DE3115192A1 - Instrument zur entnahme von tracheobronchialem sekret und zum einfuehren von tuben, sonden, kathetern, endoskopen und dergleichen in den respirationstrakt - Google Patents
Instrument zur entnahme von tracheobronchialem sekret und zum einfuehren von tuben, sonden, kathetern, endoskopen und dergleichen in den respirationstraktInfo
- Publication number
- DE3115192A1 DE3115192A1 DE19813115192 DE3115192A DE3115192A1 DE 3115192 A1 DE3115192 A1 DE 3115192A1 DE 19813115192 DE19813115192 DE 19813115192 DE 3115192 A DE3115192 A DE 3115192A DE 3115192 A1 DE3115192 A1 DE 3115192A1
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- distal end
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/04—Endoscopic instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00098—Deflecting means for inserted tools
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00147—Holding or positioning arrangements
- A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/267—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the respiratory tract, e.g. laryngoscopes, bronchoscopes
- A61B1/2676—Bronchoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/04—Tracheal tubes
- A61M16/0488—Mouthpieces; Means for guiding, securing or introducing the tubes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
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- Life Sciences & Earth Sciences (AREA)
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- Animal Behavior & Ethology (AREA)
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- Heart & Thoracic Surgery (AREA)
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- General Health & Medical Sciences (AREA)
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- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Pathology (AREA)
- Optics & Photonics (AREA)
- Physics & Mathematics (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Otolaryngology (AREA)
- Emergency Medicine (AREA)
- Physiology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Endoscopes (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Prostheses (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
Description
t» »
Anmelder: Prof. Dr. med. Christian Krüger, Curtiusstraße 4, 2400 Lübeck
Instrument zur Entnahme von tracheobronchialem Sekret und zum
Einführen von Tuben, Senden, Kathetern, Endoskopen und dergleichen in den Respirationstrakt.
Für die Diagnostik intrathorakaler Krankheiten ist es erwünscht, tracheobronchiales Sekret z.B. zur bakteriologischen
Untersuchung zur Verfügung zu haben. Hierzu ist man in der Praxis auf die Untersuchung des Speichels, der
auch Bestandteile' der Mundhöhle und des Rachenraumes enthält, angewiesen. Die notwendige Separierung von tracheobronchialen
Sekretanteilen kann nur von erfahrenen Laboratorien durchgeführt werden und erfordert einen hohen
Aufwand. Es ist jedoch möglich, unter Anwendung von Bronchoskopen eine Absaugung von tracheobronchialem Sekret
oder eine transtracheale Aspiration zum Keim- oder Zellnachweis vorzunehmen. Beide Methoden sind jedoch sehr aufwendig,
nur von geübten Ärzten durchzuführen und sind nicht ohne Risiko anzuwenden.
Die Aufgabe der Erfindung besteht darin, ein Instrument zur !Entnahme
von tracheobronchialem Sekret zu entwickeln, welches mit geringsten Mitteln einfach herstellbar ist und routinemäßig von jedem Arzt zur
Anwendung gebracht werden kann. Weiterhin soll das Instrument zum Einführen
bestimmter Teile, wie Tuben, Katheter und dergleichen, in den Respirationstrakt geeignet sein.
Diese Aufgabe wird nach der Erfindung durch ein Instrument gemäß den kenn-
zeichnenden Merkmalendes Anspruches 1 gelöst. Weitere vorteilhafte
Merkmale ergeben sich aus den Unteransprüchen, auf die zur Vermeidung von Wiederholungen verwiesen wird.
Durch die Verwendung dieser Lösung ist es möglich/ tracheobronchiales
Sekret auf einfache unterschiedliche Art zu entnehmen .
Nach einer Möglichkeit ist nach öffnen der Tubusdurchbrechung
ein in den Tubus eingeführter Sammelbehälter mit der dem Larynxraum zugekehrten Durchbrechung in Überdeckung
zu bringen^1 so daß dann tracheobronchiales Sekret in den
Sammelbehälter gehustet werden kann, welches anschließend nach Herausziehen des Sammelbehälters aus dem Tubus zu
untersuchen ist.
