DE102009018627A1 - Apparatus for impact crushing of excrement in rectum of e.g. paraplegic patient and for removing excrement from rectum, has visualization component, where visual control takes place by component during impacting water jet on excrement - Google Patents

Abstract

The apparatus has an intestine tube (10), a nozzle tub (20) and a visualization component movable with respect to each other. The tubes and the visualization component are not connected to each other in position fixed or angularly rigid manner. Operational modes of the apparatus are visually controlled by the visualization component, which includes an optical speculum or a camera. The visual control takes place by the visualization component during impacting water jet (25) on excrement (6) in rectum (1) or within time span of ten minutes before or after impacting water jet on the excrement.

Description

Technical area:

The The invention relates to an apparatus for impact crumbling of faeces especially in the human rectum (rectum) and for removal of shredded faeces from the rectum. About thirty percent People in Germany suffer from constipation (constipation). Hard bugs damage the continence organ to the following Manner: The rectum can not reduce the diameter of hard bugs relaxes and widens. At every defecation (faeces excretion) hard and big droppings of, for example, five centimeters Diameter it comes to overstretching and damage of the Anal canal, which in adults through the anorectal muscle ring designed for droppings of about three centimeters in diameter is. The fecal bales can not permanently softer, malleable and be made thinner by exercise or sport by increased supply of fluid, fiber or more food in general, about the transit speed of the food through the gastrointestinal tract to accelerate, it comes to progressive Damage important for the fine continence Hemorrhoidal pads in the form of nodules, thrombosis, open bleeding, inflammation or scarring. at The defecation of hard and large droppings will be the mostly enlarged by the previous damage Hemorrhoidal pad from the feces through the anorectal muscle ring pressed outside, what a violent and painful detachment the rectal mucosa of the rectal musculature and as a result of which can cause anal fissures. Even if the anal prolapse (Incident) in third-degree enlarged Hämorrhoidalpolstern can still be repositioned (pushed back manually) becomes the connective tissue of the detached mucosa between Do not adequately regenerate the defecations.

Standard treatment proposal the proctologist (rectal specialist) is the operative rehabilitation means Stacker hemorrhiodopexia or lobule plastic associated with inpatient hospitalization. The operational rehabilitation can be made difficult by the injured Rectal mucosa or by existing inflammation and would be easier and less risky or possibly even superfluous if there were an apparatus which allow defecation without anal prolapse would. The surgical rehabilitation of the continence organ eliminated not the constipation, so the cause of the tissue damage.

at People, for example, under the so-called slow-transit constipation may suffer despite surgical rehabilitation of the continence organ and surgical Colonic shortening does not shorten the suffering of constipation always be eliminated, which may be an artificial one Intestinal exit is necessary.

Also for many people with paraplegia would be a device for removing faeces from the rectum is desirable, to the disadvantages of hours of toilet rest, uncontrolled droppings or digital clearing (manual faeces removal) to avoid.

State of the art:

In the known method of colon hydro-therapy (intestinal lavage), as described for example in DE 29710842 U1 , a twin tube is inserted into the rectum, and with the drainage tube closed, irrigation fluid is passed through an inlet tube under low pressure into the intestine. After a contact time, the rinsing liquid is allowed to drain through the drainage pipe, whereby the feces are only dissolved but not mechanically broken up. Constipation is useless in constipation because hard and large bugs block the outlet.

At the in DE 3233401 A1 and DE 2343492 A1 Rinsing devices described can be sprayed in different directions without visual control after introduction of the jet into the rectum water jets, which can perforate the intestinal wall at high pressure. The defecation leads to anal prolapse, because it lacks a gut tube to drain.

Also known is the removal of faeces from the intestine by means of an endoscope as described, for example, in US Pat DE 3933085 C2 , The disadvantages of this solution are the high costs for endoscope, holder, light source, camera, monitor, jet pump and suction pump, as well as the complicated cleaning after use and the enormous amount of time, for example, to shred one hundred grams of feces and through the endoscope working channel with three To suck off the diameter of a millimeter.

The Object of the present invention is an apparatus for fast Removal of faeces, including hard and large droppings, from the rectum, taking the feces in the rectum to shred and possibly by mucosal detachment, enlarged by third degree Hemorrhoidal pads, through anal fissures, through scars or tissue damaged by inflammation of the continence organ and to avoid an anal prolapse is. A single person should use the apparatus in a usual Can operate toilet room. The solution of the task takes place by the features of claim 1.

