CN111632242A

CN111632242A - Direction-controllable tracheal catheter guiding device

Info

Publication number: CN111632242A
Application number: CN201910156294.XA
Authority: CN
Inventors: 孙扬
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-03-01
Filing date: 2019-03-01
Publication date: 2020-09-08

Abstract

The invention relates to the technical field of medical auxiliary equipment, and discloses a tracheal catheter guiding device with controllable direction. The direction-controllable tracheal catheter guiding device comprises a bougie, wherein the bougie comprises a push rod proximal section and a push rod distal section which are sequentially arranged; the push rod far section comprises a bendable section and a tail section which are arranged in sequence; the pull wire is arranged in a spring shape, a spiral shape or a wave shape, so that the pull wire has extensibility along the length direction and simultaneously generates pull back force.

Description

Direction-controllable tracheal catheter guiding device

Technical Field

The invention belongs to the technical field of medical auxiliary equipment, and particularly relates to a direction-controllable tracheal catheter guiding device.

Background

Endotracheal tubes have been widely used in various fields of medicine as a tool for the management of the respiratory tract of patients. Although doctors can see the patient's glottis using conventional laryngoscopes and video laryngoscopes, it is often difficult to insert the endotracheal tube into the patient's glottis due to anatomical variation in the different patient's respiratory tracts.

Therefore, manufacturers make endotracheal tubes to have a universal preset curvature, trying to match the curvature of the endotracheal tube to the curvature of the patient's airway to help physicians insert the endotracheal tube into the patient's glottis or trachea, but since the anatomical structure of each patient's airway has individual variability, there is still a problem of difficulty in insertion when physicians use such endotracheal tubes.

Therefore, a probe for assisting the insertion of the endotracheal tube, which is made of a bendable metal material or a plastic material, is invented, the probe is inserted into the endotracheal tube before the endotracheal tube is inserted, and then the probe and the endotracheal tube are bent to different angles according to the requirements of an operator, but during the intubation process, a doctor cannot change the bent angle of the probe unless the endotracheal tube is pulled out and the probe and the endotracheal tube are bent and then inserted, so that the intubation process of the endotracheal tube can be interrupted and a plurality of serious consequences can be caused.

In recent decades, video laryngoscopes have been introduced into endotracheal tubes in clinical practice, and if used properly, they provide good images to the physician, but the curvature of the distal end of the endotracheal tube is still difficult to change at the discretion of the operator while operating in real time, and thus it is still difficult to accurately insert the endotracheal tube into the patient's glottis or trachea.

In recent years, attempts have been made to invent a probe capable of changing and controlling the extending end of an endotracheal tube, such as U.S. patent nos. 8695,590 and 9,010,320, and a recently clinically used truflex metal probe, which can adjust the bending degree of the extending end of the endotracheal tube to provide convenience for the endotracheal tube, but most of the endotracheal tubes are made of metal, are hard in material and easy to damage the respiratory tract, and still can be bent only in one direction, and the bending angle is difficult to reach the degree aligned with the glottic opening, so that the endotracheal tube still does not substantially solve the problem of difficult insertion of the endotracheal tube.

Disclosure of Invention

In order to overcome the defects of the prior art, the invention provides a direction-controllable tracheal catheter guiding device, which is convenient for pushing the tracheal catheter guiding device into the glottis of a patient.

The technical scheme adopted by the invention for solving the technical problems is as follows: the direction-controllable tracheal catheter guiding device is inserted into a lumen of a tracheal catheter, is used together with the tracheal catheter and comprises a bougie, wherein the bougie is of a long strip rod-shaped structure and comprises a push rod proximal section and a push rod distal section, the push rod distal section comprises a bendable section and a tail section, the bendable section proximal end is connected with the push rod proximal section and forms a first bending point, and the bendable section distal end is connected with the tail section; the pull wire is a strip-shaped or rope-shaped linear structure, a part or the whole of the pull wire is arranged into a spiral, spring-shaped or wave-shaped linear structure, the pull wire can be extended and elongated under the action of external force and generates a back tension force, the proximal end of the pull wire is temporarily fixed at the proximal opening of the endotracheal tube before use, the distal end of the pull wire is fixed at the distal section of the push rod, and the pull wire is elongated and generates the back tension force in the process of moving the distal section of the push rod to the distal end; from the near end to the far end, the stay wire and the bougie go with each other, the stay wire is arranged on one side of the bougie, or the stay wire is wound around or wound around the bougie.

As a further improvement of the above technical solution, under the action of an external force, the distal rod section is easier to bend than the proximal rod section to form a curve, and the bendable section includes a first bending section and a second bending section, the first bending section and the second bending section are connected to form a second bending point, and the second bending point is easier to bend than the first bending section and the second bending section.

As a further improvement of the above technical solution, the end segment is configured to be bent downward in advance, and is opposite to the bending direction in which the bendable segment is bent upward, and can be further bent by an external force, and a proximal end of the end segment is connected to a distal end of the bendable segment to form a third bending point, and the third bending point is easier to bend than the bendable segment and the end segment.

As a further improvement of the above technical solution, the pulling wire includes a pulling wire proximal section and a pulling wire distal section, the pulling wire proximal section may be completely straightened or not completely straightened during the pulling and elongation process, and the pulling wire distal section may not be completely straightened during the pulling and elongation process.

As a further improvement of the above technical solution, the cross-sectional areas (or their thicknesses) of the proximal and distal segments of the pulling wire may be the same or different, and may be varied, and their materials may be the same or different, so that they may be easily elongated and the degree of generating the pulling back force may be the same or different.

As a further improvement of the above technical solution, the bending device further comprises an auxiliary pulling wire, one end of the auxiliary pulling wire is connected to a junction between the proximal pulling wire section and the distal pulling wire section, the other end of the auxiliary pulling wire is connected to a position where the distal end of the bendable section is close to the second bending point, and the auxiliary pulling wire pulls the bendable section together with the proximal pulling wire section and bends the first bending point in the process of being gradually straightened or almost straightened by the proximal pulling wire section.

As a further improvement of the above technical solution, the left side or the right side of the longitudinal direction of the end segment is connected to the distal end of the bendable segment through a bendable connecting segment, the distal end of the auxiliary pull wire is connected to the proximal end of the end segment, and when the proximal end of the end segment is pulled, the connecting segment is twisted to move the end segment obliquely downward with the connecting segment as a rotation point.

As a further improvement of the above technical solution, the cross-sectional areas of the first curved section and the second curved section may be the same or different, the materials of the first curved section and the second curved section may be the same or different, and the first curved point is bent upward by being significantly pulled out of the distal opening of the endotracheal tube.

As a further improvement of the technical proposal, the proximal end of the pull wire is non-permanently fixed on the front wall or the side wall of the proximal opening of the endotracheal tube through a docking device.

As a further improvement of the above technical solution, the bendable section may also be provided with a smooth arc shape which is bent upward in advance, the end section is provided with an arc shape which is bent downward in advance, the end section is connected to the distal end of the bendable section, when the end section is connected to the bendable section, the transverse cross-sectional area becomes smaller so as to be pulled and bent by the pull wire and continue to be bent along the original downward arc shape, the material hardness of the bendable section is higher than that of the endotracheal tube, the bending arc shape of the bendable section and the hardness of the manufacturing material thereof enable the distal section of the endotracheal tube to be further bent upward, and the upward bending arc shape of the bendable section may also be limited by the distal section of the endotracheal tube so as to reduce the original bending degree of the bendable section.

