US20090205645A1 - Pneumostoma management method for the treatment of chronic obstructive pulmonary disease - Google Patents

Pneumostoma management method for the treatment of chronic obstructive pulmonary disease Download PDF

Info

Publication number
US20090205645A1
US20090205645A1 US12388451 US38845109A US2009205645A1 US 20090205645 A1 US20090205645 A1 US 20090205645A1 US 12388451 US12388451 US 12388451 US 38845109 A US38845109 A US 38845109A US 2009205645 A1 US2009205645 A1 US 2009205645A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
pneumostoma
chest
patient
vent
chest mount
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
US12388451
Inventor
Don Tanaka
Joshua P. Wiesman
David C. Plough
Jeffrey C. Cerier
Richard A. Abraham
Stephen C. Evans
Gary L. Boseck
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Portaero Inc
Original Assignee
Portaero Inc
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

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL, OR TOILET PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/007Pulmonary tract; Aromatherapy
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/04Artificial pneumothorax apparatus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M13/00Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816Joints or connectors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/08Bellows; Connecting tubes ; Water traps; Patient circuits
    • A61M16/0816Joints or connectors
    • A61M16/0833T- or Y-type connectors, e.g. Y-piece
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M16/00Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20Valves specially adapted to medical respiratory devices
    • A61M16/201Controlled valves
    • A61M16/202Controlled valves electrically actuated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02Holding devices, e.g. on the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02Holding devices, e.g. on the body
    • A61M25/04Holding devices, e.g. on the body in the body, e.g. expansible
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • 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
    • A61B2017/00809Lung operations
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M11/00Sprayers or atomisers specially adapted for therapeutic purposes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M11/00Sprayers or atomisers specially adapted for therapeutic purposes
    • A61M11/005Sprayers or atomisers specially adapted for therapeutic purposes using ultrasonics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M11/00Sprayers or atomisers specially adapted for therapeutic purposes
    • A61M11/04Sprayers or atomisers specially adapted for therapeutic purposes operated by the vapour pressure of the liquid to be sprayed or atomised
    • A61M11/041Sprayers or atomisers specially adapted for therapeutic purposes operated by the vapour pressure of the liquid to be sprayed or atomised using heaters
    • A61M11/042Sprayers or atomisers specially adapted for therapeutic purposes operated by the vapour pressure of the liquid to be sprayed or atomised using heaters electrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M15/00Inhalators
    • A61M15/0085Inhalators using ultrasonics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M15/00Inhalators
    • A61M15/009Inhalators using medicine packages with incorporated spraying means, e.g. aerosol cans
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M15/00Inhalators
    • A61M15/02Inhalators with activated or ionised fluids, e.g. electrohydrodynamic [EHD] or electrostatic devices; Ozone-inhalators with radioactive tagged particles
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0252Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body for access to the lungs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0247Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body
    • A61M2039/0276Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body for introducing or removing fluids into or out of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2202/00Special media to be introduced, removed or treated
    • A61M2202/02Gases
    • A61M2202/0208Oxygen
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2202/00Special media to be introduced, removed or treated
    • A61M2202/02Gases
    • A61M2202/025Helium
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2202/00Special media to be introduced, removed or treated
    • A61M2202/06Solids
    • A61M2202/064Powder
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/07General characteristics of the apparatus having air pumping means
    • A61M2205/071General characteristics of the apparatus having air pumping means hand operated
    • A61M2205/075Bulb type
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/75General characteristics of the apparatus with filters
    • A61M2205/7518General characteristics of the apparatus with filters bacterial
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/75General characteristics of the apparatus with filters
    • A61M2205/7536General characteristics of the apparatus with filters allowing gas passage, but preventing liquid passage, e.g. liquophobic, hydrophobic, water-repellent membranes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites

Abstract

A method for maintaining the patency of a pneumostoma while controlling the flow of material through the pneumostoma. A pneumostoma management system includes a two-part pneumostoma management device and associated insertion and removal tools. The pneumostoma management device includes a pneumostoma vent and a chest mount for positioning and securing the vent into a pneumostoma. To use the system, the chest is first cleaned and the chest mount secured to the chest adjacent the pneumostoma. The pneumostoma vent is then inserted into the pneumostoma through an aperture in the chest mount until it is engaged and secured by a coupling of the chest mount. The pneumostoma vent may be replaced periodically such as daily. The chest mount may be changed less frequently such as weekly.

Description

    CLAIM TO PRIORITY
  • This application claims priority to all of the following applications including: U.S. Provisional Application Ser. No. 61/029,830, filed Feb. 19, 2008, entitled “ENHANCED PNEUMOSTOMA MANAGEMENT DEVICE AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06013US0);
  • U.S. Provisional Application Ser. No. 61/032,877, filed Feb. 29, 2008, entitled “PNEUMOSTOMA MANAGEMENT SYSTEM AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06001US0);
  • U.S. Provisional Application Ser. No. 61/038,371, filed Mar. 20, 2008, entitled “SURGICAL PROCEDURE AND INSTRUMENT TO CREATE A PNEUMOSTOMA AND TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG 1-06000US0);
  • U.S. Provisional Application Ser. No. 61/082,892, filed Jul. 23, 2008, entitled “PNEUMOSTOMA MANAGEMENT SYSTEM HAVING A COSMETIC AND/OR PROTECTIVE COVER” (Attorney Docket No. LUNG1-06008US0);
  • U.S. Provisional Application Ser. No. 61/083,573, filed Jul. 25, 2008, entitled “DEVICES AND METHODS FOR DELIVERY OF A THERAPEUTIC AGENT THROUGH A PNEUMOSTOMA” (Attorney Docket No. LUNG1-06003US0);
  • U.S. Provisional Application Ser. No. 61/084,559, filed Jul. 29, 2008, entitled “ASPIRATOR FOR PNEUMOSTOMA MANAGEMENT” (Attorney Docket No. LUNG1-06011US0);
  • U.S. Provisional Application Ser. No. 61/088,118, filed Aug. 12, 2008, entitled “FLEXIBLE PNEUMOSTOMA MANAGEMENT SYSTEM AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06004US0);
  • U.S. Provisional Application Ser. No. 61/143,298, filed Jan. 8, 2009, entitled “METHODS AND APPARATUS FOR THE CRYOTHERAPY CREATION OR RE-CREATION OF PNEUMOSTOMY” (Attorney Docket No. LUNG1-06006US0); and
  • U.S. Provisional Application Ser. No. 61/151,581, filed Feb. 11, 2009, entitled “SURGICAL INSTRUMENTS AND PROCEDURES TO CREATE A PNEUMOSTOMA AND TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06002US0).
  • All of the afore-mentioned applications are incorporated herein by reference in their entireties.
