CA1221288A

CA1221288A - Intercostal tube

Info

Publication number: CA1221288A
Application number: CA000466736A
Authority: CA
Inventors: Edward M. Ring
Original assignee: Sherwood Medical Co
Current assignee: Sherwood Medical Co
Priority date: 1984-10-31
Filing date: 1984-10-31
Publication date: 1987-05-05

Abstract

Abstract of the Disclosure:
An intercostal tube designed to be inserted between the ribs of a patient for drainage purposes of the chest area, made of relatively stiff but pliable plastic material with its inserting end at a sharp taper that nevertheless preserves the ade-quate rigidity to permit the tube to be compressed transversely and inserted between the ribs, without widening the portion of the tube required to pass between the ribs, which would require a larger opening in the patient, and increased pain.

Description

- ~2,~288 The present invention relates to an intercostal tube designed to be inserted between the ribs of a pa-tient for drainage purposes of the chest area, made of relatively stiff but pliable plastic material with its inserting end at a sharp taper that nevertheless preserves the adequate rigidity to permit the tube to be compressed -transversely and inserted between the ribs, without widening -the portion of the tube required to pass between the ribs, which would require a larger opening in the patient, and increased pain.
Intercostal tubes have been heretofore made with squared ends. When such a tube is inserted between the ribs, it is very difficult to insert because of the squared end and the large area that must be inserted. Accordingly, the end to be inserted is usually squeezed or compressed transversely to make the tube narrower to require less of an incision in order to pass between the ribs. But this squee-zing increases the vertical dimension of the tube and there-by requires a larger opening in the area between the ribs, which can cause the patient pain. It is also recognized that some tubes for other uses have been made with sloping ends but not of the present material and not with the pre-sent type of end that can be inserted between the ribs. An example of this is the Sanders U.S. patent No. 2,458,305.
Also intravascular catheters have been made with trocars wherein the trocar has a sloping end. But in that case, the trocar is usually of metal and it is of a very small size designed to enter a vein or -the like part of the human body.
Thus it does not have the problem of being flexible and yet being stiff enough to be inserted between the ribs, or of being widened upon being squeezed.

According to the present invention therefore there is provided an intercostal tube of plastic material, the tube being of a size to enable drainage from a body cavity into which it is inserted, and being flexible about its .
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longitudina1 axis but relatively resistant to transverse crushing force; the tube having a sloping tip end portion for insertion into the body by way of a passage therein made such as one between the ribs; the end of the tube being blunted to reduce its tendency to bend or to snag body tis-sue during insertion, the sloping tip, when viewed trans-versely of the tube axis, extending in a single slope from a point on the surface of the tube toward the end of the tube and toward the opposite side of the tube bu-t terminating short of the opposite side of the tube, leaving a continuous end that is blunted and that extends around the tube, and the blunted part of which when viewed from the end of -the tube, is arcuate and is relatively rigid agains-t collapse upon being forced through a passage such as the one bet-ween -the ribs. Suitably the slope is abou-t -twenty-five degrees to -the longitudinal axis, and the tip of the tube being rigid enough to be inserted between the ribs without bending.

The present invention will be fur-ther illustrated by way of the accompanying drawings, in which:-Figure 1 is a view of an intercostal tube broken away, showing the present invention;

Figure 2 is a top plan view thereof;

Figure 3 is an end view of a squared-end tube of the prior art with the end of the tube compressed to narrow it for its entrance between the ribs; and Figure 4 is an end view of the present invention showing the sloping end of the tube squeezed for insertion.

The tube 10 is here shown as having its upper, discharge end 11. Its other end is given an acute sloping .~,, ,~

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~;~2~288 edge 12 that has an angle of approixmately twenty-five degrees to the axis of the tube, which means -that i-ts top angle is approximately twenty-five degrees. Preferably the sloping edge does not extend entirely across the tube but it stops, leaving an end edge 13 that is arcuate and thereby stronger against bending under axial pressure than the end of the tube would be if the sloping edge 12 went entirely across the tube, and the end were nearly pointed.

The tube has drainage tubes 15 spaced from its end 12, to admit fluids -Erom the body after insertion. These fluids can drain out the upper end 11.

~ - lb -~Z~ 8 The tube may be made of one of the polyhaloginated polyethylenes or its equlvalent plastic material suitable for medical use. Typically, these products are known under the trademarks Tygon or TeElon. They are flexible but rather resis-tant to distortion transversely of the tube. The tubes are nor-mally about 18 to 20 inches long, to 40 French diameter, with walls approximately 2 millimeters thick for a tube of approxi-mately 14 millimeters outside diameter, or 40 French.

In use:

The tube of the present invention can be inserted between the ribs into the thoracic area. In this, the lip 13 remains strong enough that the end of the tube will not collapse and bend over, this result coming from the fact that the lip is somewhat blunt and is arcuate in shape. The steep slope 12 per-mits the tube to be inserted between the ribs with the minimum size of the opening between the ribs to receive the tube. Usu-ally, a clamp is applied to the inserted end of the tube, as is indicated by the arrows in Figures 1 and 4. This squeezes the end, as shown in Figure 4. Because of the sloping edges, and the cut-away sides, the squeezing applied along the sloping end does not bulge lateral parts of the tube significantly beyond the diameter of the tube. In Figure 3, the lateral extension of a square-ended tube, when squeezed, is illustrated. Such extension causes pain to the patient.

Thus, the invention does not require a trocar as is true of the Calinog U.S. patent 3,703,899. It remains flexible so that its axis can be bent. It is insertable without the tro-car because it remains rigid enough with the extreme slope of the edge 12 and with the enlarged end produced by the cutoff 13.

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Claims

THE EMBODIMENTS OF THE INVENTION IN WHICH AN EXCLUSIVE
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS:

1. An intercostal tube of plastic material, the tube being of a size to enable drainage from a body cavity into which it is inserted, and being flexible about its longitudinal axis but relatively resistant to transverse crushing force; the tube having a sloping tip end portion for insertion into the body by way of a passage therein made such as one between the ribs; the end of the tube being blunted to reduce its tendency to bend or to snag body tissue during insertion, the sloping tip, when viewed transversely of the tube axis, extending in a single slope from a point on the surface of the tube toward the end of the tube and toward the opposite side of the tube but ter-minating short of the opposite side of the tube, leaving a continuous end that is blunted and that extends around the tube, and the blunted part of which when viewed from the end of the tube, is arcuate and is relatively rigid against col-lapse upon being forced through a passage such as the one between the ribs.

2. The tube of claim 1, the slope being about twenty-five degrees to the longitudinal axis, and the tip of the tube being rigid enough to be inserted between the ribs without bending.