As a further improvement of the above technical solution, a far-end connecting plate of the pull wire or a far-end connecting root of the pull wire is provided at the far end of the pull wire, and the far-end connecting plate of the pull wire or the far-end connecting root of the pull wire is connected to the end section, so that when the pull wire pulls the end section, the end section bends downward.

The invention has the beneficial effects that:

when the direction-controllable tracheal catheter guiding device is used, the far end of the pull wire is temporarily fixed on the front wall or the side wall of the opening at the near end of the tracheal catheter through a fixing device, then an operator pushes the bougie to move towards the glottis of a patient, the pull wire is stretched and generates back tension in the moving process, the bendable section bends under the action of the pull wire, the bending radian of the bendable section is changed through pushing and loosening operations, and the tracheal catheter guiding device can be conveniently stretched into the glottis of the patient.

Drawings

The invention is further illustrated with reference to the following figures and examples.

FIG. 1 is a left side elevational view of a steerable endotracheal tube guiding device in accordance with a first embodiment of the present invention;

FIG. 2 is an enlarged schematic view of the distal portion of FIG. 1;

FIG. 3 is a graph comparing the change in curvature of the endotracheal tube before and after insertion of the steerable endotracheal tube guiding device of the first embodiment of the present invention into the endotracheal tube;

FIG. 4a is a schematic structural view of a docking device according to a first alternative embodiment of the present invention;

FIG. 4b is a schematic structural view of a docking device according to a second alternative embodiment of the present invention;

FIG. 5a is a schematic structural view of a controllable orientation endotracheal tube guiding device in a preparation stage according to the first embodiment of the present invention;

FIG. 5b is a schematic structural view of the first stage of pushing of the steerable endotracheal tube guiding device according to the first embodiment of the present invention;

FIG. 5c is a schematic diagram of a second stage of pushing of the steerable endotracheal tube guiding device in accordance with the first embodiment of the present invention;

FIG. 5d is a schematic diagram of a third stage of pushing the steerable endotracheal tube guiding device in accordance with the first embodiment of the present invention;

FIG. 6a is an enlarged, top plan view of a distal portion of a steerable endotracheal tube guiding device in accordance with a second embodiment of the present invention;

FIG. 6b is an enlarged top structural view of an alternative embodiment of the distal portion of the second embodiment of the present invention, showing the structure of the connecting section;

FIG. 7a is a schematic structural diagram of a second embodiment of the present invention illustrating a preparation stage of a steerable endotracheal tube guiding device;

FIG. 7b is a schematic structural diagram of a first pushing stage of the steerable endotracheal tube guiding device in accordance with the second embodiment of the present invention;

FIG. 7c is a schematic diagram of a second stage of pushing of the steerable endotracheal tube guiding device in accordance with the second embodiment of the present invention;

FIG. 7d is a schematic diagram of a third stage of pushing of the steerable endotracheal tube guiding device in accordance with the second embodiment of the present invention;

FIG. 7e is an alternative of the steerable endotracheal tube guidance rod showing pull wires extending distally, back, left and right, around the proximal section of the push rod in accordance with the second embodiment of the present invention;

FIG. 8 is a left side elevational view of a steerable endotracheal tube guiding device in accordance with a third embodiment of the present invention;

FIG. 9a is a schematic structural diagram of a third embodiment of the present invention illustrating a preparation stage of a steerable endotracheal tube guiding device;

FIG. 9b is a schematic structural diagram of a first pushing stage of the steerable endotracheal tube guiding device in accordance with the third embodiment of the present invention;

FIG. 9c is a schematic diagram of a second stage of pushing of the steerable endotracheal tube guiding device in accordance with the third embodiment of the present invention;

FIG. 9d is a schematic structural diagram of a third stage of pushing of the steerable endotracheal tube guiding device in accordance with the third embodiment of the present invention;

FIG. 10 is a schematic diagram of another method of using the third embodiment of the present invention.

Detailed Description

Name and label:

bougie 10, push button 14, push rod proximal segment 11, push rod distal segment 12, endotracheal tube 40, endotracheal tube proximal opening front wall 41, endotracheal tube proximal opening 42, endotracheal tube distal segment 43, endotracheal tube front wall 46, endotracheal tube rear wall 47, endotracheal tube distal segment opening 48, endotracheal tube distal segment opening front wall 49;

the first embodiment:

the device comprises a bougie 10, a push rod proximal section 11, a push rod distal section 12, a bendable section 13, a push button 14, a first bending section 15, a second bending section 16, an auxiliary stay wire 17, a tail section 18, a tail section tip section 19, a stay wire 20, a hook 21, a stay wire proximal section 22, a stay wire distal section 23, a stay wire fixing ring 24, a stay wire sectional point 25, a stay wire fixing plate 26, an auxiliary stay wire second connecting end 27, a first bending point 28, a third bending point 29 and a second bending point 32;

second embodiment:

the device comprises a bougie 10, a push rod proximal section 11, a push button 14, a pull wire 20, a hook 21, a pull wire proximal section 22, a pull wire distal section 23, a pull wire segmentation point 25, a first bending point 28, a bendable section 30, a connecting section 31, a terminal section proximal end 33, a pull wire angle 35, a terminal section proximal section 36, an auxiliary pull wire 37, a terminal section circular arc section 38 and a terminal section 39;

the third embodiment:

the probe 10, the push rod proximal section 11, the push button 14, the hook 21, the first bending point 28, the push rod distal section 51, the pull wire 52, the pull wire distal end connecting root 53a, the pull wire distal end connecting plate 53b, the bendable section 55, the terminal bendable section 56, the terminal middle section 57, the terminal section 58 and the terminal sharp section 59.

The conception, the specific structure and the technical effects of the present invention will be clearly and completely described in conjunction with the embodiments and the accompanying drawings to fully understand the objects, the schemes and the effects of the present invention. It should be noted that the features of the first, second and third embodiments and each of the embodiments and alternative embodiments in the present application may be combined with each other without conflict.

It should be noted that, unless otherwise specified, when a feature is referred to as being "fixed" or "connected" to another feature, it may be directly fixed or connected to the other feature or indirectly fixed or connected to the other feature. Further, the description of the upper, lower, left, right, front, rear, etc. used in the present invention is made with respect to the positional relationship of the respective components of the present invention with respect to each other in the drawings.

Furthermore, unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. The terminology used in the description herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any combination of one or more of the associated listed items.

In the present invention, the end near the body of the operator, or the end of the operator holding the device, is referred to as the proximal end; the end remote from the operator, i.e. the end of the device that extends into the patient's glottis, is called the distal end; the above, below, front and back directions referred to in the description of the present invention are determined according to the angle of the drawings, and the above, below, front and back directions referred to in the present invention are necessarily changed after the device is rotated by a certain angle, and therefore, the scope of the present invention should not be limited.

The present invention can be designed based on the same idea and distance, and three preferred embodiments, namely, the first embodiment, the second embodiment and the third embodiment can be designed. There may also be some minor local variations in each embodiment, referred to as alternatives or alternative embodiments or alternatives.

