MXPA98006512A - Laringosco - Google Patents

Abstract

An endotracheal inspection and intubation device comprises a handle (2) and a leaf (4) for opening the trachea and allowing visualization of the vocal cords and opening to the trachea, the leaf maintains an illuminator (22) for illumination of the epiglottis and the opening to the trachea, with energy source (8) that is contained within the handle (2). The blade (4) comprises a rigid rear (12) and front (20) portion and a flexible intermediate portion (14). The rear portion and the intermediate portion generally have a cross-sectional shape similar to L with a horizontal base (16) for lowering the tongue and a vertical member (18), the front end (20) being essentially flat and having a shape and size such as to allow lowering the base of the tongue and the vallecula to elevate the epiglottis, the blade (4) maintains a flexible deflection member (48, 160) with a front end fixed to the front portion of the leaf , the guiding member to at least the intermediate portion. The handle having an activator (56) with an arrangement member for coupling with a rear end of the deflection member to cause axial displacement thereof on the actuation of the activator, thus transmitting the deflection of the

Description

LARYNGOSCOPE FIELD OF THE INVENTION The present invention relates to the field of medical equipment and more specifically relates to a device for endotracheal inspection and intubation, referred to as a laryngoscope.

BACKGROUND OF THE INVENTION Endotracheal inspection is required to visualize the vocal cords and the opening towards the trachea made by doctors for many purposes. Endotracheal intubation where an airway is inserted into the trachea), is carried out in a general anesthesia procedure is a first and most important stage in resuscitation due to respiratory arrest. The intubation procedure should be performed as quickly and smoothly as possible and without harming the patient.

The laryngoscopes that exist require highly qualified personnel to perform a correct intubation procedure and individual physiological and anatomical parameters of each patient must be considered, p.

REF: 28043 ex. size of the tongue, length of the neck, variations of the jaw and lower teeth, etc., and even more, special conditions such as spasm of the neck and facial muscles, head and neck injuries, etc.

The known laryngoscopes are of standard sizes and shapes and do not provide any adjustment to anatomical variants. In many cases, the laryngoscope blade loses adhesion to the tongue and comes out of position due to the oral mucous membranes, losing lethal time and possibly injuring the patient.

It is an object of the present invention to provide a new device for performing tracheal inspection and intubation procedures essentially reducing the required level of skill to perform such procedures and reducing the likelihood of injuring patients.

BRIEF DESCRIPTION OF THE INVENTION According to the present invention there is provided an endotracheal inspection and intubation device comprising a handle and a leaf to open the trachea and allow visualization of the vocal cords and opening to the trachea, the leaf maintains an illuminator for illumination of the epiglottis and the opening to the trachea, with the source of energy that is included within the handle; The blade comprises a rigid rear and front portion and a flexible intermediate portion; the rear portion and the intermediate portion generally have a cross-sectional shape similar to L with a horizontal base for lowering the tongue and a vertical member, the front end being essentially flat and having a shape and size such as to allow lowering the base of the tongue and the vallecula to elevate the epiglottis; the blade maintains a flexible deflection member with a front end fixed to the front portion of the blade, the deflection member which slidably remains by means of guiding at least the intermediate portion; the handle having an activator with an arrangement member for coupling with a rear end of the deflection member to cause axial displacement thereof on the actuation of the activator, thus transmitting deflection of the leaf. The arrangement is such that the intermediate portion of the blade provides the inherent elasticity of the blade and the adjustable bending force, whereby the blade tends to retain its original position.

According to a preferred embodiment of the present invention, the vertical member in the intermediate portion is segmented by a plurality of grooves, each of the grooves having an open end at the top of the members and extending downwardly ending at the end. base; the blade maintains a flexible drive rod with a front end fixed to the front portion and a free rear end, the rod that remains sliding inside the guide means at the rear portion and at the upper end of the vertical member of each of the segments of the intermediate portion; the actuator has a drive member for supporting on the free end and causing forward axial displacement of the drive rod on the activator drive.

In another embodiment of the present invention the deflection member in a cable fixed under the leaf to the front end thereof and extending essentially flush with the lower surface of the leaf by means of a guiding means; the coupling member which is a traction member attached to the rear portion of the cable for extracting the cable on the actuator drive.