1 shows a cross section of the rectum with the working apparatus of the invention, wherein the representation of two jet pipes 20 and two jets of water 25 the movement of the same should be indicated.

2 shows the two most important components of the apparatus according to the invention.

3 and 4 show a cross-sectional view of a person operating the apparatus.

A possible embodiment of the apparatus according to the invention, hereinafter referred Exfercator (feces remover), requires as a working environment a conventional toilet room with toilet bowl, hand basin and additional water outlet valve, preferably a thermostatically controlled shower fitting, and half filled with water Ten-liter bucket ( 29 in 3 ) on a table or chair 30 , By way of example, a gut tube is used as exferator components 11 ( 2 ) with stylet (insertion aid, obturator) 17 , a beam pipe 20 with valve 21 and connection hose 23 , a mirror 27 in 4 (preferably a swiveling magnifying mirror with a diameter of twenty centimeters and a base), a lamp 28 with ten to twenty light-emitting diodes with neutral white ten-degree cone of light for use.

Of the Exfecator can be provided by a qualified helper or as in the following Example of a non-paralyzed adult without a helper to be served.

To prepare is the hose 23 of the jet pipe 20 to connect to the water outlet valve and to ensure that the closed valve 21 of the jet pipe 20 about thirty-seven degrees Celsius warm water with the usual line pressure of three to ten bar is pending. A pressure reducer can be used if required.

The rod-shaped exfercator stylet 17 ( 2 ) until the depth stop 18 into the cylindrical exferator tube 10 inserted and coated both with a suitable lubricant.

For use on the adult has the intestinal tube 10 an outer diameter of 25 to 30 mm with 2 to 3 mm wall thickness, consists of a water, manure, lubricant, cleaning agent and disinfectant-resistant metal or plastic, is suitable for an insertion depth in the rectum of about 14 cm, has rounded edges 11 and may have an insertion depth limitation by a thickening or collar 12 exhibit.

The Exfecator intestinal tube 10 and the Exfecator Mandrin 17 correspond in shape and material to a conventional proctoscope according to Kelly, but differ in the following points: Proctoscopes have predominantly a maximum insertion depth of about eight centimeters, the Exfecator intestinal tube 10 about fourteen inches. Third-degree enlarged Hämorrhoidalpolster fall in front of the opening of the proctoscope, the exfercator tube pushes it to the side. Proctoscopes are led by proctologists and usually have a sharp-edged intestinal tube to facilitate insertion into the rectum together with the proctoscope stylet. In DE 10157288 A1 The problems of the sharp-edged proctoscope intestine tubes, which make an axial displacement impossible without an inserted proctoscope stylet, are described in detail. To minimize the risk of injury when used by medical laypersons, and to allow for axial displacement without stylet, the Exfecator Intestinal Tube should 10 rounded edges 11 with a millimeter radius of curvature. The with attached exfercator stylet 17 remaining level is smeared with lubricant and hardly interferes with practical use.

Particularly cylindrical, non-cone-shaped proctoscope intestine tubes and proctoscope mandrels, when put together, usually form an air-impermeable unit. After insertion into the rectum, pulling out the proctoscope mandrin in the rectum produces a negative pressure which often sucks tissue of the intestinal mucosa over the sharp proctoscope-intestinal tube edge into the intestinal tube and thereby injures it. To work around this problem with the Exfecator, there is a ventilation gap 19 ( 2 ) of about half a millimeter width between a cylindrical expectorator tube and mandrin.

Proktoscopes must be guided by proctologists to a stable, large handle, the exfercator tube handle is superfluous and missing. Instead, the exfercator tube becomes 10 with a light, flexible attachment 13 ( 1 ) is loosely fixed to the body of the user so that it does not slip out after insertion into the rectum. As particularly hygienic, inexpensive and easy to handle here is the execution of the intestinal tube attachment 13 in the form of two wire loops pulled through intestinal tube bores 14 and 15 ( 2 ) made of plastic-insulated copper wire with about two millimeters outside diameter, the first wire loop 14 ( 3 ) a length of about 140 cm and the second wire loop 15 has a length of about 50 cm.

