GB2426933A - Device to locate the trachea and mark the skin - Google Patents
Device to locate the trachea and mark the skin Download PDFInfo
- Publication number
- GB2426933A GB2426933A GB0611040A GB0611040A GB2426933A GB 2426933 A GB2426933 A GB 2426933A GB 0611040 A GB0611040 A GB 0611040A GB 0611040 A GB0611040 A GB 0611040A GB 2426933 A GB2426933 A GB 2426933A
- Authority
- GB
- United Kingdom
- Prior art keywords
- trachea
- marker
- location
- skin
- identifying
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 210000003437 trachea Anatomy 0.000 title claims abstract description 27
- 239000003550 marker Substances 0.000 claims abstract description 28
- 238000002604 ultrasonography Methods 0.000 claims abstract description 6
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 5
- 230000000007 visual effect Effects 0.000 claims description 3
- NOESYZHRGYRDHS-UHFFFAOYSA-N insulin Chemical compound N1C(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(NC(=O)CN)C(C)CC)CSSCC(C(NC(CO)C(=O)NC(CC(C)C)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CCC(N)=O)C(=O)NC(CC(C)C)C(=O)NC(CCC(O)=O)C(=O)NC(CC(N)=O)C(=O)NC(CC=2C=CC(O)=CC=2)C(=O)NC(CSSCC(NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2C=CC(O)=CC=2)NC(=O)C(CC(C)C)NC(=O)C(C)NC(=O)C(CCC(O)=O)NC(=O)C(C(C)C)NC(=O)C(CC(C)C)NC(=O)C(CC=2NC=NC=2)NC(=O)C(CO)NC(=O)CNC2=O)C(=O)NCC(=O)NC(CCC(O)=O)C(=O)NC(CCCNC(N)=N)C(=O)NCC(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC=CC=3)C(=O)NC(CC=3C=CC(O)=CC=3)C(=O)NC(C(C)O)C(=O)N3C(CCC3)C(=O)NC(CCCCN)C(=O)NC(C)C(O)=O)C(=O)NC(CC(N)=O)C(O)=O)=O)NC(=O)C(C(C)CC)NC(=O)C(CO)NC(=O)C(C(C)O)NC(=O)C1CSSCC2NC(=O)C(CC(C)C)NC(=O)C(NC(=O)C(CCC(N)=O)NC(=O)C(CC(N)=O)NC(=O)C(NC(=O)C(N)CC=1C=CC=CC=1)C(C)C)CC1=CN=CN1 NOESYZHRGYRDHS-UHFFFAOYSA-N 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010011409 Cross infection Diseases 0.000 description 1
- 102000004877 Insulin Human genes 0.000 description 1
- 108090001061 Insulin Proteins 0.000 description 1
- 206010029803 Nosocomial infection Diseases 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 239000002537 cosmetic Substances 0.000 description 1
- 206010012601 diabetes mellitus Diseases 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940125396 insulin Drugs 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 229920003023 plastic Polymers 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 238000007920 subcutaneous administration Methods 0.000 description 1
- 238000012285 ultrasound imaging Methods 0.000 description 1
Classifications
-
- 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
- A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
- A61M16/0472—Devices for performing a tracheostomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4411—Device being modular
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/11—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis with guides for needles or instruments, e.g. arcuate slides or ball joints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
- A61B2090/395—Visible markers with marking agent for marking skin or other tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- Radiology & Medical Imaging (AREA)
- Pulmonology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Emergency Medicine (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Ultra Sonic Daignosis Equipment (AREA)
Abstract
A tracheostomy instrument may include an ultrasound transducer 10 connected to provide an image on a display 2 of the location of the trachea and of blood vessels in the vicinity. The transducer 10 is removably attached to a marker device 11 having a spring-loaded needle 26 that can be released by actuating a catch button 43 when the location of the trachea has been identified, so as to mark the skin.
Description
TRACHEOSTOMY INSTRUMENTS
This invention relates to tracheostomy instruments.
When a tracheostomy procedure is carried out, the clinician must have accurate knowledge of the correct location at which the incision into the trachea is to be made. In some cases there can be difficulties in identifying the anatomical landmarks that enable the correct location to be determined. This may be because the patient is obese and has excessively thick tissue over the trachea. Also, in some patients, the trachea is offset, or blood vessels overlie the trachea, making it difficult safely to access the trachea.
It is an object of the present invention to provide alternative tracheostomy instruments.
