EP0181814B1 - Pressure therapy apparatus for oedemas of the limbs - Google Patents

Description

The present invention relates to an apparatus for the treatment of edema of the limbs by the method of compressing the limb to be treated by immersion in a liquid of very high density.

French Patent No. 2,267,747 describes an apparatus consisting of a vertical cylindrical tank containing a flexible tubular pocket closed at one end and fixed by the periphery of its opposite end open on the periphery of the upper part of said tank.

The member to be treated is introduced into the flexible bag and mercury is introduced into the tank at the lower end thereof while a pressurized gas is introduced into the upper part of the tank, above the mercury, the latter thus exerting a pressure controlled perpendicularly and uniformly over the entire surface of the member, this pressure being higher at the lower part of the tank and decreasing towards the top thereof.

This process and the device developed following the work of Doctor Cartier have proven to be extremely effective in the treatment of edema of the upper and lower limbs.

However, the device thus designed is too expensive to find the development it deserves because of the large quantity of mercury required and the high price that it represents for each device.

Indeed, the sizes of the limbs to be treated vary from one individual to another and, so that a single device can be used for patients of all sizes, we are led to give the tank the largest dimensions possible, that is to say a diameter of the order of 250 to 300 mm and a height of about 1.20 m corresponding to the maximum length of a leg.

As a result, the volume of mercury required becomes very large and the price of the device thereby becomes practically unaffordable.

The object of the invention is therefore to provide an apparatus of the aforementioned type making it possible on the one hand to obtain an identical result by requiring only a very small amount of mercury and on the other hand to treat the upper and lower limbs patients of different sizes, thus ensuring considerable savings.

The subject of the invention is therefore an apparatus for treating edema of the limbs using a high density liquid whose pressure acts on the limb to be treated by means of a pocket, into which said limb is to be introduced. , this apparatus comprising a cylindrical tank containing a flexible tubular pocket extending inside the tank and being closed at one end and fixed by the periphery of its opposite end open on the periphery of the upper part of the tank, characterized in that the apparatus comprises a second flexible tubular pocket extending coaxially in the first pocket, the external and internal pockets delimiting between them a small closed interval, means for introducing said high density liquid into said interval when the member to to treat is introduced into the internal pocket and means for carrying out in the tank around the external pocket a solid molding, capable of being disaggregated, of the member introduced into the has internal pocket, whatever the size of this member, the tank being vertical or inclined.

According to one embodiment of the invention, said means for producing a solid molding capable of being disaggregated comprise a fluidizable granular material disposed in the tank and a chamber delimited by a perforated upper wall forming the bottom of the tank and in which a fluid in motion is introduced under pressure by means of a nozzle to fluidize said material.

According to a characteristic of the invention, the tank comprises at its upper part on the one hand a first outlet orifice for the fluid (gas or liquid) for fluidization and on the other hand a second exhaust orifice for overflow of the fluidized granular material, and means for collecting this overflow.

Preferably, the fluid outlet orifice is provided with a filter adapted to retain the granular molding material and said means for collecting the overflow of the fluidized material comprise a container mounted to rotate on said second orifice, and orientable between a low position for receiving the overflow and a high position in which the collected material pours back into the tank.

Advantageously, a device is provided for closing said second orifice to prevent any untimely movement of return of the granular material from the tank to said container.

Advantageously, there is provided a flexible pipe extending from the outside to the inside of said second pocket, along the wall thereof, for introducing a gas into this pocket.

Preferably, said pipe extending into the second pocket is connected to a source of pressurized fluid supplying the fluidization chamber via a two-way valve also controlling the supply of said chamber.

The granular material is a powdery molding product, for example sand, a plastic material in the form of grains with controlled particle size, an ion exchange resin or other similar material fluidizable by means of a moving fluid.

The high density liquid is mercury, a fluid mud of the type of oil drilling mud or other.

According to another embodiment, the tank is telescopic and said means for carrying out a solid molding comprise a granular material having a density less than 1 disposed in a tank located below the tank and communicating with the latter through an opening capable of be closed by a perforated plate, means being provided for sending a liquid having a density at least equal to 1 in said tank.

According to another characteristic, the telescopic tank has at its upper part a liquid overflow outlet orifice provided with a filter for retaining the granular material.

The means for introducing a liquid of high density into the closed space between the two pockets comprises a pipe extending through the wall of the tank, the molding material and the external pocket, integral with the latter and opening into said interval.

Preferably, the opening at the upper part of the tank is closed by means of a shutter made of a flexible and elastic material, comprising a central opening, the first external pocket being held between said shutter and the periphery of the tank. , and the second pocket, internal, being fixed on the periphery of said opening of the shutter.