The lubricant-coated exferator tube 10 with inserted exfercator stylet 17 is standing over the toilet bowl with bared abdomen slowly inserted into the rectum, the wires of the longer loop 14 be over the Back and both shoulders out and in front of the belly with the shorter wire loop 15 connected by means of spiral spring with hooks or simply by twisting 16 ( 3 ). The Exfecator Mandrin 17 gets slow at the depth stop 18 pulled out and with the soiled tip into the water of the water bucket 29 hanged.

The now finished-installed intestinal tube 10 ( 1 ) prevents anal prolapse, protects the hemorrhoid pads 3 , allows a view into the rectum for visual control, creates freedom of movement for the radiant tube 20 and water jet 25 , allows the outflow of pressureless water 7 and crushed droppings 6 and, if necessary, thanks to its rounded edge 11 used as a scraper for feces, more feces in the sphere of action of the water jet 25 to transport.

The mirror 27 ( 4 ) is placed on the back of the toilet seat, and the inside of the rectum 1 is by means of a lamp 28 visually inspected. Normally, only feces can be seen, so that can be started with the impact crushing. The main problem with crushing faeces in the rectum is that they are hard bugs 2 much more stable than the surrounding intestinal mucosa 8th who may be deficient, deficient in blood circulation, injured, inflamed or scarred. Users of the exferator must be aware that a liquid jet whose impact energy is suitable for crushing hard feces in an acceptable time, when hitting the mucous membrane 8th Within a few seconds a bleeding wound is produced.

The However, risks when working with the Exfecator are not higher to estimate as when driving or handling dangerous Tools.

Normally, the use of the exfercator beam is not critical even for users with average sensitive rectal mucosa and average hearing after about fifty applications, even without visual control. You feel the beam direction and the beam intensity and the feces thickness up to the mucous membrane, and you can hear the gurgling sounds with active water jet, whether you are radiating against the intestinal tube or feces. However, with limited mucosal sensitivity or paraplegia, visual control is essential. The simple visual control by means of mirror 27 and lamp 28 is possible without further technical effort such as splash guard and automatic mirror cleaning in a standard toilet room only with deactivated water jet, so that impact crushing and visual inspection must be done alternately sequentially.

An example is the guidance of the water jet 25 a forty-centimeter long stainless steel tube 20 ( 2 ) with four millimeters outside diameter and two millimeters inside diameter without further nozzle 24 used. The jet pipe 20 is bent at an angle of one hundred and five degrees after thirty centimeters and is attached to a valve via suitable screw connections 21 , preferably on a half inch ball valve, with a flexible hose 23 connected to the power supply. The bent part of the jet pipe 20 when not in use (during visual inspection) on the edge of the bucket 29 ( 4 ) or when used in the intestinal tube 10 ( 3 ). The valve 21 of the jet pipe 20 ( 3 ) is located about twenty inches in front of the pubic bone of the user sitting on the toilet bowl, so that the jet pipe 20 comfortably with the left hand on the valve can be performed. If the valve is pulled up or to the left relative to the body axis, the jet direction of the water jet also changes 25 in the intestinal tube and rectum up or to the left (relative to the tube in horizontal position as during the visual inspection). Further beam angle changes when using, for example, directly at the beam exit 24 angled jet pipes can be brought about by rotation of the jet pipe, wherein the angular position of the axis of the valve lever 22 indicates the angle of rotation of the jet pipe.

By turning the valve lever 22 with the right hand that will be the valve 21 opened and the water jet 25 activated. Advantageous for a uniform material removal is a meandering movement of the jet pipe. If you direct the stream of water against the inner walls of the intestinal tube, it fans out ( 9 in 1 ) and can neither chop feces nor injure mucous membrane. This angle-controlled weakening of the impact shredder saves frequent valve operation. Pressure-free liquid 7 and crushed droppings 6 fall or slide immediately by gravity through the intestinal tube 10 in the toilet bowl. After about twenty seconds of beam time, the valve becomes 21 closed again and the result by mirror 27 ( 4 ) and lamp 28 visually inspected. Usually, after about eighty seconds of total jet time, one hundred and twenty grams of feces are crushed and removed. Detecting a clean intestinal mucosa during visual inspection in a region of the radiation area 8th It is necessary to leave this region at the next irradiation, or to stop use of the expectorator, the intestinal tube 10 to remove and in the bucket 29 take off where it later along with the stylet 17 by water jet 25 can be roughly cleaned.