According to the present invention there is provided a tracheostomy instrument including means for identifying the location of the trachea and a marker arranged to mark the skin when the correct location has been identified.
The marker is preferably arranged to cause a visible surface damage to the skin, such as to cut, scratch or bum the skin. The marker preferably includes a needle. The marker may be sprung loaded in a retracted position and released to mark the skin when a catch is released. The means for identifying the location of the trachea preferably includes an ultrasound device. The means for identifying the location of the trachea may also be adapted to identify blood vessels. The means for identifying the location of the trachea may include a visual display. The marker may be removable from the means for identifying the location of the trachea such that the means for identifying the location of the trachea can be used again with a different marker.
A tracheostomy instrument according to the present invention will now be described, by way of example, with reference to the accompanying drawings, in which: Figure 1 is a perspective view of the instrument; Figure 2 is a perspective view of a part of the instrument with the marker separated from the transducer; Figure 3 is a perspective view of a part of the instrument showing the marker in use; and Figure 4 is a cross-sectional elevation view of the marker.
As shown in Figure 1, the instrument includes a hand-held unit 1, a display monitor 2 and an electrical cable 3 by which the unit and monitor are interconnected. Figure 2 shows that the hand-held unit I comprises an ultrasonic transducer 10 and a separate attachment, which is the marker 11.
The transducer 10 is a conventional ultrasound transducer having a linear array of several ultrasound transducer elements arranged along an elongate, straight end face 12 of the transducer.
The head 13 of the transducer 10, on which the end face 12 is provided, is enlarged laterally relative to a rear handle portion 14 from which the cable 3 extends. The transducer 10 is preferably a Sonosite Linear Array Transducer Model L38.
The marker 11 is shown more clearly in Figures 2 to 4. It comprises a forward frame 21 of rectangular shape and with an open centre 22 in which the head 13 of the transducer is received. The dimensions of the frame 21 are such that the end face 12 of the transducer lies level with the end face 23 of the frame so as to ensure that the frame does not prevent close contact of the end face 12 of the transducer with the patient's skin. An enclosure 24 projects rearwardly from the centre of one of the longer sides of the frame 21 to extend centrally in contact with the upper surface of the transducer 10. The enclosure 24 contains a spring- loaded needle mechanism 25, shown most clearly in Figure 4. This mechanism may be similar to those used commonly for subcutaneous self-administration of medication, such as insulin by people with diabetes. At its lower end, the mechanism 25 has an axially-aligned short metal needle 26, which could be solid or hollow, having its sharp, tissue-penetrating tip 27 located at the lower, forward end of the mechanism adjacent the end of the enclosure 24. The upper, rear end of the needle 26 is mounted at the forward, lower end of a rigid plastics shaft 28, which extends axially the length of the enclosure 24. Towards its upper end, the shaft 28 is bifurcated to form an elongate, resilient catch member 29 attached at its upper end with the shaft and extending down in parallel with the shaft about half its length. The lower end 30 of the catch member 29 is thickened to provide a lower end face 31, a side face 32 and a tapering ramp 33. The shaft 28 is mounted within the enclosure 24 such that the side face 32 of the catch member 29 contacts the inside wall of the enclosure and is urged resiliently into contact with it by flexing of the catch member. The upper end portion 34 of the shaft is reduced in thickness, forming a step 35, and projects through an opening 40 at the upper, rear end of the enclosure 24. An enlarged head 41 at the rear end of the shaft 28 locates outside the enclosure 24 within a conical cap 42.
The marker mechanism 25 is completed by an actuating button 43 mounted in the enclosure 24 about halfway along its length. The button 43 has a head 44 located externally of the enclosure 24 and a plate 45 located within a recess 46 formed on the inside of the enclosure 24 and connected with the head by a thin stem 47. A helical spring 50 is located in compression between the step 35 of the shaft 28 and the inside of the enclosure 24 around the opening 40 to apply a force to the shaft urging it downwardly or forwardly.
The user loads the marker 11 by pulling the cap 42 upwardly or rearwardly so that the shaft 28 is pulled up against the action of the spring 50 until the lower end face 31 of the catch member 29 snaps outwardly, resiliently into the recess 46. The cap 42 is then released and the shaft 28 is retained in the loaded, retracted state by engagement of the lower end face 31 on the catch member 29 on the lower edge 48 of the recess 46. The shaft 28 and the needle 26 are released by pushing the head 44 of the button 43 inwardly so that the plate 45 pushes in the lower end 30 of the catch member 29 sufficiently for its lower end face 31 to clear the lower edge 48 of the recess 46. This allows the spring 50 to advance the shaft 28 and the needle 26 so that its pointed tip 27 projects beyond the forward, lower end of the enclosure 24.