It should be noted that the components of the above three embodiments may be replaced with each other in some cases to form new embodiments, which are all within the protection scope of the present invention.

In the following description, the usage of the present invention is described by taking an endotracheal tube as an example, but a hollow tube similar to the endotracheal tube and having two open ends can be used to replace the endotracheal tube and perform the same function, so the meaning of the words "endotracheal tube" in the present invention also includes other similar hollow tube structures having two open ends, because the present invention can also be used with hollow tubes having two open ends.

The material used for the embodiment of the present invention is flexible and elastic, and can be plastic, silicon, metal, other materials with similar characteristics, or a mixture of these materials.

First embodiment and method of operation

Referring to fig. 1 to 5, a first embodiment of the present invention provides a direction-controllable endotracheal tube guiding device, which includes a bougie 10 and a pull wire 20. The bougie 10 comprises a proximal push rod section 11 and a distal push rod section 12 in sequence from the proximal end to the distal end, the distal push rod section 12 comprises a bendable section 13 and a distal section 18 in sequence from the proximal end to the distal end, and the distal end of the pull wire 20 is fixedly connected with the bendable section 13. In this embodiment, the distal end of the pulling wire 20 can be fixedly connected to any one of the bendable sections 13, and the pulling wire 20 is configured to be spring-shaped, spiral-shaped or wave-shaped in whole or in part, and has an extensibility in the length direction thereof, so that during the forward movement of the bougie 10, the pulling wire 20 first extends forward along with the movement of the bendable section 13, and then simultaneously during the elongation of the pulling wire 20 and when the extensibility of the pulling wire 20 is gradually exhausted, the pulling wire 20 will pull the bendable section 13 to bend the bendable section 13 in the pulling direction of the pulling wire 20, thereby forming a curve.

All three embodiments of the invention can only realize that in the operation process, the stay wire and the bougie have two accompanying position relations. After the device of the present invention is placed in an endotracheal tube, a portion of the pull wire 20 located in the endotracheal tube may accompany one side of the bougie 10, see fig. 1, 5a-5d, 9a-9d, 10, or the pull wire 20 located in the proximal portion of the first bending point 28 may be wrapped around or around the proximal portion 11 of the push rod proximal to the first bending point 28, see fig. 7 e.

As shown in FIG. 1, the proximal end of the pulling wire 20 is further provided with a stopping device for temporarily fixing the proximal end of the pulling wire 20 to the front wall 41 of the proximal opening of the endotracheal tube, and the fixing position can be either the left side wall or the right side wall of the front wall 41 of the proximal opening of the endotracheal tube, so that the pulling wire 20 is gradually extended and pulled back during the forward advancement of the proximal push rod segment 11. In the preferred embodiment shown in fig. 1, the stop means at the proximal end of the pull wire 20 is a hook 21, and the hook 21 can be hung on the anterior wall 41 of the proximal opening of the endotracheal tube or on the side wall thereof, thereby providing a fixing point for the proximal side of the pull wire 20. In another embodiment, as shown in fig. 4a, the docking means may be a pull wire securing ring 24, the pull wire securing ring 24 being disposed on the proximal side of the pull wire 20, the pull wire securing ring 24 being in the form of a semi-circular ring structure that removably seats against the anterior wall 41 of the proximal opening of the endotracheal tube to provide a fixed position for the proximal end of the pull wire 20. In an alternative embodiment, the docking device may also be a pull wire fixation plate 26, as shown in fig. 4b, the pull wire fixation plate 26 may temporarily fix the proximal end of the pull wire 20 to the proximal opening 42 of the endotracheal tube, and the proximal end of the pull wire 20 is fixed to the pull wire fixation plate 26, thereby providing a fixed position for the proximal end of the pull wire 20.

In this embodiment, in order to enable the finger to conveniently push the proximal section 11 of the push rod to move towards the distal end, a push button 14 is further disposed on one side of the proximal end of the proximal section 11 of the push rod, the push button 14 is annular, and the operator can conveniently push the finger through the push button 14 to push the proximal section 11 of the push rod.

The bendable section 13 includes two or more sections having bendability in the same direction. In this embodiment, the bendable section 13 includes a first bendable section 15 and a second bendable section 16 sequentially disposed from the proximal end to the distal end. The first curved segment 15 is connected to the proximal pushrod segment 11 and forms a first curved point 28 at the connection to the pushrod 11, the second curved segment 16 is connected to the first curved segment 15 and forms a second curved point 32 at the connection of the second curved segment 16 to the first curved segment 15, and the distal segment 18 is connected to the second curved segment 16 and forms a third curved point 29 at the connection of the distal segment 18 to the second curved segment 16. Thus, the first curved segment 16 may be curved relative to the proximal putter segment 11 at a first curve point 28, between the second curved segment 16 and the first curved segment 15 at a second curve point 32, and between the distal segment 18 and the second curved segment 16 at a third curve point 29. It is noted that in alternative embodiments, the bendable section 13 may also be provided with a third, or even more, bendable sections, these simple increasing of the number of bendable sections being within the scope of the present invention. Also, the three bending points described above may be the same or different in flexibility, but in a preferred embodiment, the third bending point 32 is less flexible than the first and second bending points 28, 32.

In the first embodiment, the first bending section 15 and the second bending section 16 are configured as a straight or slightly upward bent thin rod-like or flat structure, and both can be bent continuously under the action of external force, and the first bending section 15 and the second bending section 16 have elasticity and return to their original shapes after the action of external force is eliminated, and the first bending section 15 and the second bending section 16 form an included angle at the position of the second bending point 32, and the included angle ranges from 90 degrees to 160 degrees. The cross-sectional areas of the first and second

curved sections

15, 16 may be arranged to be the same or different and thus have the same or different bendability, for example: the second curved segment 16 may have a smaller cross-sectional area than the first curved segment 15, so that the second curved segment 16 is more flexible, and further, the cross-sectional areas of the first curved segment 15 and the second curved segment 16 may be gradually smaller or larger from the proximal end to the distal end of each. In the operation process, along with the push rod proximal segment 11 is pushed to the far end, the pull wire 20 gradually pulls the second bending segment 16, so that the second bending segment 16 is continuously bent upwards, further, the angle of the included angle between the first bending segment 15 and the second bending segment 16 is reduced, when an operator continuously pushes the push rod proximal segment 11 and the second bending segment 16 is bent to a certain degree, the first bending segment 15 is also bent upwards under the action of the second bending segment 16, and therefore a multi-stage bending structure is formed, the throat anatomical characteristics of a patient are adapted, and finally the farthest end of the device is sent to the glottis of the patient.

To facilitate the bending between the first bending section 15 and the second bending section 16, it is preferable to set the bending property of the second bending point 32 to be greater than the bending properties of the first bending section 15 and the second bending section 16, and there are various methods for increasing the bending property, such as: the cross-sectional area at the second bending point 32 is smaller than the cross-sectional areas of the first bending section 15 and the second bending section 16; or the material at the second bending point 32 may have a greater bendability than the first bending section 15 and the second bending section 16. In this embodiment, it is preferable that the materials of the first bending section 15, the second bending section 16 and the second bending point 32 are the same, and the cross-sectional area of the second bending point 32 is smaller than that of the first bending section 15 and the second bending section 16, so that the processing and production can be more convenient. Of course, in different embodiments, some changes may be made on the basis that the flexibility at the second bending point 32 is different from that of the first bending section 15 and the second bending section 16, such as setting the materials of the three sections to be partially the same or totally different, and these changes are within the protection scope of the present invention.