  • CROSS-REFERENCE TO RELATED APPLICATIONS
  • This application is related to all of the above provisional applications and all the patent applications that claim priority thereto including:
  • This application is related to all of the following applications including U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “ENHANCED PNEUMOSTOMA MANAGEMENT DEVICE AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06013US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “PNEUMOSTOMA MANAGEMENT DEVICE FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06001US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “TWO-PHASE SURGICAL PROCEDURE FOR CREATING A PNEUMOSTOMA TO TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06000US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “ACCELERATED TWO-PHASE SURGICAL PROCEDURE FOR CREATING A PNEUMOSTOMA TO TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06000US2);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “SINGLE-PHASE SURGICAL PROCEDURE FOR CREATING A PNEUMOSTOMA TO TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06000US3);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “PERCUTANEOUS SINGLE-PHASE SURGICAL PROCEDURE FOR CREATING A PNEUMOSTOMA TO TREAT CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06000US4);
  • U.S. patent application Ser. No. 12/______, filed Feb. 13, 2009, entitled “PNEUMOSTOMA MANAGEMENT SYSTEM HAVING A COSMETIC AND/OR PROTECTIVE COVER” (Attorney Docket No. LUNG1-06008US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “DEVICES AND METHODS FOR DELIVERY OF A THERAPEUTIC AGENT THROUGH A PNEUMOSTOMA” (Attorney Docket No. LUNG1-06003US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “ASPIRATOR FOR PNEUMOSTOMA MANAGEMENT” (Attorney Docket No. LUNG1-06011US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “ASPIRATOR AND METHOD FOR PNEUMOSTOMA MANAGEMENT” (Attorney Docket No. LUNG1-06011US2);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “FLEXIBLE PNEUMOSTOMA MANAGEMENT SYSTEM AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06004US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “METHODS AND DEVICES FOR FOLLOW-UP CARE AND TREATMENT OF A PNEUMOSTOMA” (Attorney Docket No. LUNG1-06006US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “SURGICAL INSTRUMENTS FOR CREATING A PNEUMOSTOMA AND TREATING CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06002US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “ONE-PIECE PNEUMOSTOMA MANAGEMENT SYSTEM AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06017US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “PNEUMOSTOMA MANAGEMENT SYSTEM WITH SECRETION MANAGEMENT FEATURES FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06019US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “MULTI-LAYER PNEUMOSTOMA MANAGEMENT SYSTEM AND METHODS FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06022US1);
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “VARIABLE LENGTH PNEUMOSTOMA MANAGEMENT SYSTEM FOR TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE” (Attorney Docket No. LUNG1-06023US1); and
  • U.S. patent application Ser. No. 12/______, filed Feb. 18, 2009, entitled “SELF-SEALING DEVICE AND METHOD FOR DELIVERY OF A THERAPEUTIC AGENT THROUGH A PNEUMOSTOMA” (Attorney Docket No. LUNG1-06025US1).
  • All of the afore-mentioned applications are incorporated herein by reference in their entireties. This patent application also incorporates by reference all patents, applications, and articles discussed and/or cited herein.
  • BACKGROUND OF THE INVENTION
  • In the United States alone, approximately 14 million people suffer from some form of Chronic Obstructive Pulmonary Disease (COPD). However an additional ten million adults have evidence of impaired lung function indicating that COPD may be significantly underdiagnosed. The cost of COPD to the nation in 2002 was estimated to be $32.1 billion. Medicare expenses for COPD beneficiaries were nearly 2.5 times that of the expenditures for all other patients. Direct medical services accounted for $18.0 billion, and indirect cost of morbidity and premature mortality was $14.1 billion. COPD is the fourth leading cause of death in the U.S. and is projected to be the third leading cause of death for both males and females by the year 2020.
  • Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the airways that is characterized by a gradual loss of lung function. In the United States, the term COPD includes chronic bronchitis, chronic obstructive bronchitis, and emphysema, or combinations of these conditions. In emphysema the alveoli walls of the lung tissue are progressively weakened and lose their elastic recoil. The breakdown of lung tissue causes progressive loss of elastic recoil and the loss of radial support of the airways which traps residual air in the lung. This increases the work of exhaling and leads to hyperinflation of the lung. When the lungs become hyperinflated, forced expiration cannot reduce the residual volume of the lungs because the force exerted to empty the lungs collapses the small airways and blocks air from being exhaled. As the disease progresses, the inspiratory capacity and air exchange surface area of the lungs is reduced until air exchange becomes seriously impaired and the individual can only take short shallow labored breaths (dyspnea).
  • The symptoms of COPD can range from the chronic cough and sputum production of chronic bronchitis to the severe disabling shortness of breath of emphysema. In some individuals, chronic cough and sputum production are the first signs that they are at risk for developing the airflow obstruction and shortness of breath characteristic of COPD. With continued exposure to cigarettes or noxious particles, the disease progresses and individuals with COPD increasingly lose their ability to breathe. Acute infections or certain weather conditions may temporarily worsen symptoms (exacerbations), occasionally where hospitalization may be required. In others, shortness of breath may be the first indication of the disease. The diagnosis of COPD is confirmed by the presence of airway obstruction on testing with spirometry. Ultimately, severe emphysema may lead to severe dyspnea, severe limitation of daily activities, illness and death.
  • There is no cure for COPD or pulmonary emphysema, only various treatments, for ameliorating the symptoms. The goal of current treatments is to help people live with the disease more comfortably and to prevent the progression of the disease. The current options include: self-care (e.g., quitting smoking), medications (such as bronchodilators which do not address emphysema physiology), long-term oxygen therapy, and surgery (lung transplantation and lung volume reduction surgery). Lung Volume Reduction Surgery (LVRS) is an invasive procedure primarily for patients who have a localized (heterogeneous) version of emphysema; in which, the most diseased area of the lung is surgically removed to allow the remaining tissue to work more efficiently. Patients with diffuse emphysema cannot be treated with LVRS, and typically only have lung transplantation as an end-stage option. However, many patients are not candidates for such a taxing procedure.
  • A number of less-invasive surgical methods have been proposed for ameliorating the symptoms of COPD. In one approach new windows are opened inside the lung to allow air to more easily escape from the diseased tissue into the natural airways. These windows are kept open with permanently implanted stents. Other approaches attempt to seal off and shrink portions of the hyperinflated lung using chemical treatments and/or implantable plugs. However, these proposals remain significantly invasive and are still in clinical trails. None of the surgical approaches to treatment of COPD has been widely adopted. Therefore, a large unmet need remains for a medical procedure that can sufficiently alleviate the debilitating effects of COPD and emphysema.
  • SUMMARY OF THE INVENTION
  • In view of the disadvantages of the state of the art, Applicants have developed a method for treating COPD in which an artificial passageway is made through the chest wall into the lung. An anastomosis is formed between the artificial passageway and the lung by creating a pleurodesis between the visceral and parietal membranes surrounding the passageway as it enters the lung. The pleurodesis prevents air from entering the pleural cavity and causing a pneumothorax (deflation of the lung due to air pressure in the pleural cavity). The pleurodesis is stabilized by a fibrotic healing response between the membranes. The artificial passageway through the chest wall also becomes epithelialized. The result is a stable artificial aperture through the chest wall which communicates with the parenchymal tissue of the lung.
