JPH0739847U - Endotracheal tube insertion aid - Google Patents

Abstract

(57) [Abstract] [Purpose] When inserting an endotracheal tube into the trachea, the present invention prevents the endoscope that assists the insertion of the endotracheal tube and the stylet from interfering with each other. The most important feature is quick and easy insertion into the patient. [Structure] Stylet 2 inserted through endotracheal tube 3
And a stylet fixing tool 15 for locking the insertion section 8 of the endoscope 4 in parallel with the endotracheal tube 3.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to an endotracheal tube insertion assisting tool that is inserted into the trachea to secure an airway during general anesthesia.

[0002]

[Prior art]

 In general, when inserting an endotracheal tube into a patient, it may be difficult to insert the endotracheal tube into the patient when the soft tissue around the upper airway is expanded, deformed, or hardened. In such a case, a stylet is put in the endotracheal tube in advance, and the stylet is bent to make it easy to insert the endotracheal tube, and then the endotracheal tube is inserted into the trachea.

After the intubation, the stylet is pulled out from the endotracheal tube, and the endoscope is inserted into the endotracheal tube instead, and the endoscope is used to determine where the tip of the endotracheal tube is located in the trachea. I try to confirm.

At this time, if the tip of the endotracheal tube is not at the desired position for insertion, the endotracheal tube is once removed from the trachea, the endoscope is also removed from the endotracheal tube, and the stylet is re-inserted into the endotracheal tube. Insert and repeat the above operation. This is repeated until the endotracheal tube is at the desired position for insertion.

[0005]

[Problems to be solved by the device]

 In the case of the conventional configuration described above, if the end of the endotracheal tube cannot be correctly inserted to the desired position by inserting the endotracheal tube once, pull out the endotracheal tube from the patient and start over. As a result, the endotracheal tube insertion operation may be repeated multiple times. In such a case, there is a problem that it takes time to insert the endotracheal tube to the desired position.

[0006] Furthermore, while inserting the stylet into the endotracheal tube and inserting it into the trachea, the endoscope is inserted into the endotracheal tube, and the insertion position of the tip of the endotracheal tube is confirmed by this endoscope. It is also possible to continue the endotracheal tube insertion work while correcting the insertion direction of the endotracheal tube. However, in this case, when inserting the endoscope into the endotracheal tube, the insertion portion of the endoscope may interfere with the stylet. There is.

The present invention has been made in view of the above circumstances, and an object thereof is to insert an endotracheal tube into an endotracheal tube so that an endoscope for assisting the insertion of the endotracheal tube and a stylet interfere with each other. It is an object of the present invention to provide an endotracheal tube insertion assisting tool that can easily and easily insert an endotracheal tube into a patient in a short time.

[0008]

[Means for Solving the Problems]

 The present invention is an endotracheal tube inserter that is detachably inserted into an endotracheal tube and includes a stylet that transforms the shape of the tube into an arbitrary shape and an endoscope that confirms the insertion position of the endotracheal tube. The auxiliary tool is provided with a stylet fixing tool that locks the stylet inserted through the endotracheal tube and the insertion portion of the endoscope in a state parallel to the endotracheal tube.

[0009]

[Action]

 The stylet inserted through the endotracheal tube and the insertion part of the endoscope are locked in parallel with the endotracheal tube by a stylet fixing tool, so that the insertion part of the endoscope inserted through the endotracheal tube is locked. It is designed to prevent interference with the stylet.

[0010]

【Example】

 A first embodiment of the present invention will be described below with reference to FIGS. 1 (A) and 1 (B). FIG. 1A shows a schematic configuration of the endotracheal tube insertion assisting tool 1 as a whole. Here, 2 is a stylet which is removably inserted into the endotracheal tube 3 shown in FIG. 1 (B) and deforms the shape of the tube 3 into an arbitrary shape, and 4 confirms the insertion position of the endotracheal tube 3. It is an endoscope.