The description which follows with reference to the attached drawing by way of nonlimiting example will make it possible to understand clearly how the invention can be put into practice.

Figure 1 is a vertical sectional view of a first embodiment of the apparatus according to the invention.

Figure 2 is a vertical sectional view of a second embodiment of the apparatus according to the invention.

Referring to the example of Figure 1, the apparatus according to the invention designated as a whole by the reference 1 comprises, as known per se, a vertical cylindrical tank 2 open at its upper end and having a height which corresponds to the maximum length of a leg, that is to say about 1.20 meters, this tank containing a flexible elongated pocket 3 closed at its lower end and fixed by the periphery of its opposite end on the periphery of the opening of the tank.

According to the invention, there is provided at the lower end of the tank a chamber 4 delimited by a perforated wall 5 disposed above the bottom 6 of the tank and communicating with the outside via a nozzle 7 .

The tank also comprises, near its upper end, on the one hand an orifice 8 provided with a filter 9 and on the other hand a second orifice 10 to which is fixed a pipe 11 provided with a closure register 12 controlled by a lever 13 and the end of which comprises a rotary joint 14 to which a container 15 is connected, the arrangement being such that this container can be rotated in a low vertical position represented in solid lines in the drawing and a high vertical position represented in dashed lines . The shape of the container 15 is such that the latter, in the high position, constitutes a hopper whose contents can flow inside the tank 2 when the register 12 is open.

According to the embodiment shown by way of example, the upper end of the tank 2 has a radial peripheral rim 16 on which is adapted a shutter member 17 which is preferably made of a flexible and elastic material, for example a closed cell foam plastic having a central opening 18, a peripheral rim 19 cooperating with the rim 16 of the tank and a circular boss 20 projecting from the periphery of the opening 18.

The flexible pocket 3 is advantageously retained by its periphery between the rim 16 of the tank and the rim 19 of the shutter 17 and a second flexible pocket 21 is provided, closed at one end, disposed in the pocket 3 and delimiting with it. ci a small interval 22, the periphery of the end of the second pocket 21 being fixed on the boss 20.

The interval 22 between the external 3 and internal pockets 21 communicates with the outside via a tube 23 extending through the wall of the tank 2 and the end of which is integral with the external pocket 3, for example in the vicinity of its lower end.

A granular molding material 24, fluidizable by means of a moving fluid is placed in the tank 2 around the external pocket 3. This material can advantageously be constituted for example by sand, a granular plastic material of controlled particle size, a ion exchange resin, or any other suitable material, the level of which, in the non-fluidized state, is located below the orifices 9 and 10.

The apparatus finally comprises a flexible pipe 25 extending down the length of the wall of the internal pocket 21 and opening to the outside, for example through the thickness of the shutter 17. The pipe 25 is connected by a conduit 26 to a two-way valve 27 connected on the one hand to the nozzle 7 of the chamber 4 and on the other hand, by a pipe 28, to a source of pressurized gas supply (not shown).

The operation of the device is as follows.

Air under pressure is sent to the chamber 4, for example, which, escaping through the perforations in the wall 5, fluidizes the granular material 24 surrounding the external pocket 3.

The granular material thus fluidized behaves like a liquid, allowing the introduction of the member to be treated into the assembly constituted by the two internal pockets 21 and external 3 and as and when the introduction of the member the granular material in excess escapes through the orifice 10 to partially fill the container 15, the register 12 being open while the fluidizing air escapes through the orifice 8, the filter 9 of which retains the material.

The fluidization of the granular material exerting a pressure on the pockets, air is injected into the internal pocket 21 by means of the valve 27 and the pipes 26 and 25, under a low pressure, this air escaping as and as the limb progresses in the internal pocket.

When the member is completely inserted into the pocket 21, the register 12 is closed in order to prevent any further transfer of the granular material into the container 15 and the injection of the fluid in the chamber 4 is stopped, the material granular 24 then settling around the pocket 3, thereby achieving a solid molding of the member to be treated.

Mercury is then injected into the interval 22 between the pockets 3 and 21, up to the desired level.

The level of the packed granular molding material, indicated for example by the arrows 29 being below the level of the mercury injected between the pockets, an annular reinforcement 30 is preferably provided, for example in inextensible fabric on the part of the external pocket 3 extending between the level of the mercury and the level of the solid molding produced in order to prevent deformation of the external pocket 3 and to maintain the pressure of the mercury at this level.