According to a specific embodiment of the invention, the handle further comprises a ratchet mechanism activated by the activator to fix the drive member in the intermediate positions, and a release mechanism for immediate release of the ratchet mechanism. According to a variation, the final travel of the ratchet mechanism is essentially longer than the preceding one and the final travel is not fixable.

According to one application, the ratchet mechanism comprises a grooved member fixed to the activator and rotatable near an operating shaft at an upper end of the activator, and a movable slotted tooth spring inclined in one direction to stop the grooved member. in a desired angular position thereof, and wherein the release mechanism consists of at least one control button projecting from the handle, said control button adjusted to displace a lever rod to disengage the slotted ratchet from the form of ratchet mechanism of the slotted member.

The blade could be integral with the handle or, it could be connected separately to the handle and secured to it by means of a standard adapter. However, the handle could also be provided with an auxiliary closure device for rigidly connecting the blade to the handle.

A specific application of the auxiliary closure device comprises a pivot, spring latch inclined at one end, upper end of the handle that is adapted to engage within an appropriate space at a rear end of the blade. Another embodiment of the closure device could comprise said auxiliary closure device comprising a rotatable closure part at one end, upper end of the handle, said closure piece provided with a slot having a peripheral opening and adapted to engage a rearward projection of the sheet.

In a preferred application of the preferred embodiment, each of the slots has at its adjacent end of the base an opening for reducing the stress concentration.

The sheet according to the present invention could be made of a plastic or thermoplastic material and the front edge of the sheet could have a concave tip in a plane of the base or a convex tip in a plane perpendicular to that of the base.

BRIEF DESCRIPTION OF THE DRAWINGS For better understanding, the invention will now describe only by way of reference, the accompanying drawings, in which: Fig. 1 is a side view of a laryngoscope according to a first embodiment of the present invention, the sheet is shown essentially in its flat position; Fig. 2 is a partially sectioned side view of the laryngoscope according to the invention, the leaf in its deviated position; Fig. 3 is a bottom view of a sheet for use with a laryngoscope according to the present invention; Fig. 4 is a side view of the sheet seen in Fig. 3; Fig. 5 is a cross section of the sheet taken along the line V-V in Fig. 4; Fig. 6 is a side view of a handle for a laryngoscope according to the present invention; Fig 7a and 7b are partially sectioned views of the auxiliary closure mechanism of a laryngoscope according to the invention on an enlarged scale, in the decoupled and coupled position, respectively; Figs. 8a and 8b are cross-sectional views of the ratchet mechanism of a laryngoscope according to the invention on an enlarged scale, in the decoupled and coupled position, respectively; Figs. 9a and 9b are rear views of a second embodiment of an auxiliary closing mechanism, in the closed and unclosed position, respectively; Fig. 9c is a cross-sectional view of the auxiliary closure mechanism of Figs. 9a and 9b; Fig. 10 is a schematic illustration of a laryngoscope according to a second embodiment of the present invention, the sheet being shown essentially in its planar position; Fig. 11 is a schematic illustration of the laryngoscope of Fig. 10, the sheet shown in its deviated position; Y Figs 12 and 13 are sagittal sections illustrating the operation of a laryngoscope with a laryngoscope according to the present invention; DETAILED DESCRIPTION OF THE PREFERRED MODALITIES First, attention is paid to Figs. 1 and 2 of the drawings illustrating a laryngoscope according to the present invention assembled from a handle generally designated 2 and a generally designated sheet 4 typically made of heat-treated surgical stainless steel and which is separately connected to the handle at 6 by an ISO 7376 Standard Adapter as per se known, allowing interchangeability with standard laryngoscope handles or blades.

As is known from the state of the art of laryngoscopes, the blade 2 accommodates two electric batteries 8 (seen only in Fig. 2) retained by a threaded cap adjustment part 10 at a lower end of the handle. As best seen in Figs 3 to 5, the sheet 4 has a slightly curved longitudinal cross section and has a rear portion 12 and an intermediate portion 14 having a generally L-shaped cross-sectional shape with a substantially horizontal planar base 16 and a vertical wall 18 and a flat front end 20.

The blade 4 is adapted with a fixed illuminator bulb 22 within a dent 24 in the vertical wall 18 and an electrical supply line 26 extending to the rear portion 30 of the blade, provided with appropriate electrical contacts and a latch hook 34 to attach to handle 2 as shown per se.