The endoscope 4 is provided with an endoscope main body 5 and a light source unit 6 connected to the endoscope main body 5. Here, the light source unit 6 is composed of a lamp (not shown) that emits light, a battery for a power source (not shown) of the lamp, and a switch 7 for turning the lamp on and off.

Further, the endoscope body 5 is provided with an insertion portion 8 to be inserted into the endotracheal tube 3 and a proximal operation portion 9 connected to a proximal end portion of the insertion portion 8. The operation section 9 includes an eyepiece section 10 for observing an observation site at the tip of the insertion section 8, a bending operation knob 11 for bending the tip of the insertion section 8, and a procedure for inserting a treatment tool such as forceps. A tool insertion opening 12 is provided. A forceps plug 13 is attached to the treatment instrument insertion port 12.

Further, the insertion portion 6 is provided with a flexible flexible tube portion 14. A stylet fixing tool 15, which will be described later, of the insertion assisting tool 1 is continuously provided on the proximal side of the flexible tube portion 14. Further, a bending portion 16 and a tip forming portion 17 connected to the tip of the bending portion 16 are provided on the tip end side of the flexible tube portion 14.

Further, the tip forming portion 17 is provided with a hard tip forming portion main body 18 as shown in FIG. 1 (B). An objective optical system 19, an illumination optical system 20, and a distal end opening portion 21a of a forceps channel 21 are arranged in the distal end constituent body 18.

Further, the objective optical system 19 is connected to the tip of the image guide fiber 22. The proximal end side of the image guide fiber 22 is connected to the eyepiece 10 through the inside of the insertion portion 8 and the inside of the operation portion 9. The illumination optical system 20 is connected to the tip of a light guide fiber (not shown). The proximal end side of this light guide fiber passes through the inside of the insertion portion 8 and the inside of the operating portion 9, and is connected to the light source connecting portion 23 protruding from the operating portion 9. Then, the light emitted from the lamp of the light source section 6 is condensed by the light source connecting section 23 and guided into the light guide fiber, guided to the illumination optical system 20 through the light guide fiber, and externally emitted from the illumination optical system 20. It is designed to be illuminated as illumination light.

Further, the forceps channel 21 is connected to the suction tube connection port 24 of the operating portion 9 from the inside of the tip forming portion main body 18 through the inside of the inserting portion 8 and the inside of the operating portion 9. The middle part of the forceps channel 21 is connected to the suction valve 25 for turning the suction on and off and the treatment instrument insertion port 12.

The body 26 of the stylet fixture 15 is made of a soft material that can maintain the shape of the stylet 2 when the stylet 2 is bent. At the end of the stylet fixture main body 26 on the side of the operating portion 9 of the endoscope 4, a tapered connecting portion 27 having a narrower distal end is formed, and the connecting portion 27 is a base of the endotracheal tube 3. 28 can be locked.

Further, a plurality of ventilation grooves 29 extending in the axial direction are formed on the outer peripheral surface of the connecting portion 27. Then, when the connecting portion 27 is locked to the mouthpiece 28 of the endotracheal tube 3, when the endotracheal tube 3 is inserted into the trachea, the inner peripheral surface of the mouthpiece 28 of the endotracheal tube 3 and the ventilation groove of the connecting portion 27. 29 ... Allows the patient to breathe through.

Further, a stylet hole 30 into which the stylet 2 is inserted is formed in the stylet fixture main body 26. The stylet hole 30 is formed parallel to the insertion portion 8 of the endoscope 4. The stylet 2 inserted into the endotracheal tube 3 with the stylet 2 inserted in the stylet hole 30 of the stylet fixture 15 and the insertion portion 8 of the endoscope 4 are combined with the stylet fixture. It is adapted to be locked in parallel with the endotracheal tube 3 by 15. Here, the inlet side of the stylet hole 30 is smaller than the outer diameter dimension of the stylet 2, and the outlet side is larger. As a result, when the stylet 2 is inserted into the stylet hole 30, it does not come off immediately.

Next, the operation of the above configuration will be described. Here, a method of inserting the endotracheal tube 3 into the patient by using the stylet 2 will be described.

