US20080243137A1 - System and methods for clearance of obstructions - Google Patents

System and methods for clearance of obstructions Download PDF

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Publication number
US20080243137A1
US20080243137A1 US11/731,725 US73172507A US2008243137A1 US 20080243137 A1 US20080243137 A1 US 20080243137A1 US 73172507 A US73172507 A US 73172507A US 2008243137 A1 US2008243137 A1 US 2008243137A1
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US
United States
Prior art keywords
obstruction
medical device
clamp
housing
obstructions
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.)
Abandoned
Application number
US11/731,725
Inventor
David W. D'Angelo
Steven Lichtenstein
Original Assignee
D Angelo David W
Steven Lichtenstein
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by D Angelo David W, Steven Lichtenstein filed Critical D Angelo David W
Priority to US11/731,725 priority Critical patent/US20080243137A1/en
Priority to US11/897,259 priority patent/US8377075B2/en
Publication of US20080243137A1 publication Critical patent/US20080243137A1/en
Application status is Abandoned legal-status Critical

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/1637Hollow drills or saws producing a curved cut, e.g. cylindrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/32053Punch like cutting instruments, e.g. using a cylindrical or oval knife
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/00336Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means with a protective sleeve, e.g. retractable or slidable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/0034Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00818Treatment of the gastro-intestinal system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0801Prevention of accidental cutting or pricking
    • A61B2090/08021Prevention of accidental cutting or pricking of the patient or his organs

Abstract

The present invention is a system and methods to clear obstructions including foreign objects and food boluses during an EGD procedure. The medical device according to the present invention includes a flexible tubular housing, power transfer device, clamp, tool element, power source, and optional hood. The present invention drills through the obstruction to rupture it into pieces. Displaced obstructions, and/or pieces thereof, can be collected into retainers positioned within the housing. The remainder of the obstruction can then be passed into the stomach where it can be digested, safely excreted, or actively removed by an endoscopist.

