passing through the meshes of the net-like member 90 and then
enters the cuff 16 through said aperture 17.
Said net-like member 90 can be provided in various forms but has
only to be flexible and formed with spaces for passing therethrough
at least air or liquid from the passage 19 up to the aperture
17.
There will now be described the case where a guide tube, for
example, a guide tube 7 shown in FIG. 4, having the above-mentioned
construction is used.
Generally, it takes several minutes to thirty minutes at the
longest to insert the flexible tube 14 of the celoscope or
endoscope 13 up to the jejunum 22 from a patient's mouth or nose as
shown in FIG. 2 while observation is being made by said celoscope
or endoscope. That is, the insertion is relatively easily carried
out. FIG. 2 shows the condition in which the flexible tube 14 of
the celoscope or endoscope 13 is sufficiently inserted just up to
the jejunum 22.
Prior to the insertion of the flexible tube 14 of the celoscope or
endoscope 13, the guide tube 7 according to the invention is
beforehand fitted into said flexible tube 14 as shown in FIG. 3.
When the flexible tube 14 has sufficiently been inserted into a
patient's body cavity, said guide tube 7 is inserted into the body
cavity along said tube 14 with said tube 14 taken as a guide, and
it is confirmed through observation by, for example, X-ray
radiation that the portion of the guide tube 7 on which the cuff 16
is mounted has reached the duodenal cap 4. Thereafter, for example,
air is introduced from the mouth piece 20 to expand the cuff 16.
The mouth piece 20 is of course positioned outside the patient's
body. As shown in FIG. 6, the cuff 16 is pressed against the inner
walls of the duodenal cap 4 due to its expansion, thereby causing
the guide tube 7 to be fixed to its inserted position. After
completion of the fluid entering, the mouth piece 20 is properly
sealed in order to maintain the cuff 16 expanded.
After completion of the guide tube 7 fixing, only the flexible tube
14 of the celoscope or endoscope 13 is drawn out externally of the
patient's body through the guide tube 7.
Where the guide tube 7 is inserted into the body cavity, it can
also be inserted thereinto together with the flexible tube 14 of
the celoscope or endoscope 13 during the insertion of the same.
The guide tube 7 is set to a predetermined position of within the
body cavity through said insertion operation. Under this condition,
said flexible section 12 of the guide tube 7 is extended up to the
downward extending section 5 of the duodenum. Accordingly, the
intestinal tube 15 can readily and quickly be inserted up to the
jejunum 22 by being passed through the guide tube 7 with the guide
tube 7 taken as a guide. Further, upon insertion of the tube 15, it
is guided by the guide tube 7 so as to be prevented from being
buckled, so that the insertion force applied to the tube 15 acts
almost entirely on the direction in which the tube 15 is thrusted,
and thereby is transmitted up to the forward end of the tube 15.
Accordingly, the tube 15 is inserted readily, quickly into the body
cavity simply by a weak insertion force.
In the prior art case of using no such guide tube 7, even after the
forward end of the tube 1 has been able to be inserted into the
interior of the duodenum, the tube advancing operation is obliged
to be carried out by the vermicular movement. The reason is that,
as shown in FIG. 8, even if attempts are made to perform the
forceful insertion of the tube 1, the insertion force will be
scattered in arrow-indicated directions only to cause the tube 1 to
be coiled or loosened within the stomach 2 large in space, so that
the insertion force is interrupted from being transmitted to the
forward end of the tube 1. For the above-mentioned reasons, the
prior art tube insertion operation performed without using the
guide tube 7 was accompanied by a large length of time and
difficulties until the tube insertion was completed.
By the use of the guide tube according to the invention a body
cavity-treating instrument, having objects to be attained, such as
the intestinal tube can be set to a predetermined position in the
interior of the body cavity within several to 30 minutes at the
longest. Accordingly, a patient's pain is alleviated and
simultaneously quick, efficient diagnostication activities can be
expected.
The guide tube of the invention can be applied not only to the
intestinal tube but also to various body cavity-treating
instruments, and it is therefore apparent that the guide tube of
the invention is not limited to the use referred to in the
preceding embodiments.
* * * * *