  • The artificial aperture into the lung through the chest is referred to herein as a pneumostoma. A pneumostoma provides an extra pathway that allows air to exit the lung while bypassing the natural airways which have been impaired by COPD and emphysema. By providing this ventilation bypass, the pneumostoma allows the stale air trapped in the lung to escape from the lung thereby shrinking the lung (reducing hyperinflation). By shrinking the lung, the ventilation bypass reduces breathing effort (reducing dyspnea), allows more fresh air to be drawn in through the natural airways and increases the effectiveness of all of the tissues of the lung for gas exchange. Increasing the effectiveness of gas exchange allows for increased absorption of oxygen into the bloodstream and also increased removal of carbon dioxide. Reducing the amount of carbon dioxide retained in the lung reduces hypercapnia which also reduces dyspnea. The pneumostoma thereby achieves the advantages of lung volume reduction surgery without surgically removing a portion of the lung or sealing off a portion of the lung.
  • In accordance with one embodiment, the present invention provides a two piece pneumostoma management system which includes two component pneumostoma management device having a partially-implantable pneumostoma vent and a chest mount. The partially-implantable pneumostoma vent is placed into a pneumostoma through the chest mount to maintain the patency of the pneumostoma, prevent the entry of foreign substances into the lung, control air flow through the pneumostoma and collect any materials that may exit the lung.
  • In accordance with one embodiment, the present invention provides a two piece pneumostoma management system which includes a partially-implantable pneumostoma vent and a chest mount. The partially-implantable pneumostoma vent is placed into a pneumostoma through an aperture in the chest mount. The partially-implantable pneumostoma management device is designed such that every component is larger than the aperture and thus cannot enter the pneumostoma.
  • In accordance with one embodiment, the present invention provides a two piece pneumostoma management system which includes a partially-implantable pneumostoma vent and a chest mount. The partially-implantable pneumostoma vent is placed into a pneumostoma through an aperture in the chest mount. Insertion and removal tools are provided for inserting the partially-implantable pneumostoma vent into the chest mount and removing it from the chest mount.
  • In accordance with one embodiment, the present invention provides a two piece pneumostoma management system which includes a partially-implantable pneumostoma vent and a chest mount. An insertion tool is used to position the partially-implantable pneumostoma vent into a pneumostoma through an aperture in the chest mount. The removal tool is designed such that it does not release the pneumostoma management device after extraction thereby protecting the non-sterile device from reuse.
  • In accordance with one embodiment, the present invention provides a two piece pneumostoma management system which includes a partially-implantable pneumostoma vent and a chest mount. The partially-implantable pneumostoma vent is placed into a pneumostoma through an aperture in the chest mount. The chest mount is secured to the skin of the patient and is replaced every two days to one week. The pneumostoma vent is replaced daily or when necessary.
  • In accordance with another embodiment of the present invention, a method is provided for using the disclosed pneumostoma management system to maintain the patency of the pneumostoma, prevent the entry of foreign substances into the lung, control air flow through the pneumostoma and collect any materials that may exit the lung.
  • In accordance with another embodiment of the invention, methods are provided utilizing insertion and removal tools to insert and remove components of the pneumostoma management system in a controlled and sterile manner.
  • Thus, various systems, components and methods are provided for managing a pneumostoma and thereby treating COPD. Other objects, features and advantages of the invention will be apparent from drawings and detailed description to follow.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The above and further features, advantages and benefits of the present invention will be apparent upon consideration of the present description taken in conjunction with the accompanying drawings.
  • FIG. 1A shows the chest of a patient indicating alternative locations for a pneumostoma that may be managed using the device and methods of the present invention.
  • FIG. 1B shows a sectional view of the chest illustrating the relationship between the pneumostoma, lung and natural airways.
  • FIG. 1C shows a detailed sectional view of a pneumostoma.
  • FIG. 2A shows a perspective view of components of a pneumostoma management system according to an embodiment of the present invention.
  • FIG. 2B shows a sectional view of the components of FIG. 2A.
  • FIG. 2C shows a perspective view of the mounting flange of FIG. 2A.
  • FIG. 2D shows a perspective view of the aperture plate of the flange of FIG. 2C.
  • FIG. 2E shows a perspective view of the pneumostoma vent of FIG. 2A.
  • FIG. 2F shows an exploded perspective view of the pneumostoma vent of FIG. 2E.
  • FIG. 3A shows an insertion tool of a pneumostoma management system according to an embodiment of the present invention.
  • FIGS. 3B-3F show aspects of the components and operation of the insertion tool of FIG. 3A.
  • FIG. 4A shows a removal tool of a pneumostoma management system according to an embodiment of the present invention.
  • FIGS. 4B-4F show aspects of the components and operation of the removal tool of FIG. 4A.
  • FIGS. 5A-5D show steps and tools for applying a chest mount according to embodiments of the present invention.
  • FIGS. 6A-6I show steps and tools for inserting a pneumostoma vent and removing a pneumostoma vent according to embodiments of the present invention.
  • FIGS. 7A and 7B show instruction for using a pneumostoma management system in accordance with an embodiment of the present invention.
  • FIGS. 8A and 8B show sterile packaging for components of the pneumostoma management system in accordance with an embodiment of the present invention.
  • FIGS. 9A-9D show alternative pneumostoma vent configurations for pneumostoma management systems according to embodiments of the present invention.
  • FIGS. 9E-9H show pneumostoma plugs according to embodiments of the present invention.
  • FIGS. 10A-10E show alternative chest mount configurations for pneumostoma management systems according to embodiments of the present invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The following description is of the best modes presently contemplated for practicing various embodiments of the present invention. The description is not to be taken in a limiting sense but is made merely for the purpose of describing the general principles of the invention. The scope of the invention should be ascertained with reference to the claims. In the description of the invention that follows, like numerals or reference designators will be used to refer to like parts or elements throughout. In addition, the first digit of a reference number identifies the drawing in which the reference number first appears.
  • Pneumostoma Formation and Anatomy
  • FIG. 1A shows the chest of a patient indicating alternative locations for creating a pneumostoma that may be managed using the system and methods of the present invention. A first pneumostoma 110 is shown on the front of the chest 100 over the right lung 101 (shown in dashed lines). The pneumostoma is preferably positioned over the third intercostal space on the mid-clavicular line. Thus the pneumostoma 110 is located on the front of the chest between the third and fourth ribs. Although the pneumostoma 110 is preferably located between two ribs, in alternative procedures a pneumostoma can also be prepared using a minithoracotomy with a rib resection.
  • In FIG. 1A a second pneumostoma 112 is illustrated in a lateral position entering the left lung 103 (shown in dashed lines). The pneumostoma 112 is preferably positioned over the fourth or fifth intercostal space under the left arm 104. In general, one pneumostoma per lung is created; however, more or less than one pneumostoma per lung may be created depending upon the needs of the patient. In most humans, the lobes of the lung are not completely separate and air may pass between the lobes.
  • A pneumostoma is surgically created by forming an artificial channel through the chest wall and joining that channel with an opening through the visceral membrane of the lung into parenchymal tissue of the lung to form an anastomosis. The anastomosis is joined and sealed by sealing the channel from the pleural cavity using adhesives, mechanical sealing and/or pleurodesis. Methods for forming the channel, opening, anastomosis and pleurodesis are disclosed in applicant's pending and issued patents and applications including U.S. patent application Ser. No. 10/881,408 entitled “Methods and Devices to Accelerate Wound Healing in Thoracic Anastomosis Applications,” U.S. patent application Ser. No. 12/030,006 entitled “Variable Parietal/Visceral Pleural Coupling,” and U.S. Provisional Patent Application Ser. No. 61/038,371 entitled “Surgical Procedure And Instrument To Create A Pneumostoma And Treat Chronic Obstructive Pulmonary Disease” which are incorporated herein by reference in their entirety.