Nach einer anderen Möglichkeit wird der Tubus im Bereich der Durchbrechung mit einer spitzwinkelig zur Längsrichtung
verlaufenden, mit dem distalen Durchbrechungsende abschließenden Rampenfiläche versehen. In diesem Fall wird die Durchbrechung
beim Einführen des distalen Tubusendes in die Speiseröhre durch einen in den Tubus eingeführten Verschluß
abgedeckt, der dann aus dem Tubus herausgezogen wird, so daß anschließend, nachdem die Durchbrechung mit dem
Larynxraum in Überdeckung gebracht ist, durch den Tubus
eine Schlauchsonde mit einem diese durchlaufenden Katheter-
röhrchen durch Ablenkung mittels der Rampe in die Luftröhre
und das Katheter in die Bronchien zum Absäugen des
Sekrets eingeführt werden kann.
Weiter besteht die Möglichkeit, in den Tubus einen Innentubus einzuführen^ der die Tubusdurchbrechung beim Einführen
abschließt und der seinerseits mit einer Durchbrechung versehen ist, die mit der Tubendurchbrechung in Überdeckung
gebracht werden kann. Dem Bereich der Innentubusdurchbrechung ist eine zur zweiten Möglichkeit erwähnte entsprechende
Rampenfläche zugeordnet. Nachdem die Durchbrechung des Innentubus der Durchbrechung des Tubus und jede Durchbrechung
dem Larynxraum gegenüberliegt, wird eine Schlauchsonde durch den Innentubus geschoben, die durch die Rampenfläche
und die beiden Tubendurchbrechungen seitlich in die Luftröhre abgelenkt wird. Durch die Schlauchsonde
ist ein Katheter geführt, welcher bis in die Bronchien schiebbar ist und durch den das Sekret aus dem Bronchien
abgesaugt werden kann.
Die konstruktiven Merkmale und die einzelnen Vorgänge bei Anwendung des Instrumentes nach der Erfindung werden später
speziell erläutert. In jedem Fall ist es jedem Arzt möglich, mit-dem besonders einfachen Instrument nach der
Erfindung routinemäßig tracheobronchiales Sekret ohne oder nahezu ohne Speichelzumischung zu entnehmen und dann anhand der festzustellenden
Keime oder Zellen eine Diagnose zu stellen. Vfeitere Anwendungsmöglichkeiten
sind in der folgenden Beschreibung erwähnt.
Die Erfindung wird nachstehend anhand der Zeichnung beschrieben, in der Beispiele dargestellt sind. Es zeigen:
Figur 1 Ein schematisch im Längsschnitt dargestelltes Instrument mit vier Einstellmöglichkeiten a, bf c, d,
Figur 2 eine zweite Ausführung des Instrumentes mit vier Einstellmöglichkeiten e, f, g, h,
Figur 3a eine dritte Ausführung des Instrumentes mit sechs
und 3b
Einstellmöglichkeiten j, k, 1, m, n, o.
Das Instrument nach der Erfindung besteht gemäß Figur 1 aus einem durch den Mund- und Rachenraum (Figur 2e, 3j)
des «Patienten einführbaren, flexiblen, im Querschnitt
formstabilen/ gebogenen und biegsamen Tubus 1, an dessen
distalem Ende sich unter Umständen abgestuft mit verringertem Durchmesser ein etwa 10 cm langer Schlauch 2
mit geschlossenem Ende aus weichem, stark biegsamem Material, wie Weichgummi oder Weichplastik, anschließt. Das
distale Ende des Tubus bzw. ein distaler Tubusteil mit dem Schlauchende 2 wird durch Schluckbewegungen des
Patienten in die Speiseröhre 3 entsprechend Figur 2e und Figur 3j eingeführt. Der Tubus 1 ist vorteilhaft entsprechend
dem Verlauf des Mund- und Rachenraumes sowie der Speiseröhre bei etwas nach hinten gekipptem Kopf
gebogen.
Der Tubus 1 mit einer Länge von etwa 25 cm ist in einem Abstand von "etwa 5. cm von seinem distalen Ende auf der
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Durchbrechung 4 distalseits des Larynxraumes 8 liegt.