The rectum is not completely cleared of feces, but it remains a small remainder until the next application. Because the Exfecator no sub Supported by intestinal perestalsis, a pressing diaphragm or a functional anorectal muscle ring 4 needed, it is also suitable for people with severe neural abdominal injury. Usually, the Exfecator must be used twice a day with normal nutrition, which in each case requires a time of about fifteen minutes, including cleaning of the intestinal tube and the mandrin.

The indirect visual control through the intestinal tube may be via mirrors 27 ( 4 ) or for use by paraplegics via a camera-screen system. The prototype exfercator camera consists of a mini-CCD camera with macro-telephoto lens, a ring light of twelve neutral-white light-emitting diodes with ten-degree cone of light, a water jet-resistant housing with only five centimeters deep for use inside the toilet Bowl and an adjustable bracket clamped between toilet bowl rim and toilet seat. For a good picture quality the visual check should be done with deactivated water jet. A dirt-repellent, nano-coated front lens of the camera is helpful.

The Image of the camera can be used on portable exfercator apparatuses A video glasses will be displayed instead of an unwieldy one Monitors or laptop PCs. For an exfécator without Pressure water pipe should work, is the power supply of the jet pipe from a canister by means of a pump (similar to a car washer) or by means of compressed air hand pump (similar to garden sprayer) proposed.

The novelty of the apparatus according to the invention results from the combination of all the components listed in claim 1 and their features. The five main features in short form are:
The intestinal tube 10 gently creates space for the jet pipe 20 , the liquid jet 25 and looking into the rectum with a mirror 27 or camera. The jet pipe 20 that is relative to the intestinal tube 10 is movable and over valve 21 and hose 23 features a steerable high pressure fluid jet 25 free. The liquid jet 25 Crushed with its impact energy 26 the droppings 2 in the rectum 1 , The angular position of the intestinal tube 10 removes spent blasting fluid 7 and crushed feces 6 by gravity from the rectum 1 , The visualization component controls the work results and enables the effective and safe use of radiant tube 20 , Liquid jet 25 and intestinal tube 10 ,

Advantages: For the first time the novel apparatus satisfies the long-standing Need of those people suffering from constipation, paralysis or suffering from the continence organ, alone and painless to rid their rectum of faeces of any consistency, taking the apparatus can be produced inexpensively and in a conventional Toilet room and with little time effort by medical layman successful can be used.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - DE 29710842 U1 [0005]
• - DE 3233401 A1 [0006]
• - DE 2343492 A1 [0006]
• - DE 3933085 C2 [0007]
• - DE 10157288 A1 [0017]

Claims (1)

Apparatus for crushing crushed feces in the rectum and for the removal of feces from the rectum, characterized in that the apparatus consists of at least one intestinal tube and at least one jet pipe from which at least one outlet opening at least one liquid jet can escape, and from at least one Visualization component, which indirectly allows the view through the intestinal tube, wherein intestinal tube, beam tube and visualization component are mutually movable or non-fixed position or angle rigidly connected to each other and that when used according to the invention in its dimensions by less than ten percent mechanically deformable intestinal tube with at least one rounded Edge with a radius of curvature of at least half a millimeter in terms of its dimensions is such that it can be introduced without damage to biological tissue through the anus in the rectum of a human or animal at least so far that no H Morrhoidengewebe the view through the intestinal tube blocked in the rectum, and that by means of at least one in use according to the invention in its dimensions by less than ten percent mechanically deformable directly or indirectly, manually or motor-guided beam tube whose outer diameter corresponds to at most half the inner diameter of the intestine tube, and which is fed by at least one shut-off or throttle valve and at least one flexible hose with liquid which is under a pressure of one to ten bar, at least one liquid jet emerging from at least one outlet opening of the jet pipe, on the faeces in the rectum can be directed and acts on the faeces, and that the feces in the rectum is crushed mainly by the impact energy of the at least one liquid jet, and that, while at least one liquid jet acts on the faeces in the rectum, the intestinal tube at an angle to the direction of gravity that allows dropping or slipping of pressureless fluid or minced manure through the rectal tube from the rectum, and that the operation of the apparatus is visually controlled by at least one visualization component consisting of at least one optical mirror or at least one camera; visual control takes place while at least one jet of liquid acts on the faeces in the rectum, or within a period of ten minutes before or after at least one jet of fluid acts on the faeces in the rectum.