  • FIG. 1B shows a sectional view of chest 100 illustrating the position of the pneumostoma 110. The parenchymal tissue 132 of the lung 130 is comprised principally of alveoli 134. The alveoli 134 are the thin walled air-filled sacs in which gas exchange takes place. Air flows into the lungs through the natural airways including the trachea 136, carina 137, and bronchi 138. Inside the lungs, the bronchi branch into a multiplicity of smaller vessels referred to as bronchioles (not shown). Typically, there are more than one million bronchioles in each lung. Each bronchiole connects a cluster of alveoli to the natural airways. As illustrated in FIG. 1B, pneumostoma 110 comprises a channel through the thoracic wall 106 of the chest 100 between two ribs 107. Pneumostoma 110 opens at an aperture 126 through the skin 114 of chest 100.
  • FIG. 1C shows a detailed sectional view of the pneumostoma 110. As illustrated in FIG. 1C, pneumostoma 110 comprises a channel 120 through the thoracic wall 106 of the chest 100 between the ribs 107. The channel 120 is joined to cavity 122 in the parenchymal tissue 132 of lung 130. An adhesion or pleurodesis 124 surrounds the channel 120 where it enters the lung 130. The thoracic wall 106 is lined with the parietal membrane 108. The surface of the lung 130 is covered with a continuous sac called the visceral membrane 138. The parietal membrane 108 and visceral membrane 138 are often referred to collectively as the pleural membranes. Between the parietal membrane 108 and visceral membrane 138 is the pleural cavity (pleural space) 140. The pleural cavity usually only contains a thin film of fluid that serves as a lubricant between the lungs and the chest wall. In pleurodesis 124 the pleural membranes are fused and/or adhered to one another eliminating the space between the pleural membranes in that region.
  • An important feature of the pneumostoma is the seal or adhesion surrounding the channel 120 where it enters the lung 130 which may comprise a pleurodesis 124. A pleurodesis 124 is the fusion or adhesion of the parietal membrane 108 and visceral membrane 138. A pleurodesis may be a complete pleurodesis in which the entire pleural cavity 140 is removed by fusion of the visceral membrane 138 with the parietal membrane 108 over the entire surface of the lung 130. However, as shown in FIG. 1C, the pleurodesis is preferably localized to the region surrounding the channel 120. The pleurodesis 124 surrounding the channel 120 prevents air from entering the pleural cavity 140. If air is permitted to enter pleural cavity 140, a pneumothorax will result and the lung may collapse.
  • Pleurodesis 124 can be created between the visceral pleura of the lung and the inner wall of the thoracic cavity using chemical methods including introducing into the pleural space irritants such as antibiotics (e.g. Doxycycline or Quinacrine), antibiotics (e.g. iodopovidone or silver nitrate), anticancer drugs (e.g. Bleomycin, Mitoxantrone or Cisplatin), cytokines (e.g. interferon alpha-2β and Transforming growth factor-β); pyrogens (e.g. Corynebacterium parvum, Staphylococcus aureus superantigen or OK432); connective tissue proteins (e.g. fibrin or collagen) and minerals (e.g. talc slurry). A pleurodesis can also be created using surgical methods including pleurectomy. For example, the pleural space may be mechanically abraded during thoracoscopy or thoracotomy. This procedure is called dry abrasion pleurodesis. A pleurodesis may also be created using radiotherapy methods, including radioactive gold or external radiation. These methods cause an inflammatory response and or fibrosis, healing, and fusion of the pleural membranes. Alternatively, a seal can be created in an acute manner between the pleural membranes using biocompatible glues, meshes or mechanical means such as clamps, staples, clips and/or sutures. The adhesive or mechanical seal may develop into pleurodesis over time. A range of biocompatible glues are available that may be used on the lung, including light-activatable glues, fibrin glues, cyanoacrylates and two part polymerizing glues. Applicant's copending U.S. patent application Ser. No. 12/030,006 entitled “VARIABLE PARIETAL/VISCERAL PLEURAL COUPLING” discloses methods such as pleurodesis for coupling a channel through the chest wall to the inner volume of the lung without causing a pneumothorax and is incorporated herein by reference for all purposes.
  • When formed, pneumostoma 110 provides an extra pathway for exhaled air to exit the lung 130 reducing residual volume and intra-thoracic pressure without the air passing through the major natural airways such as the bronchi 138 and trachea 136. Collateral ventilation is particularly prevalent in an emphysemous lung because of the deterioration of lung tissue caused by COPD. Collateral ventilation is the term given to leakage of air through the connective tissue between the alveoli 134. Collateral ventilation may include leakage of air through pathways that include the interalveolar pores of Kohn, bronchiole-alveolar communications of Lambert, and interbronchiolar pathways of Martin. This air typically becomes trapped in the lung and contributes to hyperinflation. In lungs that have been damaged by COPD and emphysema, the resistance to flow in collateral channels (not shown) of the parenchymal tissue 132 is reduced allowing collateral ventilation to increase. Air from alveoli 134 of parenchymal tissue 132 that passes into collateral pathways of lung 130 is collected in cavity 122 of pneumostoma 110. Pneumostoma 110 thus makes use of collateral ventilation to collect air in cavity 122 and vent the air outside the body via channel 120 reducing residual volume and intra-thoracic pressure and bypassing the natural airways which have been impaired by COPD and emphysema.
  • By providing this ventilation bypass, the pneumostoma allows stale air trapped in the parenchymal tissue 132 to escape from the lung 130. This reduces the residual volume and intra-thoracic pressure. The lower intra-thoracic pressure reduces the dynamic collapse of airways during exhalation. By allowing the airways to remain patent during exhalation, labored breathing (dyspnea) and residual volume (hyperinflation) are both reduced. Pneumostoma 110 not only provides an extra pathway that allows air to exit the lung 130 but also allows more fresh air to be drawn in through the natural airways. This increases the effectiveness of all of the tissues of the lung 130 and improves gas exchange. Increasing the effectiveness of gas exchange allows for increased absorption of oxygen into the bloodstream and also increased removal of carbon dioxide. Reducing the amount of carbon dioxide retained in the lung reduces hypercapnia which also reduces dyspnea. Pneumostoma 110 thus achieves many of the advantages sought by lung volume reduction surgery without surgically removing a portion of the lung or sealing off a portion of the lung.
  • Applicants have found that a pneumostoma management system in accordance with embodiments of the present invention is desirable to maintain the patency of the pneumostoma and control flow of materials between the exterior of the patient and the parenchymal tissue of the lung via a pneumostoma. The pneumostoma management system includes a two-component pneumostoma management device and may also include one or more of the associated tools, packaging and methods described herein.
