FR2697434A1 - Surgical syringe plunger withdrawal attachment - has lever and transmission member which allow plunger to be withdrawn with one hand, leaving other one free - Google Patents

Abstract

The attachment consists of a bracket (4) which is fitted to the body (10) of a syringe, a movement transmission member (2) which slides relative to the bracket, and a pivoted lever (5) which is hinged to the bracket and causes the transmission member to move step by step, pushing the syringe plunger (11) out of its body (10) to create a depression inside the latter. The bracket is made with a trough-section portion (40) which fits against the body of the syringe, with locking elements (44) to engage with the syringe body lugs (100), while the transmission member has two projections (200) which fit under the tip (110) of the plunger, and a toothed surface which interacts with a plate (71) inside the lever to form a non-return mechanism for the plunger. USE/ADVANTAGE - Creates depression inside a syringe to facilitate the insertion of a catheter, wire guide or other instrument. Allows syringe plunger to be withdrawn with one hand, leaving other hand free to perform other specific tasks.

Description

DEVICE FOR ACTUATING THE PUSH-BUTTON OF A SYRINGE
WITH A VIEW TO CREATING A DEPRESSION, SYSTEM AND METHOD
APPLYING FOR TEMPORARY SETUP
A CATHETER AND / OR A GUIDED WIRE
The present invention relates to a device for actuating the plunger of a syringe in order to create a depression therein.

 It also relates to a system and method for the temporary placement of a catheter and / or a guide wire in a cavity with liquid content of the organism, using the aforementioned device.

 The purpose of the invention is to facilitate access to the cavities with liquid contents of the organism, such as for example the urinary cavities and the blood vessels, to introduce therein by puncture through the skin, a material (catheter and / or guide wire) intended to allow the realization of a therapeutic act. This is for example to allow a topical intravenous infusion of a chemotherapeutic compound. It can also be the extraction of urinary stones or blood clots. Finally, it may involve allowing the intravascular pathway of instruments for the treatment of certain venous or arterial diseases in the blood network.

 In application No. 92 06815 of June 2, 1992 in the name of the applicant, a movement reversing element for a syringe is proposed which allows it to be manipulated with one hand, in particular to create a depression there. It also proposes a device and a method which make it possible to achieve the objectives defined above, by the temporary installation of a guide wire and / or of a catheter at a particular place of the organism.

 The present invention aims to propose a new device for creating a depression in the body of the syringe, as well as systems and method which allow in particular the easy and risk-free installation of a guide wire and / or d '' a catheter in a fluid-containing cavity in the body.

The device according to the invention, for actuating the plunger of a syringe in order to create a depression therein, is characterized in that it comprises
- a fixing part intended to be made integral with the syringe body
- A movement transmission member slidingly mounted on said part and which comprises a fixing element adapted to come into engagement with the pusher
- an operating lever articulated on said part, the actuation of which by pivoting causes the step-by-step movement of the transmission member so as to cause the extension of the plunger out of the syringe body and simultaneously a vacuum in this latest.

 The structure of this device allows its actuation with one hand, so that the practitioner still has a free hand, for example for adjusting devices or any other manipulation.

 It therefore makes it possible to perform punctures in cavities with fluid content of the body in a simple manner and without the risk of generating movements of the syringe which could cause incidents.

According to other advantageous but non-limiting characteristics of this device
- Said fixing part comprises a part in the form of a gutter that can be force-fitted onto the syringe body as well as locking tabs intended to be positioned against ears provided at the proximal end of the # syringe body, at their face opposite the body
- Said fixing element has the shape of a jumper, which has two tabs adapted to be force fitted on the pusher
- it includes non-return means making it possible to prevent the plunger from being pushed into the syringe body
- it is provided with means making it possible to make non-return means inoperative
- said movement transmission member slides inside a sleeve integral with or forming an integral part of said fixing part
- Said movement transmission member comprises a rod forming a rack and the operating lever comprises a spring leaf forming a pawl, so that each time the lever is brought closer to the rod, the pawl comes first in taken against a tooth of the rack then makes the rod undergo a translation, the loosening of the lever causing the withdrawal of the pawl
- The lever comprises a second leaf spring forming a pawl capable of engaging in turn with another tooth of the rack as the rod moves, so as to prevent the plunger from being pushed into the body syringe
- Said transmission member comprises a rod which passes through at least one plate through a hole of diameter slightly larger than that of the rod, so that the actuation of the lever causes the pivoting of the plate, then, simultaneously, the jamming of the rod through the hole in the plate and its translation, said plate returning to its initial position when the lever is released.