Description

    FIELD OF THE INVENTION
  • The present invention generally relates to a medical system and methods and, more particularly, to a system and methods to clear obstructions within the upper gastrointestinal tract.
  • BACKGROUND OF THE INVENTION
  • Foreign object ingestion and food bolus impactions are a common occurrence. Urgent intervention is required to prevent aspiration and perforation. Foreign object ingestion or food bolus impaction creates an obstruction. Obstruction is anything that is obstructs, blocks, or closes off a bodily cavity. Food bolus impactions occur in the upper gastrointestinal tract (GI tract), with the most common site of impaction at the stomach-esophagus (gastro-esophageal) junction, or at other regions of narrowing within the esophagus. The upper GI tract consists of the mouth, pharynx, esophagus, stomach and duodenum terminating at the ligament of Treitz.
  • Typically, an initial endoscopic examination verifies, locates and identifies the obstruction. An endoscope is shaped as a long tube, which is inserted through the mouth into the esophagus and stomach to identify the foreign object or food bolus. Once the foreign object or food bolus has been identified with the endoscope, various instruments can be passed through the endoscope to grasp and remove or displace the obstruction. An endoscopist is a person trained to use an endoscope.
  • The foreign object or food bolus can usually be removed en bloc or in a piecemeal fashion with the instruments. Instruments include forceps, which come in varying shapes, sizes and grips, snares, and oval loops that can be retracted from outside the endoscope to lasso objects, as well as baskets, or mesh nets that can be closed to trap small objects, and magnets placed at the end of the scope. Some techniques have been described that use catheters to trap objects, or use two snares to orient foreign bodies.
  • These current instruments are not ideal in that they each are limited to specific uses. Furthermore, a “pull” and “push” technique is required. This technique requires the instrument to be manipulated by pulling it back and then pushing it gently to displace the obstruction into the stomach. This is not desirable for objects that cannot be digested or that cannot be safely excreted. Nor is this technique desirable to perform on obstructions that are firmly impacted with the upper GI tract including the walls of the esophagus.
  • As an alternative to the endoscopic clearance described, a food bolus impaction can be cleared passively through the use of medication, such as Glucagon. This approach is often not successful.
  • The currently available instruments for foreign object ingestion and food impaction clearance are not ideal. Likewise, medication does not offer consistent success to passively clearing a food impaction. Thus, there is a strong need for improvement in the clearance of obstructions in the upper gastrointestinal tract.
  • SUMMARY OF THE INVENTION
  • The present invention clears obstructions including foreign objects and food boluses by drilling through the obstruction to rupture or displace the obstruction in order to clear it. The obstruction is cleared by passing into the stomach where it can be digested or safely excreted. The obstruction can also be cleared by actively removing it from the human cavity by an endoscopist. The present invention is applicable to anything that can be swallowed and subsequently obstructs the upper GI tract.
  • The present invention includes a flexible tubular housing, such as a catheter device. The flexible tubular housing can further include one or more retainers therein. The retainers can be any size or shape that allows displaced obstructions, and/or pieces thereof, to be collected, for example, pockets, chambers, or compartments. The housing can be inserted into a human cavity, typically via an endoscope. The housing can be any material that is flexible, for example metal or plastic such as stainless steel, aluminum, titanium, silicone, or polyurethane. Although the tubular housing is flexible, it must maintain a tensile strength to stabilize the other components of the medical device, such as the clamp and tool element, throughout the procedure.
  • A power transfer device, for example drive shaft or laser, is positioned within the tubular housing, extending therethrough. A drive shaft power transfer device includes a clamp that is rotated by a power source that provides electrical output, or power. The power transfer device and clamp can be any material for example metal or plastic such as stainless steel, aluminum, titanium, silicone, or polyurethane. A laser power transfer device includes a coherent beam of light.
  • The output from the power source can be automatic, manual, and even computer controlled. The power source can further include a regulator for adjusting the power, for example by a knob or foot pedal. Likewise, the output applied to the power transfer device can be variable or fixed. Output is in the form of rotational speed, or revolutions per minute (rpm). Examples of power sources include electrical power supplies, mechanical power supplies, linear power supplies and computer power supplies.
  • The clamp securely holds removable parts and includes a receiving unit to accept tool elements. Clamps can include collets and chucks such as pin chuck, drill chuck, magnetic chuck, three or more-jaw chuck, to name a few. It is also contemplated that the clamp is universal such that it receives all shaped and sized tool elements.
  • A tool element is received within the receiving unit of the clamp. Tool elements come in a variety of shapes and sizes such that the appropriate tool element is used for the procedure. It is contemplated that the tool elements may be disposable or re-used upon sterilization.
  • Tool elements include bits. Bits are cutting tools to create cylindrical-shaped holes, although bits are also available for non-cylindrical-shaped holes. Bits can be of any material that displaces and clears the obstruction, for example metal such as stainless carbide steel or carbine tungsten steel. Bits include a cutter and a shank. Shanks are received within the receiving unit of the clamp. Shanks include brace shanks, straight shanks, hex shanks, SDS shanks, triangle shanks, and morse taper shanks, for example. Different styles of shank/clamp combinations deliver different performance, such as allowing higher torque or greater centering accuracy.