Initially, the marker 11 is set in the loaded, retracted position so that the needle tip 27 is withdrawn rearwardly into the enclosure 24. The instrument is then held with face 12 of the transducer 10 against the skin of the neck overlying the expected location of the trachea. A gel may be applied to the skin in the usual way to promote transmission of the ultrasound energy between the transducer 10 and neck tissue by filling air pockets between the face 12 of the transducer and the skin. The clinician views the screen of the monitor 2 while moving the transducer 10 up and down and side to side until the desired position is found. It is possible in this way to identify the major anatomical landmarks and to identify an offset trachea and blood vessels. He presses the button 43 on the marker 11 when the correct location has been found so that the needle 26 is driven down by the spring 50 into the top layer of the skin 60. The needle puncture point forms a non-erasable mark on the skin. The needle 26 is then withdrawn into the enclosure 24 by pulling up the cap 42, in order to latch it again. A single mark may be formed or the clinician may move the instrument slightly and re-activate the marker 11 to make a second mark on the skin to indicate that the tracheostomy incision must be made between the two marks.
In alternative instruments the marker could create two or more marks in a single actuation. It will be appreciated that the marker could be arranged to be single use so that, once the needle has been retracted following actuation it cannot be actuated again. This would avoid the risk of cross-infection. Because the mark takes the form of an incision, it can be made effectively even if the skin is wet. Also, there is no risk it will be removed when the skin is cleaned before surgery. Normally the mark is made when the patient is anaesthetised so there is no discomfort. Also, because the mark is made at the proposed site of the surgery, it does not cause any additional cosmetic damage to the patient.
Preferably the marker is of the kind that causes visible surface damage to the skin, such as an incision, scarification or the like. One alternative form of marker could include a device to cause a small burn on the skin. This could be achieved by a heated element or by electrodes arranged to pass a localized current sufficient to burn. Whilst it might be possible to use some form of pen or the like containing an ink, dye or stain these would be less suitable because they might not be effective to create a visible mark if the skin surface were wet or if it were subsequently washed. The needle could contain an ink that is injected just beneath the skin in the manner of a tattoo.
Alternative means for identifying the location of the trachea could be used instead of ultrasound imaging. For example, a light-emitting device could be inserted into the trachea through the mouth and the instrument could include some external means for viewing the light transmitted through the neck tissue. A magnetic device could be used in the manner described in US443 1005, US4416289, US443 1005, US4905698, US5941858 orUS5669383. Alternatively an X-ray, MRJ, thermal device or radar scanner could be used to provide an image of the anatomical landmarks in the region of the trachea.
Instead of having a screen on a separate monitor, the instrument could be self-contained with a screen built into the hand-held device. It is not essential to provide a visual indication of the location of the trachea. Instead, an acoustic indication could be provide, such as by generating an audible tone that changes in character as the instrument is moved over the region of the trachea.
Claims (11)
1. A tracheostomy instrument including means for identifying the location of the trachea and a marker arranged to mark the skin when the correct location has been identified.
2. A tracheostomy instrument according to Claim 1, wherein the marker is arranged to cause a visible surface damage to the skin.
3. A tracheostomy instrument according to Claim 2, wherein the marker is arranged to cut, scratch or burn the skin.
4. A tracheostomy instrument according to Claim 3, wherein the marker includes a needle.
5. A tracheostomy instrument according to any one of the preceding claims, wherein the marker is sprung loaded in a retracted position and is released to mark the skin when a catch is released.
6. A tracheostomy instrument according to any one of the preceding claims, wherein the means for identifying the location of the trachea includes an ultrasound device.
7. A tracheostomy instrument according to any one of the preceding claims, wherein the means for identifying the location of the trachea is also adapted to identify blood vessels.
I
8. A tracheostomy instrument according to any one of the preceding claims, wherein the means for identifying the location of the trachea includes a visual display.
9. A tracheostomy instrument according to any one of the preceding claims, wherein the marker is removable from the means for identifying the location of the trachea such that the means for identifying the location of the trachea can be used again with a different marker.