  • Pneumostoma Management Device
  • FIGS. 2A and 2B illustrate views of a pneumostoma management device (“PMD”) 200 in accordance with an embodiment of the present invention. PMD 200 includes a chest mount 202 which may be mounted to the skin of the patient and a pneumostoma vent 204 which is fitted to the chest mount 202. In a preferred embodiment pneumostoma vent 204 is mounted though an aperture 224 in chest mount 202. Chest mount 202 has a first coupling that engages a second coupling of the pneumostoma vent to releasably secure the pneumostoma vent 204 to the chest mount 202. As will be further described below, the join between the two components is engineered so as to ensure that pneumostoma vent 204 cannot be over-inserted into the lung if it separates from chest mount 202. In preferred embodiments, pneumostoma vent 204 is formed from biocompatible/implantable polymers or biocompatible/implantable metals. In preferred embodiments, chest mount 202 is also formed from biocompatible polymers or biocompatible metals. A patient will typically wear a PMD at all times and thus the materials should meet high standards for biocompatibility. Further description of suitable materials for manufacturing a PMD are provided in the Materials section below.
  • Pneumostoma vent 204 includes a tube 240 sized and configured to fit within the channel of a pneumostoma. Tube 240 is stiff enough that it may be inserted into a pneumostoma without collapsing. Over time a pneumostoma may constrict and it is one function of PMD 200 to preserve the patency of the channel of the pneumostoma by resisting the natural tendency of the pneumostoma to constrict. A crush recoverable material may be incorporated into tube 240 in order to make it crush recoverable. In one example, Nitinol, or another superelastic material, incorporated into tube 240 will give the tube collapse resistance and collapse recovery properties.
  • Tube 240 of pneumostoma vent 204 is sufficiently long that it can pass through the thoracic wall and into the cavity of a pneumostoma inside the lung. Pneumostoma vent 204 is not however so long that it penetrates so far into the lung that it might interfere with a major blood vessel. Fortunately, the larger blood vessels of the lung are located centrally and associated with the bronchi. Thus, the pneumostoma will typically only be adjacent to smaller peripheral blood vessels and risk from injury by the pneumostoma vent is small.
  • The length of tube 240 required for a pneumostoma vent 204 varies significantly between different pneumostomas. A longer tube 240 is usually required in patients with larger amounts of body fat on the chest. A longer tube 240 is usually required where the pneumostoma is placed in the lateral position 112 rather than the frontal position 110. Because of the variation in pneumostomas, pneumostoma vents 204 are manufactured having tubes 240 in a range of sizes and a patient is provided with a pneumostoma vent 204 having a tube 240 of appropriate length for the patient's pneumostoma. Tube 240 may be from 30 to 120 mm in length and from 5 mm to 20 mm in diameter depending on the size of a pneumostoma. A typical tube 240 may be between 40 mm and 80 mm in length and between 8 mm and 12 mm in diameter. In alternative embodiments a pneumostoma vent 204 is made with a single length (such as 120 mm) of tube 240 and tube 240 is then cut to the length appropriate for a particular patient.
  • Tube 240 of pneumostoma vent 204 preferably comprises an atraumatic tip 252 at the distal end as shown in FIGS. 2A and 2B. (This application uses the terms proximal and distal regarding the components of the pneumostoma management system in the conventional manner. Thus, proximal refers to the end or side of a device closest to the hand operating the device, whereas distal refers to the end or side of a device furthest from the hand operating the device.) Tip 252 may be rounded, beveled or curved in order to reduce irritation or damage to the tissues of the pneumostoma or lung during insertion or while in position. Where a single length tube 240 is provided and subsequently cut to length it is desirable that the tube be shaped such that at each of a plurality of cut points cutting will generate an atraumatic tip. This can be achieved, for example, by including a series of rounded narrow points on tube 240.
  • The material and thickness of tube 240 of pneumostoma vent 204 is selected such that tube 240 is soft enough that it will deform rather than cause injury to the pneumostoma or lung. Pneumostoma vent 204 has an opening 254 in tip 252 of tube 240. Opening 254 allows the entry of gases from the cavity of the pneumostoma into lumen 258 of tube 240. Tube 240 is optionally provided with one or more side openings (not shown) positioned near tip 252 and/or along the length of tube 240 to facilitate the flow of gas and/or mucous/discharge into lumen 258.
  • Pneumostoma vent 204 includes a cap 242 and a hydrophobic filter 248 over the opening 255 in the proximal end of tube 240. Hydrophobic filter 248 is positioned over the proximal opening 255 into lumen 258. Hydrophobic filter 248 is positioned and mounted such that material moving between lumen 258 and the exterior of pneumostoma vent 204 must pass through hydrophobic filter 248. Hydrophobic filter 248 is preferably designed such that it may be fits into a recess in cap 242. As shown in FIG. 2B, cap 242 comprises a recess 238 into which hydrophobic filter 248 may be fit. Hydrophobic filter 248 may alternatively be fitted into cap 242 using a joint such as a threaded coupling or adhesive or, in some cases, formed integrally with cap 242. Hydrophobic filter 248 may be made from a material such as medical grade GOR-TEX (W. L. Gore & Associates, Inc., Flagstaff, Ariz.). As shown in FIG. 2B, a snap ring 243 locks cap 242 and hydrophobic filter 248 onto the proximal end of tube 240.
  • Hydrophobic filter 248 serves several purposes. In general, hydrophobic filter 248 controls the passage of solid or liquid material between the lumen 258 and the exterior of cap 242. For example, hydrophobic filter 248 prevents the flow of water into the lumen 258 through proximal opening 255. Thus, a patient using PMD 200 may shower without water entering the lung through the pneumostoma. Hydrophobic filter 248 may also be selected so as to prevent the entry of microbes, pollen and other allergens and pathogens into the lumen 258. Hydrophobic filter 248 also prevents the exit of liquid and particulate discharge from lumen 258 to the exterior of pneumostoma vent 204. This is desirable to prevent contact between liquid and particulate discharge and clothing for example.
  • Chest mount 202 connects to the proximal end of pneumostoma vent 204. In one embodiment, illustrated in FIGS. 2A and 2B, chest mount 202 comprises a flange 222 and an aperture 224. The aperture 224 is adapted and configured to receive the pneumostoma vent 204. Chest mount 202 is designed to have a smooth surface and a low profile so it is comfortable for the patient to wear. Chest mount 202 should be designed so as not to snag on the patient's clothing or to restrict motion of the patient's arm (if placed in a lateral pneumostoma 112). Flange 222 is significantly wider than pneumostoma vent 204. Flange 222 thus comprises a contact surface 232 which contacts the skin of the patient surrounding the pneumostoma and positions the aperture 224 over the opening of the pneumostoma. Flange 222 is designed such that it is sufficiently flexible that it can conform to the surface of the chest. Contact surface 232 is also provided with a pad of biocompatible adhesive 234, such as a hydrocolloid adhesive, for securing flange 222 to the skin of the patient. The adhesive 234 may be protected by a protector sheet that is removed prior to use of flange 222. Adhesive 234 should be selected so as to secure flange 222 to the chest of the patient in the correct position relative to the pneumostoma without causing undue irritation to the skin of the patient. The adhesive need not create an air tight seal between flange 222 and the skin of the patient. Suitable adhesive pads are available commercially from Avery Dennison (Painesville, Ohio).