First, as shown in FIG. 1A, after inserting the stylet 2 into the stylet hole 30 of the stylet fixing tool 15, the stylet 2 is bent into a shape that can be inserted into the patient's trachea. Mold. Next, as shown in FIG. 1 (B), the stylet fixture 15 is inserted into the endotracheal tube 3 and fixed while the stylet 2 is still inserted. At this time, if the endotracheal tube 3 is not shaped so as to be inserted into the trachea of the patient, the shape of the stylet 2 is corrected at this point.

Next, the switch 7 is turned on to turn on the lamp of the light source unit 6, and the illumination light from the light source unit 6 is emitted from the illumination optical system 20 at the tip of the insertion unit 6 of the endoscope 4 to the outside. To illuminate the front of the insertion portion 6. Then, the endotracheal tube 3 is inserted while expanding the larynx with a laryngoscope. At this time, the endotracheal tube 3 is continuously inserted while observing with the endoscope 4.

In addition, during insertion work of the endotracheal tube 3, if the insertion position is shifted, the endotracheal tube 3 is moved and adjusted, or the endotracheal tube 3 is removed from the patient's trachea and inserted. I will do it again.

Then, when the tip of the endotracheal tube 3 reaches the target position, the stylet 2 and the endoscope 4 are removed from the endotracheal tube 3 to anesthetize the patient through the endotracheal tube 3.

Therefore, in the case of the above configuration, the stylet fixing tool 15 is fixed to the endotracheal tube 3 by inserting the stylet fixing tool 15 into the endotracheal tube 3. You can operate the endotracheal tube 3 with one hand. Therefore, workability when inserting the endotracheal tube 3 into the trachea of a patient can be improved as compared with the conventional work.

Further, a stylet fixing tool 15 is integrally formed on the insertion portion 8 of the endoscope body 5, and the stylet 2 inserted into the endotracheal tube 3 by the stylet fixing tool 15 and the endoscope 4 are inserted. Since the insertion portion 8 can be locked in parallel with the endotracheal tube 3, it is possible to prevent the stylet 2 and the insertion portion 8 of the endoscope 4 from interfering with each other in the endotracheal tube 3. You can Therefore, when inserting the endotracheal tube 3 into the patient's trachea, the endotracheal tube 3 can be easily inserted into the patient in a shorter time than in the conventional case.

Further, FIGS. 2A to 2C show a cleaning brush 41 which is inserted into the forceps channel 21 of the endoscope 4 shown in FIGS. 1A and 1B to wash the forceps channel 21. It is shown. In this cleaning brush 41, a brush main body 43 is arranged at the tip of a flexible sheath 42.

The brush body 43 is provided with a plurality of elastic wires 44 that are bent in a substantially mountain shape. The ends of these elastic wires 44 ... Are bundled together by a wire stopper 45. Further, the rear ends of the elastic wires 44 ... Are bundled together and joined to the front end of the sheath 42.

Further, each elastic wire 44 is radially arranged with respect to the central axis of the sheath 42. Further, a large number of hairs 46 ... Are planted on each elastic wire 44 so as to move together with the elastic wire 44.

Further, FIG. 2C shows an insertion state of the cleaning brush 41 inserted in the forceps channel 21 of the endoscope 4. Here, when the brush main body 43 of the brush 41 is inserted into the large-diameter duct 47 of the forceps channel 21, the bristles 46 ... Contact the inner wall surface of the duct 47. In this state, by moving the sheath 42 back and forth, the inner wall surface of the conduit 47 can be brushed.

Further, when the small diameter conduit 48 in which the inner diameter of the large diameter conduit 47 changes small is formed in the forceps channel 21, when the brush main body 43 of the brush 41 is inserted into the small diameter conduit 48, The bristles 46 are pushed by the wall surface of the small diameter conduit 48, and the elastic wires 44 are deformed so as to converge toward the center of the small diameter conduit 48. Further, thereafter, when it is moved to the large diameter conduit 47 having a large inner diameter, each elastic wire 44 is restored until the bristles 46 hit the inner wall surface of the large diameter conduit 47.