10. A tracheostomy instrument substantially as hereinbefore described with reference to the accompanying drawings.
11. Any novel and inventive feature or combination of features as hereinbefore described.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GBGB0511520.9A GB0511520D0 (en) | 2005-06-07 | 2005-06-07 | Tracheostomy instruments |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| GB0611040D0 GB0611040D0 (en) | 2006-07-12 |
| GB2426933A true GB2426933A (en) | 2006-12-13 |
Family
ID=34835224
Family Applications (2)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| GBGB0511520.9A Ceased GB0511520D0 (en) | 2005-06-07 | 2005-06-07 | Tracheostomy instruments |
| GB0611040A Withdrawn GB2426933A (en) | 2005-06-07 | 2006-06-06 | Device to locate the trachea and mark the skin |
Family Applications Before (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| GBGB0511520.9A Ceased GB0511520D0 (en) | 2005-06-07 | 2005-06-07 | Tracheostomy instruments |
Country Status (1)
| Country | Link |
|---|---|
| GB (2) | GB0511520D0 (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| ES2387667A1 (en) * | 2012-07-04 | 2012-09-27 | Universidad Politecnica De Madrid | Assisted Tracheotomy Device |
| GB2554372A (en) * | 2016-09-22 | 2018-04-04 | Guys And St Thomas Nhs Found Trust | System for marking the surface of a patient's tissue in the course of imaging |
| US20220265948A1 (en) * | 2021-02-23 | 2022-08-25 | Joshua D. Pollack | Tracheotomy Device and Method of Use |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4108165A (en) * | 1977-06-20 | 1978-08-22 | Krautkramer-Branson, Incorporated | Transducer probe for pulse-echo ultrasonic exploration |
| US5924992A (en) * | 1997-11-26 | 1999-07-20 | Acuson Corporation | Semi-compliant needle guide for use with ultrasound transducers |
| US6475152B1 (en) * | 2000-03-13 | 2002-11-05 | Koninklijke Philips Electronics N.V. | Biopsy needle guide for attachment to an ultrasound transducer |
| US20030120154A1 (en) * | 2001-11-28 | 2003-06-26 | Frank Sauer | Method and apparatus for ultrasound guidance of needle biopsies |
| GB2418618A (en) * | 2004-10-02 | 2006-04-05 | Smiths Group Plc | Tracheostomy apparatus |
-
2005
- 2005-06-07 GB GBGB0511520.9A patent/GB0511520D0/en not_active Ceased
-
2006
- 2006-06-06 GB GB0611040A patent/GB2426933A/en not_active Withdrawn
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4108165A (en) * | 1977-06-20 | 1978-08-22 | Krautkramer-Branson, Incorporated | Transducer probe for pulse-echo ultrasonic exploration |
| US5924992A (en) * | 1997-11-26 | 1999-07-20 | Acuson Corporation | Semi-compliant needle guide for use with ultrasound transducers |
| US6475152B1 (en) * | 2000-03-13 | 2002-11-05 | Koninklijke Philips Electronics N.V. | Biopsy needle guide for attachment to an ultrasound transducer |
| US20030120154A1 (en) * | 2001-11-28 | 2003-06-26 | Frank Sauer | Method and apparatus for ultrasound guidance of needle biopsies |
| GB2418618A (en) * | 2004-10-02 | 2006-04-05 | Smiths Group Plc | Tracheostomy apparatus |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| ES2387667A1 (en) * | 2012-07-04 | 2012-09-27 | Universidad Politecnica De Madrid | Assisted Tracheotomy Device |
| WO2014006259A1 (en) * | 2012-07-04 | 2014-01-09 | Universidad Autonoma De Madrid | Assisted tracheotomy device |
| GB2554372A (en) * | 2016-09-22 | 2018-04-04 | Guys And St Thomas Nhs Found Trust | System for marking the surface of a patient's tissue in the course of imaging |
| US20220265948A1 (en) * | 2021-02-23 | 2022-08-25 | Joshua D. Pollack | Tracheotomy Device and Method of Use |
| US11596756B2 (en) * | 2021-02-23 | 2023-03-07 | Joshua D. Pollack | Tracheotomy device and method of use |
Also Published As
| Publication number | Publication date |
|---|---|
| GB0511520D0 (en) | 2005-07-13 |
| GB0611040D0 (en) | 2006-07-12 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| WAP | Application withdrawn, taken to be withdrawn or refused ** after publication under section 16(1) |