The intermediate portion 14 comprises a plurality of grooves 40 that divide the intermediate portion into the segments 42 and extend the total length of the vertical wall 18, each groove ends with an elongated oval shaped opening 44 to reduce stress concentration as it is known per se, thus making the intermediate portion 14 flexible.

The blade 4 further comprises a guide tube 46 fixed to the top of the vertical wall 18 by welding and extending along the rear and intermediate portions 12 and 14 respectively, the guide tube 46 has the segments 46" in the intermediate portion 14 in register with the segments 42 hidden by the upper, essentially horizontal wall 47. A flexible drive rod 48 is attached to a front end thereof 20 of the sheet 4 and has a free rear end 50 which is project from the guide tube 46. The arrangement is such that the drive rod 48 slides inside the guide tube 46, whereby the forward axial displacement of the drive rod 48 within the guide tube 46 transmits bending the intermediate flexible portion 14, as shown in Fig. 2. The bending speed depends on the amount of axial displacement of the drive rod 48.

As can be better understood in Fig. 5 the handle 2 further comprises an actuating lever 56 pivoted at 58 to an upper end 59 of the handle 2 between a released position (as shown in Fig. 1) and a compressed position (as it is shown in Fig. 2). The upper end of the actuating lever has a driving member 60 having a surface 62 for supporting on the free rear end 50 of the driving rod 48 when the blade 4 is assembled on the handle 2.

The handle 2 further comprises at its upper end 59 and an auxiliary closure mechanism generally designated 64 to ensure the rigid and solid connection of the blade 4 to the handle 2. The auxiliary locking mechanism 64 is shown in more detail in Figs. 7a and 7b in their closing or non-closing positions, respectively. The auxiliary closure mechanism consists of a ratchet 66 pivoted at 68 to the upper end 59 of the handle 2 and biased in a counterclockwise direction by a compression ring 70 accommodated at its ends by the appropriate spaces 72 and 74 on the handle and the ratchet respectively. The ratchet 66 has a hook-shaped upper end 76 engageable by a space 78 in the rear closing end 30 of the blade 4.

The arrangement is such that due to the assembly of the blade 4 to the handle 2 by means of the standard adapter at 6 (via the closing hook 34 of the blade 4) the pawl 66 is rotated first to the position seen in Fig. 7a by the lower edge of the rear closing end 30 meeting the pawl and where the blade 4 is rotated in its final position as seen in Fig. 7b, the pawl 66 closes in its closed position with the shaped end hook 76 grasping handle 4 through space 78. Disconnecting blade 4 from handle 2 is performed in an inverse operation sequence, e.g. ex. , first the pawl 66 is pivoted in a clockwise direction by applying pressure on the control knob 80 (to the position shown in Fig. 7a) and then disconnecting the blade as shown per se.

The blade 2 also comprises a ratchet mechanism generally designated 86, illustrated on an enlarged scale in Figs. 8a and 8b in their coupled and uncoupled positions, respectively. The purpose of the ratchet mechanism 86 is to fix the drive member 60 of the activation lever 56 in variable angular positions for the reasons that will be explained later.

The ratchet mechanism 86 comprises a grooved member 88 having a circular sector shape with only a portion 89 of its perimeter that is grooved, the grooved member being concentric with the pivot 58 of the actuating lever 56. The grooved member 88 it is fixedly attached to the actuating lever 56 by means of screws at 92, whereby the angular displacement of the actuating lever 56 transmits angular displacement of the slotted member 88 in the same direction.

A slotted socket tooth 96 is appropriately grooved at a first end to equalize the portion of the slotted member 88 and rotated at 98 to the handle. The slotted slotted tooth 96 is the spring inclined in a counterclockwise direction by means of the compression spring 100 received within an angular groove and which bears at a first end against a second end of the grooved socket tooth 96 and at an opposite end against an upper wall inside the handle. The arrangement is such that the lacing tooth 96 normally engages with the slotted member 88 and the angular displacement of the latter is irreversible unless the slotted fitting tooth 96 is decoupled from the slotted member by the release mechanism 106 as will be explained later. .

As can be seen in Figs. 2, 6 and 8 of the drawings, the release mechanism 106 consists of a rod 108 having its upper end 110 supported against the rear end of the slotted fitting tooth 96, opposite the inclined spring 100. The opposite end of the rod 108 it is attached to a bar 112, which has two arms 114 (only one of which is seen in Fig. 2). The arms 114 extend flush with the inner wall of the handle 2 and each of the arms has at its end a control button 116 projecting laterally from the handle.