Therefore, in the above-described configuration, the bristles 46 of the brush main body 43 can be constantly applied to the inner wall surface of the forceps channel 21 regardless of the change in the inner diameter of the forceps channel 21, It is possible to effectively brush the inside of the pipe line where the change occurs with one brush 41.

FIG. 3 shows a first modification of the cleaning brush inserted into the forceps channel 21 of the endoscope 4. In the cleaning brush 51 of this modified example, a brush main body 53 is arranged at the tip of a sheath 52 made of a flexible material (eg, PTFE tube, polypropylene tube, metal coil, synthetic resin material, etc.). There is. At least two kinds of sponge members 54 having different outer diameters are superposed on the brush main body 53. The laminated sponge members 54 may or may not be adhered.

Further, restriction members 55 and 56 for restricting the axial movement of the sponge member 54 with respect to the sheath 52 are provided on the most distal end side and the rearmost end side of the sponge member 54 through which the distal end of the sheath 52 penetrates. It is fixed. The material of these regulating members 55, 56 is made of metal, synthetic resin, rubber material, or the like. The sponge member 54 may differ not only in the outer diameter but also in the hardness of the sponge itself.

Further, the shape of each sponge member 54 is not limited to a disc shape, but may be a petal-shaped sponge member 54 as in the first modification shown in FIG. The sponge member 54 having a trapezoidal cross section as in the second modification may be used. Further, the sponge members 54 may have the same color or different colors.

Further, the regulating member 56 on the rearmost end side may be configured such that a member separate from the sheath 52 is fixed to the sheath 52, or like the second modification of the brush shown in FIG. The regulating member 56 on the rearmost end side may be configured by the step portion 57 formed integrally with the case 52.

In the method of assembling the cleaning brush 51 of FIG. 3, first, the rear end side regulation member 56 is passed through the tip of the sheath 52 and fixed, and then a set of sponge members 54 suitable for the channel size is attached to the sheath 52. Insert from the tip. Then, the front side regulation member 55 and the sheath 52 are fixed by, for example, adhesion or welding. By changing the combination of the sponge members 54, the brush main body 53 suitable for each channel size can be manufactured.

Further, the combination of the sponge members 54 having different hardness can be changed for each channel size. Furthermore, not only the shape of the brush main body 53 but also the colors of the brush main body 53 are used according to the hardness of the brush main body 53 so that the usable channel size can be seen at a glance from the color arrangement. When the sheath 52 is formed of a tube, it can be washed while feeding water from the proximal side through the tube of the sheath 52.

Further, by preparing a plurality of types of replacement units for the sponge members 54 in advance, the replacement unit for the sponge members 54 may be appropriately selected when the brush 51 is assembled. There is no need to change the conditions and make the brush body.

In this embodiment, the core material of the sponge member 54 is formed by the sheath 52. However, as in the third modification of the brush shown in FIG. The core member 61 may be provided, and the core member 61 and the distal end portion of the sheath 52 may be connected by a connecting member 62 made of a flexible material.

As in the cleaning brush 71 of the fourth modified example shown in FIG. 7, a brush main body 73 integrally formed of an elastic material such as rubber is arranged at the tip of a flexible sheath 72. Good. In this case, the brush main body 73 is connected to the distal end of the sheath 72 by means of press fitting or bonding.

8 (A) and 8 (B) show a second embodiment of the present invention. This is so configured that the stylet fixture 15 of the first embodiment can be attached to and detached from the flexible tube portion 14 of the insertion portion 8 of the endoscope 4.

That is, the stylet fixture 81 of the present embodiment has a mouthpiece fixture 82 for press-fitting and fixing the stylet fixture 81 into the mouthpiece 28 of the endotracheal tube 3, and a pair of fixture component members 8 3, 84 which can be divided into two. And a fixing screw 86 for fixing the fixing member constituting members 83 and 84 by crimping and stopping in an integrated state, and a fixing screw 86.