The invention also relates to a system for the temporary placement of a guide wire and / or a catheter in a cavity with liquid content of the organism. According to the invention, this system comprises
- a syringe comprising a body, a plunger and a hollow needle
- a connector with three branches, one of which is connected to the distal end of the syringe body, while the second is fixed to the needle, the third being free and allowing introduction through said connector and needle, into the body cavity, the guidewire and / or the catheter
- A device for actuating the plunger of the syringe in accordance with one of the above characteristics.

Finally, the invention also relates to a method for temporarily placing a catheter and / or a guide wire in a cavity with liquid content of the organism. This process includes the steps of
- Introduce into said cavity the needle of the aforementioned system, the plunger being in the retracted position in the body of the syringe
- Ensure that the needle is correctly positioned by causing a depression inside the body of the syringe, this depression being obtained by actuating said operating lever.
- when a fraction of the liquid in the cavity has risen inside the syringe body, introduce the guidewire and / or the catheter inside the fitting through its free branch
- position the guide wire and / or the catheter to the desired position.

Other characteristics and advantages of the invention will appear on reading the description which follows. This description will be made with reference to the accompanying drawings in which
- Figure 1 is an exploded perspective view of the first embodiment of the device for actuating the plunger of a syringe
- Figures 2 to 4 are views in longitudinal section of the device of Figure 1, which allow to understand its operation when in place on a syringe
- Figure 5 is a partial perspective view of the means which allow the introduction of a guide wire into a fluid-containing cavity of the body
- Figure 6 is a schematic sectional view of a second embodiment of the device for actuating the plunger of a syringe.

 Throughout the description and claims, the terms "proximal (e)" and "distal (e)" are used taking as reference the operator that he sets up the device of the invention. According to this definition, the proximal end of an element is that which is closest to the operator, while the distal end is that which is furthest from it.

 The device for actuating the plunger of a syringe which is shown in FIGS. 1 to 4 essentially comprises a fixing part 4 intended to be made integral with the body 10 of the syringe 1, a movement transmission member 2, an operating lever 5 articulated on the part 4 and two pawls 6 and 7.

 We will now describe in detail each of these organs and also explain their function.

 The fixing part 4 is a molded plastic part. It essentially comprises a part 400 in the form of a gutter. The side cheeks are marked 40 while the bottom is marked 41. As the figures clearly show, the cheeks 40 are inscribed in side view in a triangle.

 Against the bottom 41, but on the side opposite to the cheeks 40, a sleeve 42 is provided, the bottom of which is situated substantially at the level of the lower part of the gutter 400. This sleeve extends only over part of the length of the gutter.

 At the other end of the gutter, the cheeks 40 are extended, on the same side as the sleeve 42, by two parallel ears 43 which, in front view, are substantially inscribed in a right triangle. Each ear has a tab 44 which extends from the side of the gutter, substantially perpendicular to the longitudinal axis thereof. Thus, there is a free space between the tab 44 and the corresponding cheek 40 of the gutter.

 The device of the invention also comprises an operating lever 5 which is integral with the fixing part 4. It is also a molded plastic part which has a bottom wall 51, two lateral partitions 50 and a partition 52. This lever is articulated on the ears 43 by two thin plastic tabs 53, which allow the lever to be operated relative to the part 4.

The bottom wall 51 internally carries a boss 510 with a tab 511 at its upper part.

 The movement transmission member 2 which also forms part of the device comprises an end part or fixing element 20 in the form of a jumper, the two legs of which are referenced 200. This part is connected to a rod 21 by a form zone curve. The face of the rod 21 which is opposite the wings 200 carries a series of non-return teeth 210 forming a rack. These teeth have a section in the form of small right triangles whose hypotenuse is located on the side of the end portion 20. This movement transmission member 2 is also made of plastic. The dimensions of the rod 21 are provided so that it can enter and slide inside the sleeve 42 of the part 4.

 Finally, the device comprises two steel spring blades 6 and 7, which form a pawl.

 The leaf spring 6 has two elongated rectangular parts 60 and 61 forming between them an angle of the order of 120.

 The leaf spring 7 has two legs 70 intended to be fixed, for example by gluing against the edges 430 of the ears 43 of the part 4, which extend perpendicular to the gutter 400. Between these legs 70 is provided, perpendicular to these last, a tongue 71 which continues with an oblique section turned towards the side of the legs 70, which bears the reference 72. The latter ends with an end portion 73 raised substantially to 900. The section 72 has a small opening 720.