  • Tool elements may also include lasers that vaporize, or burn, the obstruction. The laser can be a solid state laser such as yttrium aluminum garnet (YAG) or any other type including gas lasers, chemical lasers and excimer lasers.
  • The present invention may further include a hood, such as a shield, guidepost, or guard. The hood surrounds the tool element to protect the human cavity and walls of the cavity from injury. The hood can be of any flexible material, for example metal or plastic such as stainless steel, aluminum, titanium, silicone, or polyurethane.
  • It is an object of the present to provide a system and method that can be mechanical-based, water-based, cautery-based, or laser-based. A mechanical-based system and method utilizes machine parts, whereas a water-based system and method utilizes a device to deliver water to the obstruction during the procedure. A cautery-based system and method utilizes a caustic device, such as a hot iron, electric current, or fire to burn the obstruction. A laser-based system and method utilizes a coherent beam of light to clear the obstruction.
  • It is an object of the present invention to provide a system and method that provides a rapid and safe removal of an obstruction from the upper GI tract of a patient.
  • Another object of the present invention is to improve patient safety. The present invention decreases the amount of anesthetic needed for anesthetic as well as decreases the risk for damaging the upper GI tract during the procedure.
  • An object of the present invention is to reduce the time it takes to clear an obstruction.
  • The present invention and its attributes and advantages will be further understood and appreciated with reference to the detailed description below of presently contemplated embodiments, taken in conjunction with the accompanying drawings.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 illustrates a perspective view of the medical device according to the present invention; and
  • FIG. 2 illustrates a cross-sectional side view of the medical device according to the present invention.
  • DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
  • The present invention is applicable to anything that can be swallowed and subsequently obstructs the upper GI tract. The present invention clears obstructions, including foreign objects and food boluses, to be passed into the stomach for digestion or safe excretion or actively removed from the human cavity by an endoscopist.
  • As shown in FIGS. 1 and 2, the mechanical-based medical device 100 according to the present invention includes a flexible tubular housing 110, power transfer device 130, clamp 150, tool element 170, hood 190 and power source 200.
  • The housing 110 includes a distal end 112 and proximal end 114. The housing 110 includes an inner diameter 116 and outer diameter 118 extending from the distal end 112 to the proximal end 114. Housing 110 further includes one or more retainers 140 positioned within the inner diameter 116 of the housing 110. Retainers 140 collect displaced obstructions, and/or pieces thereof, for removal.
  • A power transfer device 130 includes a first end 132 and a second end 134 with a clamp 150 positioned at the first end 132. Clamp 150 includes a receiving unit 152 to receive tool elements 170. Hood 190 surrounds the tool element 170 to protect the human cavity from injury during the procedure.
  • As shown more specifically in FIGS. 1 and 2, housing 110 is a catheter 111 and power transfer device 130 is a drive shaft 131. Catheter 111 includes retainers 140 that are cylindrical columns 142. Drive shaft 131 is positioned within inner diameter 116 of catheter 111. Clamp 150, here a chuck 151, is positioned at the first end 132 of drive shaft 131. Upon positioning drive shaft 131 within inner diameter 116, chuck 151 is positioned at distal end 112 of catheter 111. Chuck 151 includes a receiving unit 152 for engagement with a tool element 170, here a bit 172. Bit 172 includes a cutter 174 and a shank 176. Shank 176 is received with in receiving unit 152.
  • An electrical power supply 202 is connected to the drive shaft 131 for rotation of the chuck 151. Guidepost 191 protects the body cavity and walls of the body cavity from injury during the procedure.
  • Once a patient has been diagnosed with a foreign object ingestion and/or food bolus impaction, the patient is prepared for an esophago-gastro-duodenoscopy (EGD) procedure.
  • An endoscope is inserted into the esophagus to verify, locate and identify the obstruction. The end of the endoscope is placed at the obstruction and the medical device 100 according to the present invention is then passed through the endoscope. Thus, the distal end 112 of the catheter 111 is positioned at the obstruction.
  • Upon reaching the obstruction, the medical device 100 is powered by an electrical power supply 202 to rotate the drive shaft 131 and chuck 151. Consequently, the bit 172 positioned with the chuck 151 rotates to drill through the obstruction causing it to rupture into pieces. Likewise, displaced obstructions, and/or pieces thereof, can be collected into the cylindrical columns 142 within the flexible catheter 111. The medical device 100 can further include a guidepost 191 to protect the esophagus from injury, for example, caused by inadvertent misdirection of the bit 172. The pieces of the obstruction are then passed into the stomach where the obstruction can be digested, safely excreted, or actively removed by an endoscopist.
  • While the disclosure is susceptible to various modifications and alternative forms, specific exemplary embodiments thereof have been shown by way of example in the drawings and have herein been described in detail. It should be understood, however, that there is no intent to limit the disclosure to the particular embodiments disclosed, but on the contrary, the intention is to cover all modifications, equivalents, and alternatives falling within the scope of the disclosure as defined by the appended claims.