In an alternative embodiment, the cross-sectional area at the second bending point 32 is the same as the cross-sectional area of the second bending section 16.

The end segment 18 is connected to the bendable segment 13 at a distal position, the end segment 18 is provided in a pre-bent arc-shaped configuration or a configuration similar to an arc, and the bending direction of the end segment 18 is opposite to the bending direction of the bendable segment 13, and in the drawing of the present embodiment, the end segment 18 is pre-bent downward. A tip section 19 is arranged at the far end of the end section 18, and the tip section 19 is pre-bent downwards and forms an obtuse angle with the rest part of the end section 18; in an alternative embodiment, the entire end segment 18 may be provided in a smooth downwardly curved arcuate configuration. In the preferred embodiment, the end segment 18 begins at a third point of inflection 29 that decreases in cross-sectional area to the distal end of the end segment 18. In an alternative embodiment, the tip section 19 is arranged in a curved configuration with a constant cross-sectional area throughout the tip section 18. If the distal side of the tip 18 encounters an obstruction such as the throat wall or base of the patient's tongue during insertion into the patient's glottis, the distal side of the tip 18 may flex downward or the tip 18 may flex sideways to clear the obstruction and slide in the direction of least resistance when the operator's hand is turned, which is typically the glottic opening. Since the distal end of the pull wire 20 is connected to the proximal side of the distal end of the bendable section 13 or the connection between the end section 18 and the second bending section 16, the end section 18 will not bend upwards under the action of the pull wire 20 during the process of extending into the glottis of the patient, but will move upwards along with the bending of the second bending section 16, and the end section 18 is arranged to guide the endotracheal tube guiding device to extend into the glottis of the patient more conveniently, when the pressure from the top downwards is met during the extending process, for example, the operator intentionally makes the end section 18 touch the upper pharyngeal wall or the tongue root of the patient, so as to bend the third bending point 29 and the end section 18, so that the position of the tip section 19 of the end section can be adjusted to enter the glottis, namely, the third bending point 29 is not directly bent by the pulling force of the pull wire 20.

In the first embodiment, the direction controllable endotracheal tube guiding device further includes an auxiliary pulling wire 17. Referring to fig. 1, 2 and 5, the drawstring 20 is further divided into a drawstring proximal segment 22 and a drawstring distal segment 23, the dividing point of which is referred to as a drawstring segmentation point 25. The cross-sectional areas or the thread-like or string-like thicknesses of the proximal and

distal string sections

22 and 23 may be the same or different, and may be made of the same material or different materials, and therefore, the degrees of the back-pulling force generated while the proximal and

distal string sections

22 and 23 are elongated may be set to be the same or different. One end of the auxiliary pulling wire 17 is fixedly connected with the wire segment point 25, i.e. fixed at the junction of the proximal pulling wire section 22 and the distal pulling wire section 23, and the other end of the auxiliary pulling wire 17 is fixed on the first bending section 15 near the second bending point 32, which is called the second connecting end 27 of the auxiliary pulling wire (as shown in fig. 1 and 2). The auxiliary wire 17 is preferably a short wire-like or ribbon-like structure, and when the endotracheal tube guiding device is not in use, the auxiliary wire 17 is in a relaxed state, and during the process of extending into the patient's glottis, the connection point of the auxiliary wire 17 to the wire segment point 25 is gradually moved proximally and the connection point of the auxiliary wire second connection end 27 to the first bending section 15 is gradually moved distally due to the gradual straightening of the wire 20, and the auxiliary wire 17 is gradually straightened as the wire 20 is elongated and extended. In more detail, the auxiliary pulling wire 17 is connected with the pulling wire subsection point 25, a section of the proximal end of the pulling wire subsection point 25 is the pulling wire proximal section 22, and a section of the distal end of the pulling wire subsection point 25 is the pulling wire distal section 23. When the proximal portion 22 is straightened or nearly straightened and is difficult to re-extend, the auxiliary wire 17 is straightened or nearly straightened by the proximal portion 22 and is aligned or nearly aligned with the proximal portion 22 and pulls the first curved section 15 in a proximal direction. Another function of the auxiliary stay 17 is: during the straightening process, the bendable section 13 is prevented from being separated from the pull wire 20 too far, and the control of the tracheal catheter guiding device by an operator is ensured. In an alternative embodiment, the auxiliary wire 17 may be provided in plural.

Referring to fig. 1 to 4, in practical use, the direction-controllable endotracheal tube guiding device of the present embodiment is used together with an endotracheal tube 40. The endotracheal tube 40 is a hollow tube-like structure with both ends open, and as illustrated by way of example in fig. 3, the bougie 10 and the pull wire 20 both extend through the lumen of the endotracheal tube 40, a portion of the bendable section 13 extends out of the distal opening 48 of the endotracheal tube, and a portion of the pusher proximal section 11 is located outside the proximal opening 42 of the endotracheal tube, where the endotracheal tube 40 can be considered a control tool to confine the bougie 10 and the pull wire 20 in a narrow space, and the distal opening front wall 49 of the endotracheal tube provides a sliding point for the pull wire 20, and the proximal opening front wall 41 or side wall of the endotracheal tube provides a stop point for the pull wire 20. Both the endotracheal tube 40 and bougie 10 are manufactured with a degree of curvature, but the bougie 10 is less curved than the endotracheal tube 40, when the bougie 10 is inserted into the lumen of the endotracheal tube 40, the two interact, as shown in figure 3, the dotted lines show the degree of curvature of the endotracheal tube 40, the solid lines show the degree of curvature of the endotracheal tube 40 after insertion of the bougie 10, after the bougie 10 is inserted into the endotracheal tube 40, the curvature of the endotracheal tube 40 is significantly reduced, i.e. the front wall 46 and the rear wall 47 of the endotracheal tube, move to the left in the figure, the proximal push rod segment 11 slightly increases its curvature under the action of the endotracheal tube 40, and at the same time, the bendable section 13 within the endotracheal tube 40 also interacts with the endotracheal tube 40, with the exception that, the bendable section 13 has a large bendability, and thus, the endotracheal tube 40 can be made small in its bending.