Sodann wird der Tubus 1 zurückgezogen, nachdem der Verschluß IO aus dem Tubus 1 herausgezogen ist, und zwar so
weit, daß die Tubusdurchbrechung 4 sich mit dem Larynxraum 8 in Überdeckung befindet. Diese Stellung wird durch
Ausatmen des Patienten festgestellt. Anschließend wird von proximal her eine Schlauchsonde 11 in den Tubus 1 eingeschoben,
der durch die Rampenfläche 9 seitlich abgelenkt wird und in die Luftröhre 12 eindringt (Figur 2h). Durch
diese Sonde 11 wird ein Katheterröhrchen 13 durchgeführt,
das bis in die Bronchien verschiebbar ist, so daß dann aus Ihnen tracheobronchiales Sekret über den Katheter 13
abgesaugt und für die Abgabe einer Diagnose untersucht werden kann,oder es kann ein Heilmittel in den Respirationstrakt eingeführt werden. In ersterem Fall wird die Schlauchsonde
11 am distalen Ende vorteilhaft mit einem leicht zu öffnenden Verschluß versehen, der durch den durchzuführenden
.Katheter geöffnet werden kann. Dieser Verschluß besteht z.B. aus einer das distale Ende der Sonde 11 überragenden
elastischen Zunge 14 (Figur 2h), die in das distale Sondenende hinein zurückgebogen werden kann und die durch das
distale Ende des durchzuschiebenden Katheters 13 wieder herausgestoßen werden kann. Dieser Verschluß 14 verhindert
beim Einführen der Sonde in die Luftröhre ein Eindringen von Speichel in diese Sonde bzw. auch "iiwden Katheter 13.
Nach dem Beispiel Figur 3 ist der Tubus 1 ebenso ausgebil-
z 43-
det wie nach dem Beispiel Figur 1. In diesem Fall wird die
Durchbrechung 4 beim Einführen des Instrumentes jedoch vom Umfang eines in den Tubus 1 einzuführenden Innentubus
15 verschlossen. Dieser Innentubus 15 besitzt ebenfalls
eine mit der Durchbrechung 4 in Überdeckung zu bringende Durchbrechung 16.
Der Innentubus 15 verschließt beim Einführen des Instrumentes mit seiner proximalseits seiner Durchbrechung 16 liegenden
Umfangswandung die Durchbrechung 4 des Tubus 1, wie aus
Figur 3j ersichtlich ist. Es werden dann entsprechend den bekannten Längenabmessungen durch Verschieben des Innentubus
15 im Tubus 1 die beiden Durchbrechungen 4 und 16 in überdeckung gebracht, wobei eine Rampenfläche 9a des Innentubus
15 ähnlich der Rampenfläche 9 nach Figur 2 vorgesehen ist, die sich im Bereich der Durchbrechung befindet (Figur
3k). Sodann werden der Tubus 1 und der Innentubus 15
proximalwärts bewegt (Figur 31), bis die beiden Durchbrechungen 4, 16 mit dem Larynxraum 8 in überdeckung gekommen
sind. Dies ist wieder durch Ausatmen des Patienten feststellbar.
Anschließend wird ein distal z.B. durch einen Adapter mit der Sonde 15 lösbar verbundener Nährbodenträger oder
ein Sammelbehälter 7a eventuell mit Nährboden (Figur 3m) mit der offenen Seite zum Larynxraum 8 in überdeckung
gebracht, so daß nun wieder durch z.B. Husten des Patienten Sekret aus den Bronchien in den Sammelbehälter 7a ge-
bzw. auf den Nährboden gelangt. Mit oder ohne Sammelbehälter
7a kann, ausgehend von Figur 31 oder 3n, auch so vorgegangen werden, daß durch den Innentubus 15 eine Schlauchsonde
11 entsprechend Figur 2a mit einem Absaugkatheter 13 geschoben wird (Figur 3o), der wieder durch die Rampenfläche
9a seitlich abgelenkt in die Luftröhre 12 gelangt und wobei der Katheter 13 sodann bis in die Bronchien
vorgeschoben werden kann, um dann aus den Bronchien Sekret abzusaugen oder ein Heilmittel einzuführen.