Claims (9)

1. A medical device for clearance of obstructions, comprising,
a flexible tubular housing including an inner diameter and an outer diameter extending from a distal end to a proximal end;
a power transfer device extending through said inner diameter of said housing, wherein said power transfer device includes a clamp positioned at said distal end of said housing for engagement with a tool element; and
a power source connected to said power transfer device for rotation of said clamp including said tool element engaged therein.
2. The medical device of claim 1 further comprising a hood at said distal end of said tubular housing.
3. The medical device of claim 1 further comprising one or more retainers positioned within said inner diameter of said housing.
4. The medical device of claim 1, where said tool element is a bit.
5. The medical device of claim 1, wherein said power transfer device is a drive shaft.
6. The medical device of claim 1, wherein said clamp is a magnetic chuck.
7. The medical device of claim 1, wherein said flexible tubular housing is a catheter.
8. A method for clearance of obstructions, comprising:
inserting an endoscope within an esophagus;
placing the endoscope at the obstruction;
feeding within the endoscope a flexible tubular housing containing a drive shaft including a clamp with a tool element engaged therein;
powering the drive shaft to rotate the clamp and tool element;
drilling through the obstruction to rupture or displace the obstruction; and
clearing the obstruction.
9. A medical device for clearance of obstructions, comprising,
a flexible tubular housing including an inner diameter and an outer diameter extending from a distal end to a proximal end;
a laser device extending through said inner diameter of said housing from said distal end to said proximal end, wherein said laser device includes a coherent beam of light; and
a power source connected to said laser device.
US11/731,725 2007-03-30 2007-03-30 System and methods for clearance of obstructions Abandoned US20080243137A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US11/731,725 US20080243137A1 (en) 2007-03-30 2007-03-30 System and methods for clearance of obstructions
US11/897,259 US8377075B2 (en) 2007-03-30 2007-08-28 System and methods for clearance of obstructions

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11/731,725 US20080243137A1 (en) 2007-03-30 2007-03-30 System and methods for clearance of obstructions
US11/897,259 US8377075B2 (en) 2007-03-30 2007-08-28 System and methods for clearance of obstructions
PCT/US2008/003985 WO2008121292A1 (en) 2007-03-30 2008-03-27 System and methods for clearance of obstructions

Related Child Applications (1)

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US11/897,259 Continuation-In-Part US8377075B2 (en) 2007-03-30 2007-08-28 System and methods for clearance of obstructions

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US11/731,725 Abandoned US20080243137A1 (en) 2007-03-30 2007-03-30 System and methods for clearance of obstructions
US11/897,259 Active 2028-08-24 US8377075B2 (en) 2007-03-30 2007-08-28 System and methods for clearance of obstructions

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US11/897,259 Active 2028-08-24 US8377075B2 (en) 2007-03-30 2007-08-28 System and methods for clearance of obstructions

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CN103654993B (en) * 2013-12-30 2015-04-01 王侨侨 Telescopic-handle type cow LDA operation reset device
CN103690265B (en) * 2013-12-30 2015-03-25 张明浩 Left cow abomasum displacement replacer with suture passage
CN103690268B (en) * 2013-12-30 2015-07-15 王侨侨 Left abomasal displacement operative reduction apparatus for cattle
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CN103919624B (en) * 2014-05-06 2015-03-18 王侨侨 Cow true stomach left deflection operation reset device of double-locking structure
CN103919582B (en) * 2014-05-06 2015-03-18 王侨侨 Cow left displaced abomasum operation restoration device
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US8377075B2 (en) 2013-02-19
US20080287734A1 (en) 2008-11-20
WO2008121292A1 (en) 2008-10-09

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