  • Referring now to FIG. 2C which shows a perspective view of chest mount 202 without pneumostoma vent 204. Flange 222 is generally circular but is provided with one or more tabs 236 to facilitate application and removal of flange 222 from the skin of the patient. As shown in FIG. 2C, chest mount 202 comprises an aperture 224 through which tube 240 of pneumostoma vent 204 may be inserted. Flange 222 is slightly convex on the upper surface 235. Flange 222 includes a recess 226 into which cap 242 of pneumostoma vent 204 may be press fit. Flange 222 is thick enough in the region of aperture 224 to receive the cap 242 of pneumostoma vent 204 so that the cap of pneumostoma vent 204 is flush with the upper surface 235 of flange 222. Recess 226 forms a coupling adapted to releasably secure the cap 242 of pneumostoma vent 204 into flange 222. As shown in FIGS. 2B and 2C, recess 226 has a lip 227 to releasably secure the cap 242 of pneumostoma vent 204 into flange 222. However, other couplings may be used to releasably secure pneumostoma vent 204 to chest mount 202 including clips, pins, snaps, catches, threaded joints, temporary adhesive and the like.
  • In a preferred embodiment, an aperture plate 228 is embedded in the conformable polymer of flange 222. FIG. 2D shows a perspective view of an aperture plate 228 that is embedded within flange 222 of chest mount 202. Note that aperture plate 228 surrounds aperture 224 of chest mount 202. Aperture plate 228 is made of a stiffer, less compliant material than flange 222 in order that the dimensions of aperture 224 are tightly controlled. Because aperture plate 228 is stiff enough that the size and shape of aperture 224 remains stable even under any reasonably possible application of force to chest mount 202.
  • Referring now to FIG. 2E which shows a perspective view of pneumostoma vent 204 without chest mount 202. Cap 242 is attached to the proximal end of tube 240. Hydrophobic filter 248 is sandwiched between cap 242 and tube 240. An opening 244 in cap 242 communicates with the lumen 258 of tube 240 via hydrophobic filter 248. As shown in FIGS. 2B and 2E, cap 242 comprises a lip 246 which releasably engages lip 227 of recess 226 of flange 222 to secure pneumostoma vent 204 within the recess 226 of flange 222. Lip 246 forms a coupling element of pneumostoma vent 204 that cooperates with recess 226 to releasably secure pneumostoma vent 204 into chest mount 202 with tube 240 positioned through aperture 224.
  • FIG. 2F shows an exploded view of pneumostoma vent 204 showing the individual components of pneumostoma vent 204. Hydrophobic filter 248 is sandwiched between tube 240 and cap 242. Tube 240 has a flange 241 at its proximal end. Snap ring 243 slides over tube 240. The inner diameter of snap ring 243 is too small to pass over flange 241 thus when snap ring 243 is locked into cap 242, tube 240 is locked to cap 242. It should be noted that the outer diameter of each of snap ring 243, hydrophobic filter 248, flange 241 and cap 242 is larger than the diameter of aperture 224 of aperture plate 228. Aperture plate 228 is sufficiently stiff that the dimensions of aperture 224 will not change even under loads significantly higher than would be expected during use of the device. Thus, snap ring 243, hydrophobic filter 248, flange 241 and cap 242 cannot pass through aperture 224 into the pneumostoma. Distal tip 252 of tube 240 and the body of tube 240 are small enough to pass through aperture 224 however, flange 241 and/or cap 242 serve to limit the passage of tube 240 through aperture 224. These safety features prevent unsafe entry of any of the components of pneumostoma vent 204 into pneumostoma even in the unlikely event of device failure. Likewise all the components of the chest mount 202 such as flange 222 and aperture plate 224 are significantly larger than the aperture of a pneumostoma thus precluding passage of any component of the chest mount 202 into a pneumostoma even in the unlikely event of device failure.
  • Insertion Tool
  • The pneumostoma management system may also include insertion and/or removal tools for use with pneumostoma vent 204. The tools help control insertion and removal of pneumostoma vent 204 and also help maintain sterility of pneumostoma vent 204 before and during insertion into a pneumostoma. FIGS. 3A-3F show views of an insertion tool 300 which forms part of the pneumostoma system according to one embodiment of the invention.
  • Referring now to FIG. 3A which shows an external view of insertion tool 300. Insertion tool 300 includes a casing 340, having a handle 360 at the proximal end and a grasper 380 at the distal end. The tool also comprises an end cap 320 at the distal end of casing 340 (not shown in FIG. 3A). When handle 360 is pushed up against the distal end of casing 340, grasper 380 is configured to lock to the cap of a pneumostoma vent. When handle 360 is pulled away from casing 340 in the direction of arrow 306, grasper 380 is configured to release the cap of a pneumostoma vent. Insertion tool 300 includes an internal mechanism that allows handle 360 to be moved away from casing 340 in the direction of arrow 306 one time and then locks handle 360 in place. Thus handle 360 is a single use device. Handle 360 is provided in sterile packaging, the one-time-use lock protects the no-longer-sterile insertion tool from reuse.
  • FIG. 3B shows a sectional view of insertion tool 300. Casing 340 has a central lumen 344 running from the proximal end to the distal end. End cap 320 is designed such that it may be snap fit into the proximal end of casing 340 to lock together the components of insertion tool 300 without the use of adhesive. End Cap 320 has a step 322 which is engaged by lip 342 of casing 340. End cap 320 has an opening 324 through which a portion of the handle 360 is received. End cap 320 also has a tongue 326 that protrudes into casing 340.
  • Handle 360 includes a mandrel 362. In this embodiment the handle and mandrel are formed in one piece. Mandrel 362 comprises a square tab 364 and a ramped tab 366. Tabs 364 and 366 are on opposite sides of slot 368 in mandrel 362. Slot 368 is sized and configured such that mandrel 362 is sufficiently flexible in the region of tabs 364 and 366 for the tabs to be pushed towards each other slightly by compressing slot 368. The portion of handle 360 external to casing 340 is too large to enter casing 340 thus precluding over insertion.
  • Grasper 380 comprises four arms 382 attached to a tubular section 381 (only two arms shown in sectional view). Between the arms 382 is a space 384 for receiving mandrel 362. The space narrows slightly towards the distal end of the arms 382 because arms 382 ramp up slightly in thickness towards the distal end. On the distal end of each of arm 382 is a wedge 390. In the tubular section 381 of grasper 380 there is a proximal detent 386 and a distal detent 388 for receiving ramped tab 366 of mandrel 362. In the tubular section 381 of grasper 380 there is also a slot 392 opposite detents 386 and 388 for receiving square tab 366 of mandrel 362. The proximal end of tubular section 381 has a lip 389 which engages a recess 305 of the casing to fix the location of grasper 380 and preclude passage of grasper 380 through casing 340.