Der Katheter 13 nach Figur 2h und Figur 3a wird vorteilhaft mit einem inneren, nach dem Einführen proximalwärts
herausziehbaren Stahldraht versehen. Dieser Draht ist am distalen Ende mit einer Abbiegung versehen, die auch
den Katheter abbiegt. Proximal ist der Draht und ebenso die Sonde 11 mit einer sich in der Nullstellung deckenden
Markierung versehen. Ist der Katheter 13 mit dem Draht in der Nullstellung in die Bronchien eingeführt, so kann
er proximal aus der Nullstellung nach links oder rechts verdreht werden, so daß nunmehr das distale abgebogene
Kathederende in eine linke oder rechte Abzweigung einführbar ist.
Im Fall der Figur 3 kann-ider Innentubus zur Verringerung
des Durchmessers des Außentubus 1 durch eine Führung mit sichelförmigem Querschnitt ersetzt werden, die sich beim
Durchschieben durch den Tubus 1 an der inneren Rückwand des Tubus entlangbewegt.
Alle drei beschriebenen Ausführungen erfordern nur einen
geringen Aufwand und sind routinemäßig von jedem Fachmann bzw. Arzt anwendbar, so daß durch das Instrument
nach der Erfindung eine besonders einfache Methode zur Entnahme von tracheobronchialem Sekret ohne oder nahezu
ohne Speichelbeimischung geschaffen ist.
Neben der Entnahme von Sekret und dem Einführen von Heilmitteln über die Sonde 11 bzw. den Katheter 13 bietet das
erfindungsgemäße Instrument auch andere Anwendungsmöglichkeiten .
So kann z.B. die in Figur 2f gezeigte Ausführungsform
verwendet werden, um Instrumente, flexible Endoskope oder Beatmungstuben in die Luftröhre einzuführen. Dabei
kann auch so vorgegangen werden, daß nach dem Einführen des Beatmungstubus das nur als Intubationshilfe dienende
Instrument herausgezogen wird, während der Beatmungstubus in der eingeführten Position verbleibt. In gleicher Weise
kann auch bei eingeführten Endoskopen, Dauerkathetern, Sonden und dergleichen vorgegangen werden, die dann natürlich
auch am proximälen Bereich einen solchen Durchmesser haben müssen, daß sie durch das Lumen des Tubus 1 passen.
Wenn man bei diesen speziellen Anwendungsfällen das Lumen des Tubus klein halten will, besteht auch die Möglichkeit,
daß durch den Tubus 1 gemäß Figur 2f.zunächst nur ein
flexibler Draht als Führungselement in die Luftröhre ein-
geführt wird, daß dann das Instrument, unter Belassung
des Drahtes in der eingeführten Position/ herausgezogen wird und daß proximal auf den Draht ein Beatmuirgstubus geschoben
wird, der unter alleiniger Führung durch den ihn durchlaufenden Draht in '.die Luftröhre geschoben wird. Der Führungs
draht aus beispielsweise Metall oder Kunststoff wird dann schließlich aus dem Beatmungstubus herausgezogen. ■
Da diese Maßnahmen in der Regel bei bewußtlosem bzw. unter
Narkose stehendem Patienten durchgeführt werden, der also keine willkürlichen Schluckbewegungen machen kann, wird
der flexible Fortsatz 2 entfallen und der· eigentliche Tubus 1 distal etwas länger als dargestellt ausgebildet. Im
übrigen sollte dann auch der distale Endbereich des Tubus unterhalb der Durchbrechung 4 gerade verlaufen.
Leerseite
Claims (17)
1. / Instrument zur Entnahme von tracheobronchialem Sekret
zur Diagnostik oder zum Einführen von Heilmitteln/ Tuben, Sonden, Endoskopen und dergleichen in den Respirationstrakt,
dadurch gekennzeichnet, daß ein durch den Mund- und Rachenraum des Patienten einführbarer,
flexibler, aber im Querschnitt formstabiler Tubus (1) mit seinem geschlossenen distalen Ende (2)
bis in die Speiseröhre schiebbar ist und daß der Tubus eine seitliche Durchbrechung (4) hat, die
bei eingeführtem Instrument auf den Larynxraum (8) ausrichtbar ist und über die das Sekret entnommen.wird bzw.