In this embodiment, the proximal shaft segment 11, the first bending segment 15, the second bending segment 16 and the distal shaft segment 18 are all flexible. However, the proximal pushrod section 11 is relatively large in cross-sectional area and therefore relatively strong and not easily bendable, and may be made of a relatively rigid material to minimize flexibility. Under the action of external force, the first bending section 15 bends relative to the proximal section 11 of the push rod, the first bending section 15 and the second bending section 16 bend relative to each other, and the second bending section 16 and the final section 18 bend relative to each other. In view of manufacturing convenience, it is preferred in this embodiment to select the proximal shaft segment 11, the first curved segment 15, the second curved segment 16, and the distal segment 18 to be made of the same material, and to change their flexibility by selecting different cross-sectional areas. In another preferred embodiment, the transverse cross-sectional area of the pusher proximal segment 11 begins to be greater than the transverse cross-sectional area of the first curved segment 15 at the first curved point 28, while the transverse cross-sectional area of the first curved segment 15 begins to be greater than the transverse cross-sectional area of the second curved segment 16 at the second curved point 32, and the transverse cross-sectional area of the second curved segment 16 begins to be greater than the transverse cross-sectional area of the distal segment 18 at the third curved point 29. In an alternative embodiment, the transverse cross-sectional area of the pusher proximal segment 11 is greater than the transverse cross-sectional area of the first curved segment 15, and the transverse cross-sectional area at the junction of the first curved segment 15 and the second curved segment 16, i.e., the second curved point 32, is less than the transverse cross-sectional area of the first curved segment 15 and the second curved segment 16; the junction of the second curved segment 16 and the end segment 18, i.e. the third bending point 29, has a smaller cross-sectional area than the cross-sectional area of the second curved segment 16 and the end segment 18. Of course, in alternative embodiments, the desired bending properties may be achieved by changing the material of the proximal segment 11, the first bending segment 15, the second bending segment 16, and the distal segment 18 of the push rod.

In summary, the bougie 10 serves as a guide, the distal end (i.e., the distal tip section 19) of the bougie 10 is moved towards the glottis of the patient under the observation of a conventional laryngoscope or video laryngoscope and finally enters the glottis during operation, and when the operator's finger pushes the proximal rod section 11 to move distally, the proximal end of the pull wire 20 is temporarily fixed to the anterior wall 41 of the proximal opening of the endotracheal tube by a non-permanent stop, so that the pull wire 20 can provide a pulling force to the bendable section 13 when pulled, so that the first and second

bendable sections

15, 16 bend at different times to form different curves. In addition, during the extension of the end segment 18 into the glottis, the end segment 18 will flex downwardly when it touches the upper pharyngeal wall or root of the tongue, thus opposing the glottis under the control of the operator and then entering the glottis.

Referring to fig. 5a to 5d, the operation of the steerable endotracheal tube guiding device will be described in detail, wherein a complete operation is subjectively divided into a preparation stage, a first pushing stage, a second pushing stage and a third pushing stage,

fig. 5a, the preparation phase. The steerable endotracheal tube guiding device has been inserted into the endotracheal tube in preparation for insertion into the patient's mouth and then into the larynx of the pharynx. Before insertion of the endotracheal tube, the distal segment 18 is wiped with a quantity of medical lubricant and inserted into the proximal opening 42 of the endotracheal tube until a portion of the bendable segment 13 or all of the bendable segment 13 is outside the distal opening 48 of the endotracheal tube, i.e., the second bending point 32 may be inside or outside the distal opening 48 of the endotracheal tube.

In the preparation stage, the hook 21 of the pull wire 20 is hung on the front wall 41 of the proximal opening of the endotracheal tube or the left or right side wall thereof, and the operator's fingers can pinch the hook 21 and the vicinity of the opening 42 of the endotracheal tube, so as to fix the proximal end of the pull wire 20, at which time the pull wire 20 is not yet stretched, and the auxiliary pull wire 17 is in a relaxed state.

Fig. 5b, the first push phase. Pressing the push button 14 with the operator's finger pushes the bendable section 13 further out of the distal opening 48 of the endotracheal tube, and at the same time, the distal movement of the bendable section 13 shifts the pulling wire 20 distally, and the pulling wire 20 is pulled and elongated. After the first pushing stage is completed, the extensibility 1/4 to 1/3 of the pulling wire 20 is consumed, and at the same time, the pulling force of the pulling wire 20 pulls the second bending portion 16 back, so that the second bending point 32 is bent on the original basis, and the distal end side of the second bending portion 16 is lifted upward. At this time, the auxiliary pulling wire 17 is not yet elongated. Specifically, the auxiliary wire 17 is not yet elongated by the proximal portion 22 of the wire, but is still in a more relaxed state.

Fig. 5c, the second push phase. The bendable section 13, the puller wire 20 are further pushed out of the distal opening 48 of the endotracheal tube, at which time the extension capability of 1/2 to 2/3 of the puller wire 20 is used, at which time the second bending point 32 is further bent, the second bending section 16 is further bent, the first bending section 15 is also pulled upward to a lesser extent, and at the same time the connection point of the auxiliary puller wire second attachment end 27 to the first bending section 15 is moved distally, while the connection point of the auxiliary puller wire 17 to the puller wire segment point 25 is moved proximally. At the completion of the second pushing phase, the first bending point 28 is already located near the distal opening 48 of the endotracheal tube.

Fig. 5d, the third push phase. At this stage, the extensibility of the proximal pull wire section 22 is exhausted or almost exhausted, and the extensibility of the distal pull wire section 23 can be set to be exhausted or still have a small amount of extensibility, and in a preferred embodiment, the distal pull wire section 23 is not completely straightened, and the total length of the proximal pull wire section 22 is difficult to be lengthened, but due to the flexibility of the probe 10, the proximal push rod section 11 can still move a small distance distally under the pushing force of the operator. In the third pushing, the first bending point 28 is already pushed out of the distal opening 28 of the endotracheal tube, the auxiliary pulling wire 17 is completely straightened, the junction between the auxiliary pulling wire 17 and the proximal pulling wire section 22 is closer to the proximal end, the auxiliary pulling wire 17 is in line or nearly in line with the proximal pulling wire section 22, and the auxiliary pulling wire 17 pulls the first bending section 15 back together with the proximal pulling wire section 22, so that the first bending point 28 is bent significantly. The bending of the first bending point 28 plays a major role in the curve formation at this stage, and the first bending section 15 is also bent more at this time.

The third bending point 29 of the end segment 18 is not significantly bent by the pulling force of the pulling wire 20 during the above curve forming process, and since the distal segment 23 of the pulling wire is not yet completely straightened, no upward pulling force is generated on the end segment 18, so that the end segment 18 can be bent downward with the third bending point 29 as a bending point if it encounters a resistance from above, such as pharyngeal wall, base of tongue, or tissue around the base of tongue, during the pushing of the end segment 18 to the glottis. At the completion of this stage, the second bending section 16, the end section 18 can still bend downward within a certain range when subjected to an external force, since the distal section 23 of the wire is not yet completely straightened.

When the end segment 18 encounters resistance from above, the end segment 18 will bend downwardly and the end segment tip segment 19 will point more downwardly, these movements being in the opposite direction to the previous upward movements of the deflectable segment 13, thereby causing the deflectable segment 13 and end segment 18 of the entire putter distal segment 12 to move in a "snake-like" motion to prevent the end segment 18 from lifting too high to abut the patient's glottic opening. During operation, the operator can push the push button 14 and release the push button 14, so that the bougie 10 will rebound to its original position in the proximal direction due to its own elastic force, causing the movement in the proximal direction, and further the operator pushes the bougie in the distal direction, causing the snake-like movement. The surface of the end segment 18 is very smooth and is lubricated prior to use so that the end segment 18 can slide into the glottis during this "snake" movement by the operator even if the operator sees little or no estimate of the location of the glottis opening. If the operator suddenly feels the resistance to decrease or disappear once the end segment 18 enters the glottis without seeing the glottic opening, the operator can then push the push rod 11 a little more and then push the endotracheal tube into the glottis along the bougie 10 in a conventional manner.