The arrangement is such that normally the release mechanism 106 is retracted downward by the biasing effect of the spring 100.

However, exerting slight force on any of the control buttons 116 moves the rod 108 in one direction against the deflection effect of the spring 100, as a result of which the slotted fitting tooth 96 causes it to rotate in a direction in sense of clock hands, decoupling thus from the grooved member 88 and allowing the spontaneous return of the latter to its original position as shown in Fig. 1, due to the elasticity of the blade.

Figs. 9a and 9c illustrate a different embodiment of an auxiliary closure mechanism 120 according to which the rear closure end 30 'of the sheet 4 has a backward projecting support 122. A closure disc 124 is rotatably mounted at 126 to the end upper 59 of the sheet 2. The closing disc 124 comprises a slot 128 that extends along an annular sector of the disc and has a peripheral opening 130.

For closing the auxiliary closure mechanism 120, the disc 124 is thus positioned with the opening 130 receiving the projection support 122 and then the disc is rotated in a clockwise direction like the arrow 132 in Fig. 9A, whereby the support 122 becomes engaged by the slot 128. For releasing the auxiliary closure mechanism 120, the disc 124 is rotated in a counterclockwise direction like arrow 134 in Fig. 9b.

Reference is now made to Figs. 10 and 11 of the drawings schematically illustrating a second embodiment of a laryngoscope according to the present invention, wherein a blade 150 is connected to the handle 152, the blade has a rigid rear portion 154, a flexible intermediate portion 156 and an end rigid front 158.

A flexible cable 160 is fixedly attached at 162 to the front end 158 of the sheet and extends rearwardly under the sheet 150 supported thereon by hooks 164 allowing axial displacement of the cable 160. The trailing end of the cable 160 passes through a guide member 166 and is attached at 168 to an actuation lever 170 pivoted at 172 to handle 152.

The arrangement is such that in the pull of the actuating lever 170, the cable 160 is retracted, causing deflection of the blade 150 as seen in Fig. 11, whereby the release of the actuating lever 170 transmits spontaneous return of blade 150 and actuating lever 170 to the original position of Fig. 10, due to the elasticity of blade 150.

It should be known to a person skilled in the art that similar applications described with reference to the first embodiment, p. ex. ratchet mechanism, release mechanism, etc. it could also be applied on a device according to the second embodiment of the invention.

The attention now goes back to Figs. 3 and 5 in which it is seen that the tip 180 of the blade 4 is concave in a plane of the base 16 (seen in Fig. 3) and also preferably in the plane perpendicular to the plane of the base 16 of the blade 4 (seen in Fig. 5). This shape of the tip 180 of the blade conforms to the anatomical shape of the tongue and the opening to the trachea. However, for neonatal and premature infants, it may be necessary to use a blade having a convex tip in the plane of the blade (not shown).

It should also be understood that different sizes of sheets could be used as shown in the art, p. ex. , leaves that are in the size range from 0 to 3. Even more, leaves of different arcs could be used for different anatomical abnormalities.

Attention now refers to Figs. 12 and 13 to understand how the laryngoscope according to the invention is actually used. The laryngoscope should be held firmly by the hand of the operator and the blade 4 is inserted from the right side of the mouth, gently lifting the tongue 200 to the right, visualizing the larynx. The curved blade is advanced slowly along the base of tongue 200 to epiglottis 202 (vallecula 204). The operator's wrist is then fixed in position and further exposure is obtained by gently pulling the activation lever 56, slowly flexing the sheet 4 without loss of stiffness along the sheet. Due to the ratchet mechanism, the curved position of the blade is fixed at any desired position or could be released quickly by the release mechanism 106, by control buttons 116 as explained above. The manipulation of the arch of the leaves allows dynamic change of the configuration of the blade during the insertion of the laryngoscope and in accordance with the congruence of the relevant anatomical structures. At the end and the critical stage of manipulation, the movement of the activator allows "bio-feedback control" by the operator, where the leaf could be deflected or released in addition as the operator feels it, allowing further improvement of the opening display towards the trachea without trauma or complications.