 In the extension of the plate 71 and on the other side of the legs 70 extends a portion 74 which continues with a small oblique section which extends opposite the legs 70. It continues with a section 77 disposed parallel and on the same side as the legs 70 and finally by an end portion 76 parallel to the section 74. In a way, the sections 75 and 77 constitute a "tooth" of profile complementary to that of the teeth 210 of the member motion transmission 2.

 As shown in Figures 2 to 4, the spring leaf 6 is fixed by its part 60 to the bottom wall of the operating lever 5, for example by gluing. Its other part 61 is directed towards the ears 43.

 We will now describe the operation of this device when mounted on a syringe.

 A common type syringe is shown in Figures 1 to 4. This syringe, which has the reference numeral 1, has a generally cylindrical body whose distal end carries a hollow needle 12. Its open proximal end carries a peripheral lining which forms two diametrically opposite ears 100. The proximal end of the pusher It is formed of a disc 110 of larger diameter than that of the pusher body proper.

 Before putting the fixing piece on the syringe body, we start by introducing the rod 21 of the movement transmission member 2 inside the sleeve 42.

 According to an important characteristic of the invention, the distance between the two cheeks 40 of the gutter 400 is slightly less than the outside diameter of the syringe body 10 so that the gutter can be force fitted onto the syringe body . Similarly, the spacing between the two tabs 200 of the member 2 is slightly less than the outside diameter of the pusher 11 so that these tabs can be force fitted therein.

 Then positioning the assembly 3 formed by the fixing piece 4 and the movement transmission member 2 so that the tabs 200 of the member 2 are in abutment against the disc 110 of the pusher 11. The part 4 is positioned so that the tabs 44 are placed against the ears 100 of the syringe body, on the side of the plunger.

In this way, the part 4 is immobilized in translation along the syringe body.

 As shown in Figure 2, when the lever 5 is tilted around the joint 53 to bring it closer to the syringe body, the free end of the part 61 of the spring leaf 6 engages with the one of the teeth 210a of the member 2.

 The section 72 of the spring leaf 7 constantly tends to return the lever 5 to a position separated from the syringe body, while the "tooth" formed by the sections 75 and 77 engages with a tooth 210b of the member. 2.

 The tab 511 of the boss 510 is engaged with the opening 720 of the section 72 of the spring leaf. Thus, the blade and the lever are integral with each other so that the latter can only have an amplitude. limited pivoting in the direction of its separation from the syringe body.

 When the lever 5 is further brought towards the syringe body in the direction of the arrow f (FIG. 3), the part 61 of the spring leaf 6 tends to exert a thrust on the bottom of the tooth 210a, which results in a small translation of a length I of the movement transmission member 2 out of the sleeve 42. During this translation, the tooth 210b caused the "tooth" of the leaf spring 7 to tilt outwards, as shown in Figure 2 in dotted lines. This "tooth" then comes back to its original place: it is now engaged with a tooth 210c of the organ 2. It is therefore understood that it is then impossible to operate the plunger in order to make it enter the syringe body , the non-return "tooth" of the blade 7 preventing this operation.

 When the operating lever 5 is released, which is illustrated in FIG. 4, the length of the part 61 of the spring leaf 6 is no longer sufficient to remain in engagement with the tooth 210a. During this maneuver, the section 72 of the leaf spring 7 tends to move the lever away from the syringe body.

 When again, the lever is brought closer to the syringe body, the part 61 of the leaf spring comes into engagement with the tooth 210d which is immediately adjacent to the tooth 210a.

 It is therefore understood that, by successive operations of the lever 5, the plunger 11 is advanced step by step in the direction of its withdrawal from the syringe body, each of a length 1.

 This device therefore makes it possible to create a depression inside the syringe. Such a device is particularly advantageous insofar as it can be operated with one hand, the palm of the hand pressing against the syringe body, while the fingers manipulate the lever.

 If one wishes to operate the plunger to return it inside the syringe body, it suffices to hold the lever 5 in the separated position and to press on the section 76 of the blade 7 so as to release the "tooth" of the latter of the rack. We can then subject the pusher to a translation in the desired direction.

 A second embodiment of the device for actuating the plunger of the syringe is shown diagrammatically in FIG. 6.

 This device comprises a fixing part 4 ′ which, as in the first embodiment, consists of a part 400 ′ in the form of a gutter, designed to be force fitted onto the body 10 of a syringe. A part 200 ′ of this gutter is open and continues with a sleeve or housing 42 also coming from molding with the gutter.