When the treatment is finished, the register 12 is open, the treated member being removed from the bag 21, possibly with a new injection of fluidizing air into the chamber 4 in order to facilitate the removal of the member and after the removal of the member. ci the register 12 is again open and the container 15 rotated in the high vertical position so that the excess of molding material collected flows again inside the tank 2.

It is found that the volume of mercury necessary for the treatment is thanks to the invention reduced to the strict minimum necessary. In fact, the volume of mercury used results from the compressibility of the molding product and from the dead space resulting from the difference in the volumes occupied by the molding material in the fluidized state and in the packed state.

It is also found that the device according to the invention makes it possible to treat under the best economic conditions both the arms and the legs of the patients.

Finally, it will be noted that the mode of transfer of the molding material from the treatment tank to the container 15, and vice versa, could also be either a new fluidization, or a transfer by flotation of the granular or pulverulent molding material, the latter means making it possible to remove the rotary joint 14. In the latter case, the closing device for isolating the container 15 from the tank 2 can be an inflatable capacity with water, or other fluid, and contained in the container 15.

Reference will now be made to FIG. 2 which shows a second embodiment of the apparatus according to the invention, in which similar members are designated by the same references.

According to this embodiment, the vertical tank 31 is formed of at least three sections 31 a, 31 b and 31 c mounted in a leaktight manner and telescopically sliding and is closed at its upper end by the shutter 17 which maintains the flexible pockets 3 and 21, as in the previous example.

The lower end of section 31 c of the telescopic tank 31 is fixed around an opening 32 made in the upper wall of a tank 33.

The opening 32 can be closed off by means of a perforated plate 34 fixed to the piston of a jack 35 shown diagrammatically and mounted in the tank 33.

The upper section 31a of the tank 31 includes an overflow outlet orifice 11 provided with a filter and connected to a tank 36 filled with water, by means of a telescopic pipe 37.

The reservoir 33 is connected by a pipe 38, which opens in the vicinity of its bottom, to the reservoir 36 by means of a multi-way valve 39 and a self-priming pump 40.

The pipe 23 connects the space 22 delimited between the two flexible pockets 3 and 21 to reservoir 41. The reservoir 41 is filled with mercury.

The pump is also connected on the one hand to the water tank 36 by a pipe 42 and on the other hand to the mercury tank 41 by a pipe 43.

Finally, there is provided an open vertical tube 44 which is arranged through the shutter 17 and opens into the space 22 and whose role will be explained below.

In this embodiment, the granular material has a density less than 1 in order to float on water.

The operation of this embodiment is as follows.

When the device is not in use, the opening 32 at the bottom of the tank is open and the granular material is collected in the reservoir 33, around the jack 35.

The space between the external pocket 3 and the wall of the tank 31 is therefore empty as well as the space 22 between the flexible pockets 3 and 21 and the tank can be retracted telescopically, thereby reducing its height, which facilitates the introduction of the member into the internal pocket 21 which can be pulled on the member like a stocking.

When the member is in place, the tank is extended upwards in its fully extended position shown in the drawing. The telescopic pipe 37 accompanies the movement of the tank.

The pump 40 is then actuated, after having adjusted the position of the valve 39 to inject the water from the reservoir 36 into the reservoir 33.

The water entering the bottom thereof floats the granular material and makes it rise in the tank 31 in which it accumulates from the top, the water escaping through the filter and returning to the tank 36 until the tank 31 is completely filled to the bottom.

The actuator 35 is then actuated to raise the plate 34 and close the opening 32. The molding is then carried out, the reservoir 33, full of water, is then emptied by means of the pump and the hose 38.

The setting of the valve 39, which closes the pipe 38, is then modified and the pump 40 injects into the tank 41 water exerting a pressure on the mercury which is injected into the space 22.

When this space is filled, the mercury is allowed to rise in the tube 44 before stopping the pump in order to ensure a pressure around the part of the member at the level of the upper end of the tank by the weight of the column of mercury in tube 44 forming a vent.

Reverse operations are carried out to free the member.

Finally, it will be noted that heat has a beneficial effect on the treatment of certain edemas, and, consequently, heating means 46a and 46b are provided in the water and mercury tanks 36 and 41.

In addition, the field of use of this device is not limited to the sole treatment of edema of the limbs and can be extended to the following applications: lymphatic pathology, vein-lymphatic pathology, pure venous pathology, trophic disorders of these pathologies , arterial pathology under certain conditions.

It can also be extended in the sports and paramedical fields for possible application in sports traumatology, physical recovery after sportsmen's effort, possible application to seasonal edemas, fatigue of the legs and comfort medicine.

In a variant, not shown, the tank 2 can be tilted instead of being vertical, this tilt making it possible on the one hand to obtain a less energetic action of the mercury and on the other hand to facilitate the introduction of the member into the internal pocket 21.