  • To assemble insertion tool 300, mandrel 362 is inserted through opening 324 in end cap 320. Tabs 364, 366 are pushed towards one another compressing slot 368 as the tabs pass through opening 324 which would otherwise be too narrow to allow tabs 364, 366 to pass. Mandrel 362 is then inserted through the tubular section 381 of grasper 380 and between arms 382 until ramped tab 366 is located in distal detent 388 and square tab 364is located in slot 392. Casing 340 is then pushed over grasper 380 until step 322 of end cap 320 engages lip 312 at the proximal end of casing 340. Note that for ease of manufacturing insertion tool comprises only four components casing 340, grasper 380, handle 360 and end cap 320. Moreover, to ensure all failure modes are as safe as possible, each of the grasper 380, handle 360 and end cap 320 is too large to pass through casing 340 any further than is necessary for their function.
  • Insertion tool 300 is assembled in its locked configuration as shown in FIGS. 3B and 3C. In this locked configuration of the insertion tool, as shown in FIG. 3B, mandrel 362 fills the space between 384 between arms 382 locking wedges 390 outward as shown by arrows 308. Ramped tab 366 of mandrel 362 is in distal detent 386 of tubular section 381. FIG. 3C shows a view of the distal end of insertion tool 300 in the locked configuration note that each of arms 382 has been forced to its outermost position by the presence of mandrel 362 at the distal end of its travel in space 384.
  • To release insertion tool 300, handle 360 is pulled in the direction shown by arrow 306 relative to casing 340. As shown in FIG. 3D, ramped tab 366 is oriented such that the motion of handle 360 in the direction 306 compresses slot 368 allowing ramped tab 366 to pass out of distal detent 386. Square tab 364 rides in slot 392 so that mandrel 362 does not rotate relative to tubular section 381. When ramped tab 366 reaches proximal detent 388, the slot 368 is decompressed and ramped tab 366 is pushed into proximal detent 388. Note that ramped tab 366 is oriented such that it is caught in proximal detent 388 and cannot be returned from proximal detent 388 to distal detent 386. The travel of square tab 364 is also limited by tongue 326 of end cap 320 so as to prevent removal of handle 360 from casing 340. Thus, handle 360 is now fixed in the unlocked configuration.
  • In this unlocked configuration, shown in FIGS. 3D, 3E and 3F, the distal end of mandrel 362 is retracted away from the distal end of casing 340. Consequently space 384 is vacant between arms 382 of grasper 380. As a consequence, wedges 390 may move inward as shown by arrows 310 because of the flexibility of arms 382 no longer constrained by the presence of mandrel 362. FIG. 3E shows a view of the distal end of insertion tool 300 in the unlocked configuration note that each of arms 382 has moved to an inner position because mandrel 362 has been withdrawn from the distal end of space 384. FIG. 3F shows a close-up of the distal end of insertion tool 300 showing how inward displacement of arms 382 because of retraction of mandrel 362 allows wedges 390 to disengage a cap 242 of a pneumostoma vent 204. Thus, in this unlocked configuration of the insertion tool 300, insertion tool 300 releases pneumostoma vent 204 after insertion into a pneumostoma.
  • Removal Tool
  • The pneumostoma management system may also include insertion and/or removal tools for use with pneumostoma vent 204. The tools help control insertion and removal of pneumostoma vent 204 and also help maintain sterility of pneumostoma vent 204 before and during insertion into a pneumostoma. FIGS. 4A-4F show views of a removal tool 400 which forms part of the pneumostoma system according to one embodiment of the invention.
  • Referring now to FIG. 4A which shows an external view of removal tool 400. Removal tool 400, in this embodiment, comprises the same casing 340, grasper 380 and end cap 320 as insertion tool 300. The structural difference between removal tool, 400 and insertion tool 300 is handle 460. The starting position for handle 460 is, as shown in FIG. 4A, spaced away from casing 340. In this unlocked configuration grasper 380 may be inserted into the cap of a pneumostoma vent. However when handle 460 is pushed against casing 340 as shown by arrow 406, removal tool 400 changes to the locked configuration and is secured to the cap of a pneumostoma vent allowing the pneumostoma vent to be removed from a chest mount. Removal tool 400 includes an internal mechanism that only allows handle 460 to be moved towards casing 340 in the direction of arrow 406 one time and then locks handle 460 in place. Thus removal tool 400 is a single use device. When removal tool 400 is secured to a pneumostoma vent for removal, the removal tool and pneumostoma vent are locked to one another and are disposed of in that from. The one-time-use lock protects the no-longer-sterile removal tool and pneumostoma vent from reuse.
  • FIG. 4B shows a sectional view of removal tool 400. The internal components of removal tool 400 are the same as for insertion tool 300 with the exception of handle 460 and mandrel 462. Handle 460 and mandrel 462 are formed in one piece. Note that mandrel 462 comprises a square tab 464 and a ramped tab 466. Tabs 464 and 466 are on opposite sides of slot 468 in mandrel 462. Slot 468 is sized and configured such that mandrel 462 is sufficiently flexible in the region of tabs 464 and 466 for the tabs to be pushed towards each other slightly by compressing slot 468. However, in mandrel 462, ramped tab 466 is ramped in the opposite direction to ramped tab 366 of the insertion tool. Moreover, ramped tab 466, square tab 464 and slot 468 are located such that in the unlocked configuration, ramped tab 466 occupies proximal detent 388 of grasper 380 and square tab 464 is at the proximal end of slot 392. Note that for ease of manufacturing, removal tool 400 and insertion tool 300 share three out of four components. Thus, only five different components (casing 340, grasper 380, handle 360, handle 460 and end cap 320) are required to make both the insertion tool 300 and removal tool 400. Moreover, to ensure all failure modes are as safe as possible, each of the grasper 380, handle 360, handle 460 and end cap 320 is too large to pass through casing 340 any further than is necessary for their function.
  • Removal tool 400 is assembled in the same way as insertion tool 300; mandrel 462 is first inserted through opening 324 in end cap 320. Tabs 464, 466 are pushed towards one another, compressing slot 468 as the tabs pass through opening 324, which would otherwise be too narrow to allow tabs 464, 466 to pass. Mandrel 462 is then inserted through the tubular section 381 of grasper 380 and between arms 382 until ramped tab 466 is located in proximal detent 388 and square tab 464 is located in slot 392. Casing 340 is then pushed over grasper 380 until step 322 of end cap 320 engages lip 312 at the proximal end of casing 340.
  • Removal tool 400 is assembled in its unlocked configuration as shown in FIGS. 4B and 4C. In this unlocked configuration of the removal tool 400, mandrel 462 does not fill the space 384 between arms 382. Thus wedges 390 can move inward as shown by arrows 408. Ramped tab 466 of mandrel 462 is in proximal detent 388 of tubular section 381. FIG. 4C shows view of the distal end of removal tool 400 in the unlocked configuration. Note that each of arms 382 can travel inwards because mandrel 462 is not at the distal end of its travel in space 384.
