U.S. patent number 3,924,633 [Application Number 05/438,180] was granted by the patent office on 1975-12-09 for apparatus and method for suprapubic catheterization.
This patent grant is currently assigned to Cook Inc.. Invention is credited to William A. Cook, Thomas A. Osborne.
United States Patent |
3,924,633 |
Cook , et al. |
December 9, 1975 |
Apparatus and method for suprapubic catheterization
Abstract
Apparatus and method for suprapubic catheterization of a bladder
when the catheter must remain in situ for a prolonged period. The
catheter includes a flexible tension member secured near its distal
end and passing through an opening in the catheter to its proximal
end, whereby, when the member is drawn tight, a self-retaining loop
is formed at the distal end portion of the catheter, and means are
provided for facilitating the drawing tight of the flexible tension
member. A body patch and other items are supplied to assist in the
catheterization procedure.
Inventors: |
Cook; William A. (Bloomington,
IN), Osborne; Thomas A. (Bloomington, IN) |
Assignee: |
Cook Inc. (Bloomington,
IN)
|
Family
ID: |
23739576 |
Appl.
No.: |
05/438,180 |
Filed: |
January 31, 1974 |
Current U.S.
Class: |
604/104; 138/103;
604/95.04 |
Current CPC
Class: |
A61M
25/04 (20130101); A61M 2025/0191 (20130101) |
Current International
Class: |
A61M
25/04 (20060101); A61M 25/02 (20060101); A61M
025/00 () |
Field of
Search: |
;128/348,349R,35R,4-8,DIG.9,347 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Truluck; Dalton L.
Attorney, Agent or Firm: Woodard, Weikart, Emhardt &
Naughton
Claims
What is claimed is:
1. In a hollow flexible catheter having a proximal end and a distal
end and having an opening near its distal end and having a flexible
tension member secured near its distal end and passing through the
opening and along within the catheter toward the proximal end,
whereby when the member is drawn tight a self-retaining loop will
be formed at the distal end portion of the catheter, the
improvement which comprises a short tube, less flexible than the
catheter, mounted within the proximal end portion of the catheter,
the flexible tension member extending along within the catheter
through the tube, exiting from the proximal end of the tube,
passing in slideable engagement between the inner wall of the
catheter and the outer wall of the tube, the wall of the catheter
including an opening near the proximal end of the catheter, the
flexible tension member extending from between the inner wall of
the catheter and the outer wall of the tube through the opening in
the catheter near the proximal end of the catheter.
2. The improvement of claim 1 in which there is a knot in the free
end of the flexible tension member along the portion which extends
beyond the opening near the proximal end of the catheter.
3. The improvement of claim 2 in which the flexible tension member
is a stainless steel wire coated with a synthetic
fluorine-containing resin.
4. The improvement of claim 3 which further comprises:
a short tube mounted within the distal end portion of the catheter;
and
means for bonding the outside of the short tube with the inside of
the catheter with the distal end of the flexible tension member
looped around the short tube within the catheter.
5. The improvement of claim 4 in which the self-retaining loop
portion of the catheter includes a plurality of sideports.
6. The improvement of claim 5 in which there is provided a second
opening between the first opening and the point of attachment of
the flexible tension member at the catheter distal end, the
flexible tension member being positioned so that it passes from
within the catheter through the second opening along the outer wall
of the catheter and returns within the catheter through the first
opening.
Description
BACKGROUND OF THE INVENTION
1. Field of the Invention
The invention is in the field of catheters.
2. Description of the Prior Art
Suprapubic catheterization of the bladder is a relatively new
approach to draining the bladder after surgery or when the
genito-urinary system is plugged by an obstruction. An older method
of catheterization utilizes a large Foley catheter which is placed
in the bladder through the urethra. The chief disadvantage of the
Foley catheter is its size, which tends to promote irritation and
infection.
The suprapubic catheter is introduced into the bladder by means of
a large hypodermic needle or trocar which pierces the lower
abdominal wall. A cannula fitted over the needle is left in place
through the abdominal wall and the needle removed. A catheter tube
is then placed through the cannula, and the cannula is withdrawn,
leaving the catheter in the bladder. The advantage of this
technique is that irritation and infection of the urinary track are
minimized. The disadvantage of the present technique of suprapubic
catheterization is that the catheter can be easily pulled out
through movement of the body or emptying of the bladder. Sometimes
one or more holes (side ports) at the distal tip of the catheter
may be inadvertently drawn into the abdominal cavity creating
potential for severe infection.
Various means have been utilized to secure a suprapubic catheter in
the bladder, including the use of a heat-set curve in the distal
end of a catheter, an inflatable portion at the distal end of the
catheter, and the use of a body patch or seal which engages the
catheter as it emerges from the body and is rigidly attached to the
skin. According to the present invention, after the suprapubic
catheter is inserted, a plastic, metal, or plastic-coated metal
wire is pulled, making a loop in the distal end portion of the
catheter, which prevents the catheter from being removed from the
bladder until the wire is released. A catheter having a similar
arrangement for setting a curve in the distal end, disclosed as
primarily for urethral catheterization, is shown in U.S. Pat. No.