Heilmittel, Führungselemente, Tuben, Sonden, Endoskope, Katheter und dergleichen in den Respirationstrakt eingeführt
werden. ..
2. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß die erwähnte Durchbrechung (4) mit Hilfe eines axial im Tubus
verstellbaren Verschlusses absperrbar ist.
3. Instrument nach den Ansprüchen 1 und 2, daäurch gekennzeichnet, daß sich
an das distale Tubusende ein Fortsatz (2) anschließt, der aus weichem, stakk biegsamer« Material, wie Vfe&chgumrni oder Meichplastik,besteht.
4. Instrument nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, daß
der Tubus (1) den anatomischen Gegebenheiten des Rachen- und Mundraumes
entsprechend gebogen ist.
• * * · μ β
5. Instrument nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet,
daß im Tubus (1) ein Sammelgefäß öder Nährbodenträger für Bakterien mit Hilfe eines Betätigungselementes (6) axial verschiebbar ist, daß eine Aufnahmeöffnung
des Sammelgefäßes mit der Tubusdurchbrechung (4) in überdeckung bringbar ist und daß das Sammelgefäß mit
einem Verschluß (5,15) kombiniert ist, der die Tubusdurchbrechung abdeckt, sobald das Sammelgefäß distalwärts über
die Tubusdurchbrechung hinaus verschoben ist.
6. Instrument nach Anspruch. 5, dadurch, gekennzeichnet, daß das
Betätigungselement (6) ein Drahtxist, daß der Verschluß
(5) ein Rohr- oder Zylinderstück ist und daß das Sammelgefäß (7) vorzugsweise lösbar am Verschluß befestigt ist.
7. Instrument nach einem der Anspruch 1 bis 6, dadurch gekennzeichnet,
daß eine Rampenfläche (9) vorgesehen ist, die sich im Bereich der Tubusdurchbrechung (4) vom rückseitigen
Tubuswandbereich aus von oben schräg nach vorn unten erstreckt und einen stetigen Obergang zum unteren
distalen Endbereich der Tubusdurchbrechung schafft und daß ein proximal in den Tubus eingeführter Katheter (13) oder ein Innentubus (15),
ein Führungseleirent, ein Endoskop oder dergleichen über die Rampe (9),
in die Luftröhre (12) schiebbar ist.
8. Instrument nach Anspruch 1, dadurch gekennzeichnet, daß
die Rampenfläche (9) durch einen aus der rückseitigen Tubuswand heraus ge trennten Lappen "gebildet wird, der nach
vorn gebogen an seinem freien Ende mit dem distalen Endbereich der Tubusdurchbrechung abschließt oder
daß ein Element mit einer Rampenfläche eingepaßt ist.
9. Instrument nach einem der Ansprüche 1 bis 8, dadurch
gekennzeichnet, daß das distale Ende des Verschlusses (10) für die Tubusdurchbrechung (4) dem Verlauf der
Rampenfläche (9) angepaßt ist.
10. Instrument nach Anspruch 7, dadurch gekennzeichnet/ daß die Rampenfläche (9a) Teil eines im Tubus (1) verschiebbaren
Innentubus (15) ist/ der mit einer mit der Durchbrechung (4) des Tubus in Überdeckung zu
bringenden Durchbrechung (16) versehen ist.
11. Instrument nach Anspruch 7 und 10, dadurch gekennzeichnet,
daß an Stelle des Innentubus eine an der inneren Rückwand des Tubus verschiebbare, im Querschnitt
sichelförmige Führung mit der Rampenfläche (9, 9a) vorgesehen ist.
12. Instrument nach einem der Ansprüche 7 bis 11, dadurch gekennzeichnet, daß der Katheter (13) durch.eine
schlauchartige Sonde (1.1) einführbar ist, die durch den äußeren Tubus (1) oder den Innentubus (11) und
über die Rampenfläche (9, 9a) in die Lufträhre schiebbar
ist, und daß das Katheterende durch eine distale öffnung der Sonde bis in den Bereich der Bronchien
schiebbar ist.