Claims (15)

1. Apparatus for treating oedema of limbs by using a liquid of high density the pressure of which acts on the limb for treatment through the medium of a pocket in which the said limb is introduced, this apparatus comprising a cylindrical tank (2, 31) containing a tubular flexible pocket (3) extending into the interior of the tank and being closed at one end and fixed by the periphery of its opposed open end on the periphery of the upper part of the tank, characterised in that the apparatus comprises a second tubular flexible pocket (21) extending coaxially in the first pocket (3), the external (3) and internal (21) pockets defining between them a closed narrow gap (22), means (23) for introducing the said high density liquid into the said gap (22) when the limb for treatment is introduced into the internal pocket (21) and means (4, 24, 33, 35) for effecting in the tank (2, 31) around the external pocket (3) a firm moulding, suitable to be removed, of the limb introduced into the internal pocket (21), whatever the size of this limb may be, the tank (2, 31) being vertical or inclined.

2. Apparatus according to claim 1, characterised in that the said means for effecting the removable firm moulding comprise a granular fluidisable material (24) disposed in the tank (2) and a chamber (4) defined by a perforated-wall (5) forming the bottom of the tank and into which a fluid in movement is introduced under pressure by means of a fitting (7) for fluidising the said material (24).

3. Apparatus according to claim 2, characterised in that the tank (2) comprises at its upper part on the one hand a first orifice (8) for outlet of the fluid of fluidisation and on the other hand a second, escape orifice (10) for overflow of the granular fluidised material (24), and means (14, 15) for recovering this overflow.

4. Apparatus according to claim 3, characterised in that the orifice for outlet of the fluid of fluidisation is provided with a filter (9) adapted for retaining the granular moulding material (24), the said means (14, 15) for recovering the overflow of the fluidised material comprising a receptacle (15) mounted by a rotary joint (14) on the said second orifice (10), the receptacle (15) being orientable between a low position for reception of the overflow and a high position in which the recovered material return flows into the tank (2).

5. Apparatus according to any of claims 1 to 4, characterised in that it comprises a device (12) for closure of the said second orifice (10) for preventing all unwanted movement of the moulding material (24) between the tank (2) and the said receptacle (15).

6. Apparatus according to any of claims 1 to 5, characterised in that the opening in the upper part of the tank (2) is closed by means of an obturator (17) of a flexible and elastic material, including a central opening (18), the external pocket (3) being held between the said obturator (17) and the periphery of the tank (2), and the internal pocket (21) being fixed on the periphery of the said central opening (18) of the obturator (17).

7. Apparatus according to claim 6, characterised in that it comprises a flexible pipe (25) extending from the exterior to the interior of the said internal pocket (21) along the wall of the latter, for introducing a gas into this pocket.

8. Apparatus according to claim 7, characterised in that the said pipe (25) extending into the internal pocket (21) is connected to a source of gas under pressure supplying the fluidisation chamber (4) by means of a valve (27) with two lines, also controlling the supply of the said chamber (4).

9. Apparatus according to claim 1, characterised in that the tank (31) is telescopic and the said means for effecting a firm moulding comprise a granular material (24) having a density lower than 1, disposed in a reservoir (33) situated below the tank and communicating with this through an opening (32) able to be closed by a movable perforated plate (34), means (38, 40) being provided for sending into the said reservoir (33) a liquid having a density at least equal to 1.

10. Apparatus according to claim 9, characterised in that the telescopic tank (31) comprises at its upper part an outlet orifice (11) for overflow of liquid, provided with a filter for retaining the granular material and connected to a reservoir (36) of the said liquid having a density at least equal to 1.

11. Apparatus according to any of claims 2 to 4, characterised in that the granular material (24) is a pulverulent moulding product, for example sand, a plastics material in the form of grains of controlled grain size distribution or other analogous material fluidisable by means of a fluid under pressure.

12. Apparatus according to claim 10, characterised in that it comprises heating means (46a, 46b) disposed in the reservoir (36) of the said liquid having a density at least equal to 1 and in the reservoir (41) of high density liquid.

13. Apparatus according to claim 1 or 2, characterised in that the means for introducing a high density liquid into the gap (22) formed between the external (3) and internal (21) two pockets comprises a pipe (23) extending through the wall of the tank, through the granular material (24) and integral with the external pocket (3).

14. Apparatus according to claim 10, characterised in that it comprises means (35) for displacing the said movable plate (34) between a position in which it closes the opening (32) and a position in which the opening is open. 15. Apparatus according to claim 14, characterised in that the said means are constituted by a jack (35).

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