It should be known that in a previously known laryngoscope, the visualization of the trachea is obtained by fixing the wrist of the operator and lifting the laryngoscope vertically forward while at the time of application, which in many cases leads to the sliding of the leaf over the tongue (due to the mucous membranes of the tongue). However, according to the present invention, the visualization of the trachea is obtained simply by manipulating the actuation lever 56.

It is noted that in relation to this date, the best method known by the applicant to carry out the aforementioned invention, is the conventional one for the manufacture of the objects to which it relates.

Having described the invention as above, the content of the following is claimed as property.

Claims (16)

1. l. An endotracheal inspection and intubation device, characterized in that it comprises a handle and a leaf for opening to the trachea and allowing the visualization of the vocal cords and the opening to the trachea, the leaf maintains an illuminator for illumination of the epiglottis and the opening to the trachea, with energy source that is contained within the handle, the blade comprises a rigid rear and front portion and a flexible intermediate portion; the rear portion and the intermediate portion generally have a cross-sectional shape similar to L with a horizontal base for lowering the tongue and a vertical member, the front end being essentially flat and having a shape and size such as to allow lowering the base of the tongue and the vallecula to elevate the epiglottis; the blade maintains a flexible deflection member with a front end of the blade, and a free rear end, the driving rod that slides smoothly by guiding means attached to the intermediate portion and the rear portion; the handle has an activator with a coupling member for applying force in an axial direction on the rear end of the driving rod, thus transmitting deflection of the blade,, and wherein the blade maintains its original position due to the termination of the blade. the force.
2. 2. An endotracheal inspection and intubation device according to claim 1, characterized in that the handle further comprises a ratchet mechanism. activated by the activator to fix the drive rod in any of a plurality of axially offset positions, and a release mechanism for immediate release of the ratchet mechanism, thereby allowing the blade to deform back to its original position.
3. 3. An endotracheal inspection and intubation device according to claim 2, characterized in that the final displacement drive path of the ratchet mechanism is essentially longer than the preceding one and where the final displacement path is not fixable.
4. 4. An endotracheal inspection and intubation device according to Claim 2, characterized in that the ratchet mechanism comprises a grooved member fixed to the activator and rotatable near an operating axis at the upper end of the activator, and a grooved socket tooth spring. movable inclined in one direction to stop the grooved member in a desired angular position thereof.
5. 5. An endotracheal inspection and intubation device according to claim 4, characterized in that a release mechanism consists of at least one control button projecting from the handle, the control button is adjusted to move a lever to decouple the tooth from grooved socket of the ratchet mechanism of the grooved member.
6. 6. An endotracheal inspection and intubation device according to claim 1, characterized in that the handle and the blade are integrated with each other.
7. 7. An endotracheal inspection and intubation device according to Claim i, characterized in that the blade is connected separately to the handle and secured thereto by a standard adapter.
8. 8. -An endotracheal inspection and intubation device according to Claim 7, characterized in that the handle 'is provided with an auxiliary closure device. to rigidly connect the blade to the handle.
9. 9. An endotracheal inspection and intubation device according to claim 8, characterized in that the auxiliary closure device comprises a pivot, biased spring latch at a rear, upper end of the handle that is adapted to engage within a suitable space at one end. back of the leaf.
10. 10. An endotracheal inspection and intubation device according to Claim 8, characterized in that the auxiliary closure device comprises a rotatable closure part at a rear, upper end of the handle f the closure part is provided with a slot having a peripheral opening and adapted to couple a backward projection of the sheet.
11. 11. An endotracheal inspection and intubation device according to claim 1, characterized in that each of the slots has an opening at an adjacent end of the base to reduce the stress concentration.
12. 12. An endotracheal inspection and intubation device according to claim 1, characterized in that the sheet is made of plastic material.
13. 13. An endotracheal inspection and intubation device according to claim 1, characterized in that the front end of the blade has a concave tip on a base piano.
14. 14. An endotracheal inspection and intubation device according to Claim 1, characterized in that the front end of the blade has a concave tip in a plane perpendicular to that of the base.
15. 15. An endotracheal inspection and intubation device according to Claim 1, characterized in that the front end of the blade has a convex tip a plane of the base.
16. 16. An endotracheal inspection and intubation device according to claim 1, characterized in that a deflection cable is fixedly attached to the front portion of the cable and is attached separately to the lower surface of the leaf by the guiding means; the coupling member which is a traction member attached to a rear portion of the cable to withdraw the cable from actuator actuation.