13. Instrument nach Anspruch 12, dadurch gekennzeichnet,
daß das distale Ende der Sonde (11) mit einem Verschluß
(14) versehen ist, der durch Anstoßen mit dem distalen Katheterende zu öffnen ist.
14i Instrument nach Anspruch 13, dadurch gekennzeichnet,
daß der Verschluß (14) durch eine Zunge am Sondenende gebildet ist, die durch Umbiegen die distale Sondenöffnung
schließt.
15. Instrument nach den Ansprüchen 14 und 15, dadurch gekennzeichnet,
daß das Sammelgefäß (7a) mittels eines Adapters oder dergleichen am distalen Ende des Innentubus
(15) oder der im Querschnitt sichelförmigen Führung lösbar zu befestigen ist.
16. Instrument nach einem der Ansprüche 1 bis 15., dadurch gekennzeichnet, daß die seitlichen Durchbrechungen (4,
16) in den Tuben (1, 15) ,in Aufsicht gesehen, die Form
eines Ovals haben, dessen größte Hauptachse parallel zur Tubenlängsachse verläuft.
17. Instrument nach Anspruch 1 und einem der Ansprüche 7,
12 und 13, dadurch gekennzeichnet, daß der Katheter (13) mit einem inneren,'· proximalwärts herausziehbaren
Stahldraht versehen ist, der am .distalen Ende eine Abbiegung besitzt und der proximal aus einer markierten
Nullstellung gegenüber der Sonde (11) nach links oder rechts verdrehbar ist.
Priority Applications (22)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3115192A DE3115192C2 (de) | 1981-04-15 | 1981-04-15 | Medizinisches Instrument |
AT1297/82A ATA129782A (de) | 1981-04-15 | 1982-04-01 | Medizinisches instrument |
SE8202173A SE456481B (sv) | 1981-04-15 | 1982-04-05 | Medicinskt instrument innefattande en flexibel tub avsedd att inforas genom en patients mun och svalg |
FI821254A FI821254L (fi) | 1981-04-15 | 1982-04-07 | Medicinskt instrument |
FR8206154A FR2504012A1 (fr) | 1981-04-15 | 1982-04-08 | Instrument medical |
US06/367,408 US4454887A (en) | 1981-04-15 | 1982-04-12 | Medical instruments for introduction into the respiratory tract of a patient |
PT74738A PT74738B (de) | 1981-04-15 | 1982-04-12 | Medizinisches instrument |
GB8210627A GB2096467B (en) | 1981-04-15 | 1982-04-13 | Medical instrument for introduction into the respiratory tract of a patient |
AR289094A AR228898A1 (es) | 1981-04-15 | 1982-04-13 | Instrumento medico para la toma de secrecion traqueobronquial o para la introduccion de medicamentos,tubos,elementos de guia,sondas,endoscopios,cateteres y similares en el tracto-respiratorio de un paciente |
DD82238952A DD202244A5 (de) | 1981-04-15 | 1982-04-13 | Medizinisches instrument |
NL8201545A NL8201545A (nl) | 1981-04-15 | 1982-04-13 | Medisch instrument. |
ES1982272710U ES272710Y (es) | 1981-04-15 | 1982-04-13 | Instrumento medico |
IL65495A IL65495A (en) | 1981-04-15 | 1982-04-13 | Medical instrument for insertion into the respiratory tract |
JP57061197A JPS57177771A (en) | 1981-04-15 | 1982-04-14 | Medical instrument |
BE2/59664A BE892831A (fr) | 1981-04-15 | 1982-04-14 | Instrument medical |
BR8202191A BR8202191A (pt) | 1981-04-15 | 1982-04-14 | Instrumento medico |
CH2265/82A CH658587A5 (de) | 1981-04-15 | 1982-04-14 | Medizinisches instrument. |
NO821215A NO821215L (no) | 1981-04-15 | 1982-04-14 | Medisinsk instrument. |
ZA822508A ZA822508B (en) | 1981-04-15 | 1982-04-14 | Medical instrument |