Here, cushioning members 87, 88 made of elastic members are interposed between the fixing member constituting members 83, 84. Then, by rotating the fixing screw 86 against the elasticity of the cushioning materials 87 and 88, the gap between the fixture component members 83 and 84 becomes smaller, and when the fixing screw 86 is returned, it is fixed by the elasticity of the cushioning materials 87 and 88. The gap between the component parts 83 and 84 becomes large.

Further, as shown in FIG. 8 (B), scope grooves 89, 90 and a stylet 2 for fixing the insertion portion 8 of the endoscope 4 by crimping are provided at the joint between the fixing member constituting members 83, 84. Stylet grooves 91 and 92 are formed by crimping and stopping.

Further, the attachment ring 85 is screwed into the mouthpiece fixture 82 so that the fixture components 83 and 84 do not come out together with the mouthpiece fixture 82 when the stylet 2 is removed.

Further, as the fixing screw 86 is rotated, the distance between the scope groove 89 of the one fixture component member 83 and the scope groove 90 of the other fixture component member 84 becomes narrower. Then, when the insertion portion 8 of the endoscope 4 is crimped by the scope grooves 89 and 90, the fixing screw 86 cannot be rotated.

At this time, since the gap between the stylet groove 91 of the fixture component member 83 and the stylet groove 92 of the fixture component member 84 is larger than the outer diameter of the stylet 2, the stylet 2 Is fixed to the stylet fixture 81 by a stop member 93 made of an elastic member provided in the middle of the stylet grooves 91 and 92. Since the force for fixing the stylet 2 by the stylet fixing tool 81 is relatively weak, it can be easily pulled out from the stylet fixing tool 81 by pushing and pulling the stylet 2.

Next, a method of intubating the endotracheal tube 3 using the stylet fixing tool 81 having the above configuration will be described. First, the insertion portion 8 of the endoscope 4 is inserted into the scope grooves 89 and 90 between the fixture constituting members 83 and 84 of the stylet fixture 81, and the insertion portion 8 is adjusted according to the length of the endotracheal tube 3. In the state where the fixing position of 1 is determined, the fixing screw 86 is turned to fix the stylet fixture 36 to the insertion portion 8. After that, the stylet 2 is inserted into the space between the stylet grooves 91 and 92 of the stylet fixture 81, and the stylet 2 is bent into a shape that allows easy insertion. After that, the endotracheal tube 3 is inserted into the patient's trachea by the same procedure as in the first embodiment.

Therefore, even in the case of the above-described configuration, the stylet 2 inserted into the endotracheal tube 3 by the stylet fixing tool 81 and the insertion portion 8 of the endoscope 4 are separated as in the first embodiment. Since it can be locked in parallel with the endotracheal tube 3, it is possible to prevent interference between the stylet 2 and the insertion portion 8 of the endoscope 4 in the endotracheal tube 3. Therefore, when inserting the endotracheal tube 3 into the patient's trachea, the endotracheal tube 3 can be easily inserted into the patient in a shorter time than in the conventional case.

Further, in this embodiment, the stylet fixture 81 can be attached to and detached from the flexible tube portion 14 of the insertion portion 8 of the endoscope 4. Therefore, according to the length of the endotracheal tube 3, Since the length between the fixing position of the fixture 81 and the distal end portion 17 of the endoscope 4 can be changed, the endotracheal tube insertion aid 1 can be used for various types of endotracheal tubes 3. it can. Furthermore, by removing the stylet fixing tool 81 from the endoscope 4, the endoscope 4 can be used as an otolaryngological endoscope.

The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention.

[0053]

[Effect of device]

 According to the present invention, since the stylet fixing device is provided to lock the stylet inserted through the endotracheal tube and the insertion portion of the endoscope in a state parallel to the endotracheal tube, the endotracheal tube is inserted into the trachea. In doing so, the endoscope for assisting the insertion of the endotracheal tube does not interfere with the stylet, and the endotracheal tube can be easily inserted into the patient in a short time.