1,207,479 to Bisgaard.
Other catheter retention means are disclosed in U.S. Pat. Nos.
3,397,699 to Kohl and 3,331,371 to Rocchi. Suprapubic
catheterization generally is disclosed in U.S. Pat. No. 3,742,958
to Rundles.
SUMMARY OF THE INVENTION
One embodiment of the present invention is, in a hollow flexible
catheter having an opening near its distal end and having a wire or
flexible tension member secured near its distal end and passing
through the opening and along the catheter toward the proximal end,
whereby when the member is drawn tight a self-retaining loop will
be formed at the distal end portion of the catheter, the
improvement which comprises a short tube less flexible than the
catheter mounted within the proximal end portion of the
catheter.
It is an object of the present invention to provide apparatus for
the catheterization of a bladder with minimum irritation or
infection of the urinary track.
It is a further object of the present invention to provide
apparatus with improved securing means for suprapubic
catheterization.
Further objects and advantages of the present invention shall be
apparent from the following detailed description and accompanying
figures.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 shows a catheter according to the present invention inserted
within a bladder.
FIG. 2 shows the catheter of FIG. 1 drawn into a secured
position.
FIG. 3 shows the catheter of FIG. 1 in a different operating
position, with the cannula removed, and with additional
apparatus.
FIG. 4 is an enlarged view, partly in cross-section, of the
proximal end of the catheter of FIG. 3 with the extension tube in
place and with a portion of the free end of the wire removed.
FIG. 5 is an enlarged view, partly in cross-section, of the
proximal end of the catheter of FIG. 1.
FIG. 6 is an enlarged view of the distal end portion of the
catheter of FIG. 1 with portions broken away.
FIG. 7 is an enlarged cross-sectional view of the distal tip of the
catheter of FIG. 1.
DESCRIPTION OF THE PREFERRED EMBODIMENT
For the purposes of promoting an understanding of the principles of
the invention, reference will now be made to the embodiment
illustrated in the drawings and specific language will be used to
describe the same. It will nevertheless be understood that no
limitation of the scope of the invention is thereby intended, such
alterations and further modifications in the illustrated device,
and such further applications of the principles of the invention as
illustrated therein being contemplated as would normally occur to
one skilled in the art to which the invention relates.
Referring to FIG. 1, a catheter 11 is shown inserted into a bladder
12. Before insertion of catheter 11, cannula 13, slidably mounted
over a needle (not shown), is percutaneously inserted into bladder
12. The needle is then removed and the cannula left in place.
Catheter 11 is then inserted through cannula 13 into bladder 12 as
shown in FIG. 1. Catheter 11 comprises a tan, 7 French, vinyl
tubing and has received therein a wire or flexible tension member
14, which in the illustrated embodiment, is a coated wire. The
distal end portion of catheter 11 includes a plurality of drainage
holes or side ports such as 16, as shown within the bladder 12 of
FIG. 1, and in more detail in FIG. 6. Flexible tension member 14
extends from within the proximal end of catheter 11 to an opening
at point 17 within the wall of catheter 11, extending outside the
catheter wall to point 18 near the distal tip of catheter 11. The
connection of flexible tension member 14 within catheter 11 shall
be described in more detail hereinafter (see FIG. 7).
Referring now to FIG. 2, catheter 11 is shown in a secured position
wherein the distal end portion of catheter 11 is drawn into a loop
within bladder 12. In order to convert catheter 11 from its
originally inserted configuration as shown in FIG. 1 to the secured
position of FIG. 2, a person positioning the catheter holds the
catheter and cannula with one hand near point 21, holding cannula
13 in position relative to bladder 12 and at the same time
maintaining catheter 11 in position relative to the cannula. The
person uses his other hand to draw flexible tension member 14 out
of the proximal end of catheter 11 enlarging loop 19. It can be
seen that drawing tension member 14 tight will take up the length
of tension member 14 between holes, openings or points 17 and 18
(FIG. 1), until point 18 is drawn adjacent point 17 as shown in
FIG. 2. It should be noted that the side ports at the distal end of
catheter 11, in the secured position, are all beyond point 17 on
the catheter and are maintained within the bladder.
After flexible tension member 14 is drawn tight and points 18 and
17 are adjacent one another, as shown in FIG. 2, the knotted end 22
of tension member 14 is pulled away from the catheter, closing loop
19. Most of the excess length of tension member 14 extending from
end 22 to its entry point in the side of the proximal end of
catheter 11 is cut off or otherwise suitably removed as shown in
FIG. 4. Then cannula 13 is removed from catheter 11 by sliding it
over the proximal end of catheter 11.
As shown in FIG. 3, body seal 23 may be applied to the skin to
provide additional mechanical support for the catheter. Body seal
23 has an adhesive surface which attaches to the skin and a molded
plastic portion 24 attached to the other side of the adhesive
surface. Molded plastic portion 24 includes a center channel which
provides a snap-in grip for catheter 11 as shown in FIG. 3. A hole
is provided through body seal 23 through which the proximal end of
catheter 11 is placed when body seal 23 is attached.