DK169182A DK169182A (da) | 1981-04-15 | 1982-04-15 | Medicinsk instrument |
IT20763/82A IT1218319B (it) | 1981-04-15 | 1982-04-15 | Strumento medico per il prelievo di secrezioni tracheo-bronchiali e per l'introduzione di sostanze curative tubi,elementi di guida,sonde,endoscopi,cateteri e simili nel tratto respiratorio del paziente |
AU82657/82A AU8265782A (en) | 1981-04-15 | 1982-04-15 | Tube for placing in respiratory tract |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3115192A DE3115192C2 (de) | 1981-04-15 | 1981-04-15 | Medizinisches Instrument |
Publications (2)
Publication Number | Publication Date |
---|---|
DE3115192A1 true DE3115192A1 (de) | 1982-11-04 |
DE3115192C2 DE3115192C2 (de) | 1983-05-19 |
Family
ID=6130191
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE3115192A Expired DE3115192C2 (de) | 1981-04-15 | 1981-04-15 | Medizinisches Instrument |
Country Status (22)
Country | Link |
---|---|
US (1) | US4454887A (de) |
JP (1) | JPS57177771A (de) |
AR (1) | AR228898A1 (de) |
AT (1) | ATA129782A (de) |
AU (1) | AU8265782A (de) |
BE (1) | BE892831A (de) |
BR (1) | BR8202191A (de) |
CH (1) | CH658587A5 (de) |
DD (1) | DD202244A5 (de) |
DE (1) | DE3115192C2 (de) |
DK (1) | DK169182A (de) |
ES (1) | ES272710Y (de) |
FI (1) | FI821254L (de) |
FR (1) | FR2504012A1 (de) |
GB (1) | GB2096467B (de) |
IL (1) | IL65495A (de) |
IT (1) | IT1218319B (de) |
NL (1) | NL8201545A (de) |
NO (1) | NO821215L (de) |
PT (1) | PT74738B (de) |
SE (1) | SE456481B (de) |
ZA (1) | ZA822508B (de) |
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DE3310870A1 (de) * | 1982-04-01 | 1983-10-06 | Krueger Christian | Medizinisches instrument |
EP0132215A1 (de) * | 1983-06-14 | 1985-01-23 | FOGARTY, Thomas J. | Ablenkführungskatheter |
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DE7424041U (de) * | 1900-01-01 | Marusho Sangyo Co., Inc., Tokio |
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US1747407A (en) * | 1928-07-20 | 1930-02-18 | Reinhold H Wappler | Catheterizing instrument |
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US3799173A (en) * | 1972-03-24 | 1974-03-26 | J Kamen | Tracheal tubes |
FR2220729B1 (de) * | 1973-03-06 | 1975-10-31 | Technological Supply | |
FR2332743A1 (fr) * | 1975-11-28 | 1977-06-24 | Inst Nat Sante Rech Med | Sondes et appareils de biopsie cerebrale |
SU610529A1 (ru) * | 1977-01-05 | 1978-06-15 | Алтайский государственный медицинский институт | Эластичный зонд |
US4168703A (en) * | 1977-07-18 | 1979-09-25 | Kenneth Kenigsberg | Gastroesophageal reflux diagnostic tool |
DD140980A1 (de) * | 1979-02-28 | 1980-04-09 | Gert Mueller | Fuehrungseinrichtung fuer medizinische geraete und instrumente |
US4230108A (en) * | 1979-03-13 | 1980-10-28 | Young Sharon L | Apparatus and method for sealing esophageal entrance to trachea above and below |
FR2459051A1 (fr) * | 1979-06-20 | 1981-01-09 | Materiels Annexes Dialyse | Dispositif pour le prelevement de secretions bronchiques |
US4364394A (en) * | 1980-11-24 | 1982-12-21 | Wilkinson Lawrence H | Combined sump drainage and irrigation device |
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1981