 One of the longitudinal faces of the housing 42 'has an opening 420', while the opposite wall has two openings 421 'and 422'. In the vicinity of the opening 420 'extends a tab 43' which comprises at its free end and substantially perpendicular thereto a piece 44 'in the shape of a stirrup.

 The wall 423 'of the housing which is opposite the gutter has an opening.

 The transmission member 2 'consists of a cylindrical rod 21' which passes through the housing 42 'through the openings 420' and 422 '. Its end turned towards the side of the opening 420 ′ has a fixing element 20 ′ in the shape of a stirrup which has two legs 200 ′.

 In the housing 42 'is mounted a lever 5' which is articulated on the latter around an axis 52 '. As shown in Figure 6, the rod 21 'passes through the bearing face 51' of this lever. In front of this bearing face are provided two metal tabs 45 'which each have an opening for the passage of the rod 21'. A helical spring is placed between the bottom of the housing 42 'and one of the tabs 45'. On the other side of the support surface of the lever is mounted a spring 47 'also helical, which surrounds the rod 21' and which comes to bear against a part 7 '. This part has an opening 70 'which is crossed by rod 21'. In this region, this part has an inclined section so that the two opposite edges of the opening 70 come to bear against the rod. This rod continues towards the outside of the device by crossing the opening 421 ′ and then rises again. and the other of the rod 21 in the form of two parallel branches 71.

 It is understood that when the branches 71 ′ are maneuvered in the direction of the arrow v, there is a tilting of the whole of the part 7 so that the rod is no longer wedged at the level of the opening 70.

 As clearly shown in the figure, the end 44 'in the shape of a stirrup of the tab 43' is wedged against the ears 100 of the syringe.

 Similarly, the legs 200 ′ of the rod 21 ′ come into engagement with the pusher 11, not far from its proximal end 110.

 According to a well-known principle, when the lever 5 ′ is maneuvered so as to bring it closer to the syringe, there is a tilting of the latter which causes the two plates 45 ′ to pivot. Their respective openings first wedge the rod and, due to their tilting, advance it step by step in the direction of the arrow w. A movement of the pusher in the opposite direction is made impossible due to the blocking of the rod by the member 7 '. On the contrary, when the branches 71 ′ of the latter are pressed the rod 21 ′ is released and can therefore slide in the direction opposite to the arrow w.

 Another aspect of the invention relates to a system for the temporary placement of a guide wire and / or of a catheter in a cavity with liquid contents of the organism.

 According to the invention, this system comprises a syringe of the type described with reference to Figures 1 to 4, as well as a device according to one or the other of the two embodiments already described. This system also comprises a connection with three branches 8, visible in FIG. 5.

 This connector comprises a first branch 80 intended to be connected to the distal end of the body of a syringe. The second branch which extends in the extension of the first which carries the reference 81 is intended to be fixed to the needle 12. The third branch 82 is free and allows the introduction of a guide wire and / or d 'a catheter 9. The third branch 82, arranged obliquely to the other two, has a head inside which is provided an O-ring. Its function is to normally close the inner conduit 820 of the branch so as to make it watertight. This seal is generally made of rubber and has sufficient elasticity to allow an object such as a guide wire or a catheter to pass through it.

 As mentioned above, the invention also relates to a method for temporarily placing a catheter and / or a guide wire in a cavity of the body with liquid content.

 We will now describe how this process is implemented, assuming that a puncture of a vein must be performed, for the placement of a guide wire, using the device of FIG. 1.

 In a first step, the device is used in the position which it occupies in FIG. 2, that is to say with the plunger 11 practically completely inserted inside the syringe body 10.

 Of course, the device of FIG. 6 could also be used, it being understood that the plunger 11 should also be practically pressed inside the syringe body 10.

 In a second step, the end of the needle 12 is introduced into the vein to be punctured.

 The third step in the process consists in ensuring that the needle is correctly positioned. To do this, we will have to create inside the syringe body a depression which will allow the ascent of blood inside the latter. The lever 5 (or 5 ′) of the device is printed with a series of successive swings which cause the plunger to move step by step out of the syringe body. If the needle of the device is correctly positioned, a fraction of blood rises inside the syringe body.

 This produces a vacuum with one hand inside the syringe body, and more precisely between the plunger piston and the bottom of the syringe body. This depression is enough to cause a volume of blood in the vein to flow into the body.

We understand that this maneuver directly informs the operator on the realization of the puncture.