Second embodiment and method of operation

In the second embodiment, if the design configuration and function of a certain component are the same as those in the first embodiment, the designation and the numerical designation of the component will be the same as those in the first embodiment, and if the function of a certain component is the same as that in the first embodiment but the design configuration is different, the component will be given the same designation but the numerical designation will be different.

Referring to fig. 6a and 6b, the structure of the second embodiment is substantially the same as that of the first embodiment, including a proximal putter segment 11, a distal putter segment 12, and a puller wire 20, the distal putter segment 12 further including a bendable segment 30 and a distal segment 39. The difference is that in the second embodiment, the end segment 39 includes an end circular arc segment 38 and an end proximal segment 36 which are arranged in sequence. In the preferred embodiment, the end segment 38 may be circular, straight or in between, as shown in fig. 7a and 7 e. The distal arc segment 38 is disposed at a distal side of the distal proximal segment 36, and the distal proximal segment 36 is disposed at a proximal side of the distal segment 39. The auxiliary puller wire 37 is attached at one end to the proximal end 33 of the distal segment, or to a portion near the proximal end 33 of the distal segment, and forms an angle with the distal segment 39, referred to as the puller wire angle 35. The other end of the auxiliary stay wire 37 is connected with the stay wire 20, and the connection position is the junction of the stay wire proximal section 22 and the stay wire distal section 23, namely the stay wire sectional point 25. At or near the intersection of the end segment circular arc segment 38 and the end segment proximal segment 26, the end segment 39 is connected to the distal end of the bendable segment 30 on its longitudinal left or right side by a short "bridge" segment, referred to as the connecting segment 31. As shown in fig. 6a and 6b, the connecting segment 31 is disposed at or near the distal end of the bendable segment 30, and the connecting segment 31 is connected to the right side of the end segment 39. In an alternative embodiment, the connecting segment 31 may also be connected to the left side of the end segment 39. When the proximally moving auxiliary pull wire 37 pulls the distal proximal segment 36, the connecting segment 31 is twisted, which acts as a shaft to tilt the entire distal segment 39 downward and the distal arc segment 38 moves downward. In the preferred embodiment, the connecting section 31 can be made of the same material as the end section 39, and is also elastic and flexible. In the preferred embodiment, the entire distal segment 39 or only the distal proximal segment 36 is made of a material that is sufficiently rigid so that when the distal proximal end 33 is pulled by the auxiliary pull wire 37, the entire distal segment 39 will move downward like a lever, and the material of the distal arc segment 38 may be the same as or different from the material of the distal proximal segment 36.

In the second embodiment, the design of the wire 20 and the push rod 11 is identical to that of the first embodiment. The distal end of the proximal pusher segment 11 is connected to the proximal end of the bendable segment 30 and forms a first bending point 28, and the proximal end of the pull wire 20 is still provided with the hook 21.

In the second embodiment, the auxiliary pulling wire 37 is not directly connected to the bendable section 30. The bendable section 30 is preferably designed as a smoothly curved arc-shaped structure. Of course, the bendable section 30 may be provided as a plurality of continuous bendable sections.

The second embodiment operates substantially the same as the first embodiment in that the operator pushes the proximal push rod segment 11 distally to form the bendable segment 30 into a curve by the pulling back force of the pull wire 20, but during the curve forming process, the second embodiment has no second bending point and the auxiliary pull wire 37 pulls the proximal end segment 33 to move the distal segment 39 in the opposite direction to the bendable segment 30.

The operation method of the second embodiment is described in detail below with reference to fig. 7a to 7d, and the second embodiment method is also divided into four stages as the first embodiment method: the method comprises a preparation stage, a first pushing stage, a second pushing stage and a third pushing stage.

Fig. 7a, the preparation phase. Preparatory phase the operator inserts the endotracheal tube guiding device into the endotracheal tube, during which phase the end segment 39 is inserted into the proximal opening 42 of the endotracheal tube until a part of the bendable segment 30 or the whole bendable segment 30 is outside the distal opening 48 of the endotracheal tube, and the hook 21 is hung on the proximal opening front wall 41 of the endotracheal tube or on the side wall thereof.

Fig. 7b, the first push phase. In the first stage, the bendable section 30 is pushed further out of the distal opening 48 of the endotracheal tube while the pull wire proximal section 22 is partially elongated. At the completion of the first push, the elongation capability of the pulling wire is exhausted at about 1/4 to 1/3, and the pulling wire is straightened while also generating its own resilience, thereby bending the bendable section 30. The bendable section 30 and the distal section 39 move distally as the proximal section 11 of the push rod is pushed. The entire length of the pull wire 20 is extended and the attachment point of the auxiliary pull wire 37 to the pull wire is pulled proximally by a small amount.

Fig. 7c, the second push phase. The operator pushes the push rod proximal segment 11 further out of the distal opening 48 of the endotracheal tube, and at the end of the second pushing, the extension capability of the pulling wire 1/2 to 2/3 is exhausted, and at the completion of the second pushing phase, the first bending point 28 is already located near the distal opening 48 of the endotracheal tube, the connection point of the auxiliary pulling wire 37 to the proximal end of the distal segment is pulled further proximally, the angle 35 of the pulling wire becomes larger, the proximal segment 36 of the distal segment gradually approaches the bendable segment 30, and the entire distal segment 39 moves obliquely downward.

Fig. 7d, the third push phase. The operator pushes the push rod even further, and the operator's finger requires more force to push the bendable section 30 further out of the distal opening 48 of the endotracheal tube, and the pull wire has run out of full or nearly full extensibility. If the pull wire has run out of its full extensibility, the proximal segment 22 of the pull wire cannot be lengthened any more, but the bendable segment 30 and the first bending point 28 can be bent any further, so that the bendable segment 30 can still be bent further in a limited upward direction, while also pushing the distal segment 39 upward; the attachment point of the auxiliary wire 37 to the wire is further pulled proximally and gradually in line or nearly in line with the proximal wire section 22, and the auxiliary wire 37 together with the proximal wire section 22 pulls the proximal end 33 of the distal section in the proximal direction, thereby further tilting the entire distal section 39 downward; the proximal end 33 of the end segment may even extend beyond the bendable segment 30, with the end segment circular arc segment 38 further sloping downward, with the distal end of the end segment circular arc segment 38 pointing upward. Thus, the entire end segment 39 can be moved against the bendable segment 30 during the third stage of pushing, resulting in a "snake-like" motion, while the operator can also choose to apply a rotational movement of the wrist while pushing against the proximal push rod segment 11, making it easier for the end of the end segment circular arc segment 38 to move towards and then into the glottis.

In the present embodiment, the end segment 38 is located at a distal portion of the end segment 39, which may also be referred to as an end distal segment. The end segment circular arc segment 38 is provided with a rounded hook-like configuration for the purpose of bending the most distal portion of the end segment 39 downwardly. However, in other embodiments, the end segment 38 may be curved downward to form an arch, an arc, a wave, a straight line or a nearly straight line. In one of the above embodiments, the distal segment 36 is of constant design, but the distal segment is arranged in a nearly straight line, smoothly connecting the distal segment 36, and the entire distal segment 39 forms a structure similar to the triangular surface of the roof, but the top of the arch is an obtuse angle, as shown in fig. 7 e. In this alternative embodiment, the end segment 39 is still connected to the bendable segment 13 and the auxiliary wire 37 in the same manner, both of which are functionally and material identical, as well as the manner in which the wire angle 35 operates during operation.