[Submission date] April 7, 1994

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0006

[Correction method] Change

[Correction content]

[0006] Furthermore, while inserting the stylet into the endotracheal tube and inserting it into the trachea, the endoscope is inserted into the endotracheal tube, and the insertion position of the tip of the endotracheal tube is confirmed by this endoscope. it is also made possible to continue the operation of inserting the endotracheal tube while correcting the direction of insertion of the endotracheal tube and. However, in this case, the insertion part of the endoscope may interfere with the stylet when the endoscope is inserted into the endotracheal tube, which makes it difficult to insert the insertion part of the endoscope and it takes time. There is.

[Procedure Amendment 2]

[Document name to be amended] Statement

[Correction target item name] 0013

[Correction method] Change

[Correction content]

Further, the insertion portion 8 is provided with a flexible flexible tube portion 14. A stylet fixing tool 15, which will be described later, of the insertion assisting tool 1 is continuously provided on the proximal side of the flexible tube portion 14. Further, a bending portion 16 and a tip forming portion 17 connected to the tip of the bending portion 16 are provided on the tip end side of the flexible tube portion 14.

[Procedure 3]

[Document name to be amended] Statement

[Correction target item name] 0049

[Correction method] Change

[Correction content]

Next, a method of intubating the endotracheal tube 3 using the stylet fixing tool 81 having the above configuration will be described. First, the insertion portion 8 of the endoscope 4 is inserted into the scope grooves 89 and 90 between the fixture constituting members 83 and 84 of the stylet fixture 81, and the insertion portion 8 is adjusted according to the length of the endotracheal tube 3. With the fixing position determined, the fixing screw 86 is turned to temporarily fix the stylet fixing tool 81 to the insertion portion 8. Thereafter, when determining the insertion length of Sutaire' DOO 2 by inserting the stylet 2 between the stylet groove 91, 92 of the stylet fixture 81, further turning the fixing screw 86, the insertion portion 8, Sutaire Tsu DOO 2 is firmly fixed to the stylet fixture 81. Next, the stylet 2 is bent into a shape that is easy to insert. After that, the endotracheal tube 3 is inserted into the trachea of the patient by the same procedure as in the first embodiment.

[Brief description of drawings]

FIG. 1A is a perspective view showing a schematic configuration of an entire endotracheal tube insertion aid according to a first embodiment of the present invention, and FIG. 1B is an insertion state of the insertion aid inserted into the endotracheal tube. FIG.

2A is a side view of a brush inserted into a treatment tool insertion channel of an endoscope, FIG. 2B is a front view of the brush, FIG.
FIG. 6C is a side view showing an insertion state of the brush inserted into the treatment tool insertion channel of the endoscope.

FIG. 3 is a perspective view showing a first modified example of the brush inserted into the treatment tool insertion channel of the endoscope.

FIG. 4A is a perspective view showing a first modification of the sponge member, and FIG. 4B is a perspective view showing a second modification of the sponge member.

FIG. 5 is a vertical cross-sectional view showing a second modified example of the brush.

FIG. 6 is a perspective view showing a third modified example of the brush.

FIG. 7 is a side view showing a fourth modified example of the brush.

FIG. 8A is a longitudinal sectional view showing a state in which the insertion assisting tool of the second embodiment of the present invention is inserted into the endotracheal tube,
(B) is the same perspective view.

[Explanation of symbols]

2 ... Stylet, 3 ... Endotracheal tube, 4 ... Endoscope,
8 ... insertion part, 15, 81 ... stylet fixture.

Claims (1)

[Scope of utility model registration request] 1. An endotracheal equipped with a stylet that is removably inserted into an endotracheal tube and transforms the shape of the tube into an arbitrary shape, and an endoscope that confirms the insertion position of the endotracheal tube. In the tube insertion aid, a stylet fixing tool for locking the stylet inserted through the endotracheal tube and the insertion portion of the endoscope in a state parallel to the endotracheal tube is provided. Endotracheal tube insertion aid.