 This operation is carried out with one hand and without effort, so that the operator's movements are flexible and precise. It is important to note that during this manipulation the operator has a free hand which allows him to palpate the patient's anatomical landmarks and therefore to orient the puncture needle in the right direction. The free hand can also handle a monitoring device such as a doppler probe or an ultrasound probe. In practice, a single manipulation is enough to perform the puncture. The final step in the process is to place the guidewire and / or catheter inside the fitting. To do this, the latter is introduced through the opening presented by the branch 82 of the connector. Due to the pressure of the guidewire or the catheter on the O-ring that this branch has, it deviates and it is then possible to introduce the guidewire or the catheter.

 The last manipulation consists in manually maneuvering the catheter or the guide wire so as to make it enter completely inside the fitting and to make it pass through the hollow needle until it reaches the body cavity .

 This temporary placement process makes it possible to implement various therapeutic acts. As an indication, we can cite the placement of a catheter in the large vessels at the base of the heart for perfusions or pressure tests, the placement of endovenous material preventive of pulmonary embolism, such as filters. Mention may also be made of the extraction of intravenous or intraarterial blood clots, the percutaneous endo-arterial treatment of arteromatous disease, the progression of endoscopic devices in the urinary cavities and the extraction of stones from the ureter or pelvis.

Claims (10)

 1 .. Device for actuating the plunger (11) of a syringe (1) in order to create a depression there, characterized in that it comprises  - a fixing part (4, 4 ′) intended to be made integral with the syringe body (10)  - a movement transmission member (2, 2 ') slidingly mounted on said part (4, 4') and which comprises a fixing element (20, 20 ') adapted to come into engagement with the pusher (11)  - an operating lever (5, 5 ') articulated on said part (4, 4'), the actuation of which by pivoting causes the step-by-step movement of the transmission member (2, 2 ') so to cause the extension of the plunger (11) out of the body (10) of the syringe and simultaneously a depression in the latter.  2. Device according to claim 1, characterized in that said fixing part (4, 4 ') comprises a gutter-shaped part (400, 400') which can be force fitted on the syringe body (10) as well as tabs locking (44, 44 ') intended to be positioned against ears (100) provided at the proximal end of the syringe body (10), at their face opposite the body.  3. Device according to one of claims 1 and 2, characterized in that said fixing element (20, 20 ') has the shape of a jumper which has two legs (200, 200'), adapted to be fitted by force on the pusher.  4. Device according to one of claims 1 to 3, characterized in that it comprises non-return means (7, 7 ') making it possible to prevent the plunger (11) from being pushed into the body (10) of syringe.  5. Device according to claim 4, characterized in that it is provided with means making the non-return means (7, 7 ') inoperative.  6. Device according to one of claims 1 to 5, characterized in that said movement transmission member (2, 2 ') slides inside a sleeve (42, 42') integral with or forming an integral part of said fixing part (4, 4 ').  7. Device according to one of claims 1 to 6, characterized in that said movement transmission member (2) comprises a rod (21) forming a rack and in that the operating lever (5) comprises a spring leaf (6) forming a pawl, so that each time the lever (5) is brought closer to the rod (21), the pawl (6) first engages against a tooth (210) of the rack then makes the rod (21) undergo translation, the release of the lever (5) causing the withdrawal of the pawl (6).  8. Device according to one of claims 4 and 7 taken in combination, characterized in that the lever (5) comprises a second leaf spring (7) forming a pawl capable of coming into engagement in turn with another tooth (210 ) of the rack as the rod (21) translates and capable of preventing the plunger (11) from being pushed into the syringe body (10).  9. Device according to one of claims 1 to 6, characterized in that said transmission member (2 ') comprises a rod (21') which passes through at least one plate (45 ') through a hole of slightly larger diameter than that of the rod (21 '), so that the actuation of the lever (5') causes the pivoting of the plate (45 '), then, simultaneously, the jamming of the rod (21') by the hole of the plate and its translation, said plate (45 ') returning to its initial position when the lever (5') is released.  10. System for the temporary placement of a guide wire and / or a catheter in a cavity with liquid content of the organism, characterized in that it comprises  - a syringe (I) comprising a body (10), a plunger (11) and a hollow needle (12)  - a connector (8) with three branches, one of which (80) is connected to the distal end of the syringe body (10), while the second (81) is fixed to the needle (12), the third (82) being free and allowing the introduction through said fitting and needle, into the body cavity, of the guide wire and / or the catheter (9)  - a device according to one of claims 1 to 9.