Either distal end segment is provided so that the entire distal end segment 39 moves downwardly during lifting by the bendable segment 13 and pulling by the auxiliary pulling wire 37, thereby creating a movement opposite to the upward bending of the bendable segment 13, thereby creating a similar serpentine-like motion.

It should be noted that in the embodiment shown in fig. 7e, another form of the stay wire 20 is shown accompanying the bougie 10, and the stay wire surrounds or wraps around the bougie 10, placing the bougie 10 in the hollow portion of the longitudinal central axis of the stay wire 20.

Third embodiment and method of operation

In the third embodiment, if the design configuration and function of a certain component are the same as those in the first embodiment. The nomenclature and number designation of the components will be the same as in the first embodiment and if a component functions the same as in the first embodiment but is not designed in the same configuration, the component will be given the same nomenclature but with a different numerical designation.

The third embodiment has substantially the same structure as the first embodiment, and is different from the first embodiment in that the provision of the auxiliary wire is eliminated in the third embodiment, with reference to fig. 8, 9, and 10. The bougie 10 also includes, in sequence, a proximal bougie segment 11 and a distal bougie segment 51. The pusher distal section 51 includes a bendable section 55 and a distal section 58. In the third embodiment, the distal end of the pulling wire 52 is fixed on the end segment 58, and the proximal end of the pulling wire 52 is detachably fixed on the front wall 41 of the proximal opening of the endotracheal tube or the side wall thereof, and is fixed by the parking device as described in the first and second embodiments, and the movement of the end segment 58 is directly controlled by the pulling wire 52 during the forward movement of the bougie 10.

In the third embodiment, the bendable section 55 is a smoothly bent arc-shaped structure, a first bending point 28 is disposed at a connection point of the bendable section 55 and the proximal section 11 of the push rod, the first bending point 28 is the same as the first bending point 28 in the first embodiment, the bendable section 55 and the end section 58 are connected to form a smooth curve, the bendability of the end section 58 and the bendable section 55 may be the same or different, and preferably, the bendability of the end section 58 is greater than that of the bendable section 55.

The distal segment 58 is further divided proximally to distally into a distal bendable segment 56, a distal mid-segment 57, and a distal tip segment 59. The distal end of the bendable section 55 is connected to the distal bendable section 56. The distal bendable section 56 may be designed to be smaller in cross-section than the bendable section 55 and thus more easily bent, with the distal end of the distal bendable section 56 being connected to the distal mid-section 57. The distal end of pull wire 52 is connected to the distal mid-section 57 in two ways: first, the distal end of the pulling wire 52 is designed into a fan-shaped plate-shaped structure, called a pulling wire distal end connecting plate 53b, as shown in fig. 8, and the fan-shaped wide end thereof is connected with the end middle section 57; second, the distal end of the pulling wire 52 is divided into three or more tree-root-like structures and then connected to the distal middle segment 57, referred to as the distal pulling wire connecting root 53a, as shown in fig. 9a-9d and fig. 10. Both of these connections, collectively referred to as the pull wire distal end connections, draw the entire distal segment 58 downward, and, in addition to the more flexible nature of the distal bendable segment 56, the entire distal segment 58 will bend downward uniformly under the pull of the pull wire 52. Of course, in a preferred embodiment, the distal connection of the pull wire may also be provided as a single wire-like structure.

In this embodiment, the bendable section 55 is shaped like the bendable section 30 of the second embodiment, but in the third embodiment, the bendable section 55 is stiffer and allows the distal endotracheal tube section 43 to bend upward when inserted into an endotracheal tube, whereas the inherent curvature of the distal endotracheal tube section 43 allows the bending of the bendable section 55 to be slightly reduced, so that the degree of bending of the bendable section 55 naturally increases and bends further upward when the bendable section 55 is pushed out of the distal endotracheal tube opening 48; the end section 58 has a thin cross-sectional diameter and a small cross-sectional area, and is prefabricated into a uniform downward-bent "crescent" arc structure, so that the end section 58 is easily bent further downward along its original arc shape under the pulling or pressing of an external force. In this embodiment, the pulling wire 52 is designed in a spring shape, a spiral shape or a wave shape as in the first embodiment, has extensibility and can generate a pulling force, but the auxiliary pulling wire is omitted, so that the proximal and distal pulling wire sections are not separated.

The third embodiment operates on substantially the same principle as the first and second embodiments, and prior to use, the device is inserted into an endotracheal tube 40, and the hook 21 secures the proximal end of the pull wire 52 to the open front wall 41 of the proximal end of the endotracheal tube, or to the left or right side wall thereof. When the pushing button 14 is pushed by the operator, the bendable section 55 moves out of the distal opening 48 of the endotracheal tube, the inherent upward bending curvature of the bendable section 55 naturally bends upward after being released from the restriction of the distal section 43 of the endotracheal tube, and when the proximal push rod section 11 is pushed to the distal end, the pull wire 52 is gradually elongated and generates a pulling force on the distal section 58, and when the pushing button 14 is pushed by the operator, the distal push rod section 51 continues to move distally, the pull wire 52 is pulled downward and backward through the distal pull wire connecting distal section 58, and the entire distal section is obliquely pulled downward with the distal bendable section 56 as a bendable section. The end tip segment 59 points downward so that the entire end segment 58 moves in the opposite direction to the bendable segment 55 and both form a "snake" like motion, thus making it easier to end the glottis.

The working principle of the third embodiment is described in detail below with reference to fig. 9a to 9 d. For convenience of description, in this embodiment, the direction-controllable endotracheal tube guiding device is also divided into 4 procedures: the method comprises a preparation stage, a first pushing stage, a second pushing stage and a third pushing stage.

Fig. 9a, the preparation phase. In the preparation stage, the bougie 10 and the pull wire 52 are inserted from the proximal end of an endotracheal tube until a part of the end segment 58 is completely located at or outside the distal opening 48 of the endotracheal tube, the hook 21 of the pull wire 52 is hung on the front wall 41 or the side wall of the proximal opening of the endotracheal tube, and the operator's fingers can hold the hook 21 and the proximal opening 42 of the endotracheal tube, so that the proximal end of the pull wire 52 is fixed.

Fig. 9b, the first push phase. The operator presses the push button 14 with his finger to push the bendable section 55 further out of the distal opening 48 of the endotracheal tube, the movement of the bendable section 55 also pulls the pull wire 52 distally, the pull wire 52 is slightly elongated, the bendable section 55 bends upward in its original curved arc and lifts the end section 58 high, and the end section 58 is not pulled significantly downward at this time.

Fig. 9c, the second push phase. As the operator further advances the bougie distally, the bendable section 55 and pull wire 52 are further moved out of the distal opening 48 of the endotracheal tube, the pull wire 52 is further pulled, its extendable capacity of about 1/2 to 2/3 is consumed, although at this time the pull wire 52 is not straightened, but at the completion of the second push phase, the first bending point 28 is located at or within the distal opening 48 of the endotracheal tube, the tension of the pull wire 52 is increased, so the pull wire 52 begins to pull the distal section 58 obliquely downward.