As also shown in FIG. 3, an extension tube 26 is stretched over the
proximal end of catheter 11 and maintained by a frictional fit.
Spring clamp 27 is provided to control the flow from bladder 12
through catheter 11 and extension tube 26. Female connector 28 is
attached to the end of extension tube 26 for attachment to a male
connector on the end of a connecting tube (not shown). The
connecting tube, like extension tube 26, may be 10 French clear
vinyl.
In FIG. 4, there is shown an enlarged cut-away view of the proximal
end of catheter 11 within the end of extension tube 26 as shown in
FIG. 3. An extension tube 26 which may be a clear, 10 French, vinyl
tube is fitted over the tan, 7 French, vinyl tubing 29 of catheter
11 after the excess length of tension member 14 has been trimmed at
the proximal end, as described above. The portion 32 of flexible
tension member 14 which extends between tubing 26 and tubing 29 is
held in place by the frictional fit therebetween. A rigid tube 31
which may be a metal, 16 gtw, tube about 3.8 centimeters long
extends from within the proximal end of catheter tubing 29, as
shown in FIGS. 4 and 5.
FIG. 5 is an enlarged view of the proximal end of catheter 11 in
the configuration of FIG. 1, prior to placing the distal end of the
catheter in the secured position of FIG. 4. A knot 32 in flexible
tension member 14 prevents the end 22 of the tension member from
being drawn through hole 33 in wall 29 of catheter 11. Metal tube
31 within catheter tubing 29 acts as a guide for tension member 14
as it is drawn from the catheter distal end through tubing 29,
expanding loop 19 and drawing the distal end of catheter 11 into
the secured position of FIG. 2.
Metal tube 31 is force fitted within tubing 29 and also serves to
hold tension member 14 between its outside wall and the inner wall
of tubing 29. As described above, after loop 19 has been extended
to its largest position by drawing tension member 14 through tubing
29, bringing the distal end of catheter 11 into the secured
position of FIG. 2, the excess of tension member 14 in loop 19 is
drawn through hole 33 by pulling end portion 22 of tension member
14 until tension member 14 is essentially in the configuration of
FIG. 4 at the proximal end of the catheter. The excess of tension
member 14 extending beyond hole 33 and tubing 29 is cut to a length
approximately as shown in FIG. 4. Extension tube 26 is then forced
over the proximal end of catheter 11 as shown in FIG. 4.
An enlarged cut-away view of the distal end portion of catheter 11
is shown in FIG. 6. The distal end portion of catheter 11, as shown
in FIG. 6, is in the unsecured configuration shown in FIG. 1. The
plurality of side ports 16 provided in the wall of the catheter
tubing 29 may be 1 millimeter in diameter and may occur every
90.degree., 5 millimeters apart along a 6 centimeter length of
tubing 29. The spacing between openings 17 and 18 along catheter
tubing 29 is about 10 centimeters. Flexible tension member 14
extends from the proximal end of catheter 11 through tubing 29 to
opening 17, where it extends through the wall of the tubing out of
tubing 29 to opening 18 and then returns through the wall of the
tubing so as to extend within tubing 29 to the distal end tip 34 of
catheter 11. As described above, when flexible tension member 14 is
drawn toward the proximal end of catheter 11, the length of tension
member 14 between holes 17 and 18 is drawn tight and the distal end
of catheter 11 loops around as shown in FIG. 2 until holes 17 and
18 are adjacent.
The distal end tip 34 of catheter 11 is shown in cross-section in
FIG. 7. The flexible tension member 14 extends within the catheter
tubing 29 from opening 18 to the distal end tip 34 of catheter 11
as shown in FIG. 7, looping around insert tubing 36. In the
illustrated embodiment, insert tubing 36 may be a 5 French vinyl,
solvent bonded to the inside diameter of the distal end tip of
catheter 11. The end of flexible tension member 14 is held in place
by the solvent bonding which is done after tension member 14 is
looped around insert tube 36 as shown.
Flexible tension member 14 may be a stainless steel wire coated
with synthetic fluorine-containing resins. The diameter of tension
member 14 may be about 0.4 millimeters. The overall length of
catheter 11 is about 60 centimeters, although other appropriate
lengths may be preferred for specific catheterization functions.
Although the method and apparatus for suprapubic catheterization of
a bladder has been described in detail according to the present
invention, the technique and apparatus may be easily adapted for
use in the catheterization of other areas of the body.
It can be seen that an apparatus has been provided for the
catheterization of a bladder with minimum irritation or infection
of the urinary track.
It can also be seen that an apparatus has been provided with
improved securing means for suprapubic catheterization.
While there have been described above the principles of this
invention in connection with specific apparatus, it is to be
clearly understood that this description is made only by way of
example and not as a limitation in the scope of the invention.
* * * * *