- 1981-04-15 DE DE3115192A patent/DE3115192C2/de not_active Expired
-
1982
- 1982-04-01 AT AT1297/82A patent/ATA129782A/de not_active Application Discontinuation
- 1982-04-05 SE SE8202173A patent/SE456481B/sv not_active IP Right Cessation
- 1982-04-07 FI FI821254A patent/FI821254L/fi not_active Application Discontinuation
- 1982-04-08 FR FR8206154A patent/FR2504012A1/fr active Pending
- 1982-04-12 US US06/367,408 patent/US4454887A/en not_active Expired - Fee Related
- 1982-04-12 PT PT74738A patent/PT74738B/de unknown
- 1982-04-13 IL IL65495A patent/IL65495A/xx unknown
- 1982-04-13 NL NL8201545A patent/NL8201545A/nl not_active Application Discontinuation
- 1982-04-13 ES ES1982272710U patent/ES272710Y/es not_active Expired
- 1982-04-13 AR AR289094A patent/AR228898A1/es active
- 1982-04-13 DD DD82238952A patent/DD202244A5/de unknown
- 1982-04-13 GB GB8210627A patent/GB2096467B/en not_active Expired
- 1982-04-14 BE BE2/59664A patent/BE892831A/fr not_active IP Right Cessation
- 1982-04-14 NO NO821215A patent/NO821215L/no unknown
- 1982-04-14 BR BR8202191A patent/BR8202191A/pt unknown
- 1982-04-14 CH CH2265/82A patent/CH658587A5/de not_active IP Right Cessation
- 1982-04-14 JP JP57061197A patent/JPS57177771A/ja active Pending
- 1982-04-14 ZA ZA822508A patent/ZA822508B/xx unknown
- 1982-04-15 DK DK169182A patent/DK169182A/da not_active IP Right Cessation
- 1982-04-15 AU AU82657/82A patent/AU8265782A/en not_active Abandoned
- 1982-04-15 IT IT20763/82A patent/IT1218319B/it active
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DE7424041U (de) * | 1900-01-01 | Marusho Sangyo Co., Inc., Tokio |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3310870A1 (de) * | 1982-04-01 | 1983-10-06 | Krueger Christian | Medizinisches instrument |
EP0132215A1 (de) * | 1983-06-14 | 1985-01-23 | FOGARTY, Thomas J. | Ablenkführungskatheter |
US4774949A (en) * | 1983-06-14 | 1988-10-04 | Fogarty Thomas J | Deflector guiding catheter |
US5389089A (en) * | 1992-10-13 | 1995-02-14 | Imagyn Medical, Inc. | Catheter with angled ball tip for fallopian tube access and method |
DE102007029162A1 (de) * | 2007-06-25 | 2009-01-08 | Tahar Benhidjeb | OP-Gerät |
Also Published As
Publication number | Publication date |
---|---|
IL65495A (en) | 1985-04-30 |
ES272710U (es) | 1983-12-16 |
GB2096467A (en) | 1982-10-20 |
FI821254L (fi) | 1982-10-16 |
DD202244A5 (de) | 1983-09-07 |
GB2096467B (en) | 1984-07-18 |
FI821254A0 (fi) | 1982-04-07 |
US4454887A (en) | 1984-06-19 |
AR228898A1 (es) | 1983-04-29 |
JPS57177771A (en) | 1982-11-01 |
IL65495A0 (en) | 1982-07-30 |
IT8220763A0 (it) | 1982-04-15 |
PT74738B (de) | 1983-11-16 |
ES272710Y (es) | 1984-07-16 |
PT74738A (de) | 1982-05-01 |
NL8201545A (nl) | 1982-11-01 |
BR8202191A (pt) | 1983-03-29 |
NO821215L (no) | 1982-10-18 |
CH658587A5 (de) | 1986-11-28 |
ATA129782A (de) | 1991-06-15 |
DK169182A (da) | 1982-10-16 |
IT1218319B (it) | 1990-04-12 |
SE456481B (sv) | 1988-10-10 |
FR2504012A1 (fr) | 1982-10-22 |
AU8265782A (en) | 1982-10-21 |
ZA822508B (en) | 1983-03-30 |
BE892831A (fr) | 1982-08-02 |
DE3115192C2 (de) | 1983-05-19 |
SE8202173L (sv) | 1982-10-16 |
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