Fig. 9d, the third push phase. Although most of the stretchability of drawstring 52 has been exhausted after the second pushing phase and its length can still be elongated, the tension of drawstring 52 is significantly increased, and thus, drawstring 52 is significantly bent by pulling distal intermediate section 57 and distal bendable section 56. At the completion of the third push, pull wire 52 may also be set to be fully straightened. Even after the third push, the total length of pull wire 52 can no longer be elongated, but because bendable section 55 is bendable, proximal shaft section 11 can still move a distance distally under the more forceful pushing action of the operator. At this point the first flex point 28 has moved out of the endotracheal tube distal opening 48 and, therefore, the first flex point 28 is flexed. At this time, in the third pushing stage, the end tip section 59 is pushed toward the glottic opening, the operator's hand intermittently releases the pushing button 14 and then pushes the pushing button 14 again, so that the bendable section 55 makes a "snake" motion, so that the end tip section 59 can be aligned with the glottic opening at the distal end and then enter the glottic opening according to the partial anatomy of the throat of different patients, and the end section 58 can be bent downward if encountering resistance from an obstacle above, such as the throat or the tongue root.

The end section 58 is formed in the above curve, the end section bendable section 56 is pulled by the pulling wire 52 to bend downward, so that the entire end section 58 is inclined downward, and further, if the end section 58 meets resistance from above, the end section bendable section 56 can be pressed to bend downward.

Referring to fig. 10, there is shown another method of using the steerable endotracheal tube guiding device according to the third embodiment of the present invention, according to the operator's experience with regard to the evaluation of the partial anatomy of the larynx of a particular patient, the operator inserts the guiding device into the endotracheal tube with a small portion of the end segment 58 outside the distal opening 48 of the endotracheal tube, and the hook 21 is suspended outside the proximal opening 42 of the endotracheal tube, i.e., the hook 21 is not yet hung on the proximal opening front wall 41 of the endotracheal tube, and when the operator pushes the push rod proximal segment 11 distally, the pull wire 52 slides down along the front wall 46 of the endotracheal tube, so that the hook 21 is hung on the proximal opening front wall 41 of the endotracheal tube during the movement, and the subsequent process is the same as that shown in fig. 9a to 9 d.

In an alternative embodiment, as shown in fig. 7e, the end segment circular arc segment 38 may be arranged not as a circular arc but as an almost straight line or a slightly circular arc. This nearly rectilinear or slightly rounded design can be used in the first, second and third embodiments described above, without the method of operation described above changing.

While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims

1. A direction controllable endotracheal tube guiding device which is inserted into a lumen of an endotracheal tube for use with the endotracheal tube, comprising

The probe is of a strip rod-shaped structure, the probe comprises a push rod proximal section and a push rod distal section, the push rod distal section comprises a bendable section and a tail section, the bendable section proximal end is connected with the push rod proximal section to form a first bending point, and the far end of the bendable section is connected with the tail section;

the pull wire is a strip-shaped or rope-shaped linear structure, a part or the whole of the pull wire is arranged into a spiral, spring-shaped or wavy linear structure, the pull wire can be extended and elongated under the action of external force and generates a back tension force, the proximal end of the pull wire is fixed at the proximal opening of the endotracheal tube, the distal end of the pull wire is fixed at the distal section of the push rod, and the pull wire is elongated and generates the back tension force in the process that the distal section of the push rod moves towards the distal end;

from the near end to the far end, the stay wire and the bougie go with each other, the stay wire is arranged on one side of the bougie, or the stay wire is wound around or wound around the bougie.

2. The steerable endotracheal tube guidance device of claim 1 wherein the distal push rod segment is more flexible under an external force than the proximal push rod segment to form a curve, and the bendable segment comprises a first bendable segment and a second bendable segment, the first bendable segment and the second bendable segment being joined to form a second bending point, the second bending point being more flexible than the first bendable segment and the second bendable segment.

3. The steerable endotracheal tube guidance device of claim 2 wherein the distal segment is configured to be pre-bent downward and is further bendable by an external force in a direction opposite to the bending direction in which the bendable segment is bent upward, and wherein the proximal end of the distal segment is connected to the distal end of the bendable segment to form a third bending point that is more bendable than the bendable segment and the distal segment.

4. The steerable endotracheal tube guidance device of claim 3, characterized in that the pull wire comprises a proximal pull wire section and a distal pull wire section, the proximal pull wire section and the distal pull wire section having the same or different cross-sectional areas, and the proximal pull wire section and the distal pull wire section are elongated to generate the same or different pull-back forces.

5. The steerable endotracheal tube guiding device of claim 4, further comprising an auxiliary wire, one end of which is connected to the junction of the proximal and distal pull wire segments, the other end of which is connected to the distal end of the bendable segment near the second bending point, the auxiliary wire drawing the bendable segment together with the proximal pull wire segment and bending the first bending point during the gradual or almost simultaneous straightening thereof.

6. The steerable endotracheal tube guiding device according to claim 5, characterized in that the left or right side of the longitudinal direction of the tip section is connected to the bendable section via a connecting section having flexibility, and the distal end of the auxiliary wire is connected to the tip section proximal section, and when the tip section proximal section is pulled, the connecting section is twisted to move the tip section obliquely downward with the connecting end as a rotation point.

7. The steerable endotracheal tube guidance device of claim 6 wherein the distal segment includes a distal circular arc segment in a downwardly curved state and a distal proximal segment connected to one end of the auxiliary pull wire, the distal segment having sufficient stiffness to allow the entire distal segment to move downwardly when the distal proximal segment is pulled by the auxiliary pull wire.

8. The steerable endotracheal tube guidance device of claim 7, wherein the first and second curved segments can have the same or different cross-sectional areas, the first and second curved segments can be of the same or different materials, and the first curved point can be curved upwardly by a significant pull after being pushed out of the distal opening of the endotracheal tube.

9. A steerable endotracheal tube guidance device according to claim 1 characterized in that the proximal end of the pull wire is non-permanently affixed to the proximal opening of the endotracheal tube by a docking device.

10. The endotracheal tube guiding device according to claim 1, wherein the bendable section is provided with a rounded arc shape which is preliminarily bent upward, the end section is provided with a rounded arc shape which is preliminarily bent downward, the end section is connected to a distal end of the bendable section, a cross-sectional area of the end section becomes smaller when the end section is connected to the bendable section so as to be pulled and bent by the pull wire and continue to be bent along an original downward arc shape, the material of the bendable section has a higher hardness than that of the endotracheal tube, the bent arc shape of the bendable section and the material of which the bendable section is made have a hardness which allows the distal end of the endotracheal tube to be further bent upward, and the upward bent arc shape of the bendable section is restricted by the distal end of the endotracheal tube so as to reduce an original bending degree of the bendable section.

11. An endotracheal tube guiding device according to claim 10, characterized in that the distal end of the pull wire is provided with a pull wire distal section attachment plate or a pull wire distal end attachment stub, the pull wire distal section attachment being connected to the tip section so that the tip section bends downward when the pull wire pulls the tip section.