  • To secure removal tool 400 to a pneumostoma tube, handle 460 is pushed in the direction shown by arrow 406 relative to casing 340. As shown in FIG. 4D, ramped tab 466 is oriented such that the motion of handle 460 compresses slot 468 allowing ramped tab 466 to pass out of proximal detent 388. Square tab 464 rides in slot 392 so that mandrel 462 does not rotate relative to tubular section 381. When ramped tab 466 reaches distal detent 386, the slot 468 is decompressed and ramped tab 466 is pushed into distal detent 386. Note that ramped tab 466 is oriented such that it is caught in distal detent 386 and cannot be returned from distal detent 388 to proximal detent 388. Thus, handle 460 is now fixed in the locked configuration. The travel of square tab 464 is also limited by tongue 326 of end cap 320 so as to prevent removal of handle 460 from casing 340.
  • In the locked configuration of the removal tool shown in FIGS. 4D-F, the distal end of mandrel 462 is pushed into the distal end of casing 340. Consequently mandrel 462 fills space 384 and pushes arms 382 outward as shown by arrows 410. FIG. 4E shows view of the distal end of removal tool 400 in the locked configuration. Note that each of arms 382 has moved to its outer position because mandrel 462 has been pushed to the distal end of space 384. FIG. 4F shows a close-up of the distal end of removal tool 400 showing how outward displacement of arms 382 by mandrel 462 causes wedges 390 to engage cap 242 of a pneumostoma vent 204. Thus, in this locked configuration of removal tool 400, removal tool 400 is secured to pneumostoma vent 204 allowing it to be removed from the pneumostoma.
  • Materials
  • In preferred embodiments, pneumostoma vent 204 and chest mount 202 of PMD 200 are formed from biocompatible polymers or biocompatible metals. A patient will typically wear PMD 200 at all times and thus the materials, particularly of tube 240, should meet high standards for biocompatibility. In general preferred materials for manufacturing PMD 200 are biocompatible thermoplastic elastomers that are readily utilized in injection molding and extrusion processing. As will be appreciated, other suitable similarly biocompatible thermoplastic or thermoplastic polymer materials can be used without departing from the scope of the invention. Biocompatible polymers for manufacturing PMD may be selected from the group consisting of polyethylenes (HDPE), polyvinyl chloride, polyacrylates (polyethyl acrylate and polymethyl acrylate, polymethyl methacrylate, polymethyl-coethyl acrylate, ethylene/ethyl acrylate), polycarbonate urethane (BIONATEG), polysiloxanes (silicones), polytetrafluoroethylene (PTFE, GORE-TEX®, ethylene/chlorotrifluoroethylene copolymer, aliphatic polyesters, ethylene/tetrafluoroethylene copolymer), polyketones (polyaryletheretherketone, polyetheretherketone, polyetherether-ketoneketone, polyetherketoneetherketoneketone polyetherketone), polyether block amides (PEBAX, PEBA), polyamides (polyamideimide, PA-11, PA-12, PA-46, PA-66), polyetherimide, polyether sulfone, poly(iso)butylene, polyvinyl chloride, polyvinyl fluoride, polyvinyl alcohol, polyurethane, polybutylene terephthalate, polyphosphazenes, nylon, polypropylene, polybutester, nylon and polyester, polymer foams (from carbonates, styrene, for example) as well as the copolymers and blends of the classes listed and/or the class of thermoplastics and elastomers in general. Reference to appropriate polymers that can be used for manufacturing PMD 200 can be found in the following documents: PCT Publication WO 02/02158, entitled “Bio-Compatible Polymeric Materials;” PCT Publication WO 02/00275, entitled “Bio-Compatible Polymeric Materials;” and, PCT Publication WO 02/00270, entitled “Bio-Compatible Polymeric Materials” all of which are incorporated herein by reference. Other suitable materials for the manufacture of the PMD include medical grade inorganic materials such stainless steel, titanium, ceramics and coated materials.
  • Additionally, the tube 240 of pneumostoma vent 204 may be designed to deliver a pharmaceutically-active substance. For purposes of the present disclosure, an “active pharmaceutical substance” is an active ingredient of vegetable, animal or synthetic origin which is used in a suitable dosage as a therapeutic agent for influencing conditions or functions of the body, as a replacement for active ingredients naturally produced by the human or animal body and to eliminate or neutralize disease pathogens or exogenous substances. The release of the substance in the environment of pneumostoma vent 204 has an effect on the course of healing and/or counteracts pathological changes in the tissue due to the presence of pneumostoma vent 204. In particular, it is desirable in some embodiments to coat or impregnate pneumostoma vent 204 with pharmaceutically-active substances that preserve the patency of pneumostoma and/or are antimicrobial in nature but that do not unduly irritate the tissues of the pneumostoma.
  • In particular cases, suitable pharmaceutically-active substances may have an anti-inflammatory and/or antiproliferative and/or spasmolytic and/or endothelium-forming effect, so that the functionality of the pneumostoma is maintained. Suitable pharmaceutically-active substances include: anti-proliferative/antimitotic agents including natural products such as vinca alkaloids (i.e. vinblastine, vincristine, and vinorelbine), paclitaxel, epidipodophyllotoxins (i.e. etoposide, teniposide), antibiotics (dactinomycin (actinomycin D) daunorubicin, doxorubicin and idarubicin), anthracyclines, mitoxantrone, bleomycins, plicamycin (mithramycin) and mitomycin, enzymes (L-asparaginase which systemically metabolizes L-asparagine and deprives cells which do not have the capacity to synthesize their own asparagine); antiplatelet agents such as G(GP) IIb/IIIa inhibitors and vitronectin receptor antagonists; anti-proliferative/antimitotic alkylating agents such as nitrogen mustards (mechlorethamine, cyclophosphamide and analogs, melphalan, chlorambucil), ethylenimines and methylmelamines (hexamethylmelamine and thiotepa), alkyl sulfonates-busulfan, nitrosoureas (carmustine (BCNU) and analogs, streptozocin), trazenes—dacarbazinine (DTIC); anti-proliferative/antimitotic antimetabolites such as folic acid analogs (methotrexate), pyrimidine analogs (fluorouracil, floxuridine, and cytarabine), purine analogs and related inhibitors (mercaptopurine, thioguanine, pentostatin and 2-chlorodeoxyadenosine{cladribine}); platinum coordination complexes (cisplatin, carboplatin), procarbazine, hydroxyurea, mitotane, aminoglutethimide; hormones (i.e. estrogen); anti-coagulants (heparin, synthetic heparin salts and other inhibitors of thrombin); fibrinolytic agents (such as tissue plasminogen activator, streptokinase and urokinase), aspirin, dipyridamole, ticlopidine, clopidogrel, abciximab; antimigratory; antisecretory (breveldin); anti-inflammatory: such as adrenocortical steroids (cortisol, cortisone, fludrocortisone, prednisone, prednisolone, 6a-methylprednisolone, triamcinolone, betamethasone, and dexamethasone), non-steroidal agents (salicylic acid derivatives i.e. aspirin; para-aminophenol derivatives i.e. acetaminophen; indole and indene acetic acids (inaperturethacin, sulindac, and etodalac), heteroaryl acetic acids (tolmetin, diclofenac, and ketorolac), arylpropionic acids (ibuprofen and derivatives), anthranilic acids (mefenamic acid, and meclofenamic acid), enolic acids (piroxicam, tenoxicam, phenylbutazone, and oxyphenthatrazone), nabumetone, gold compounds (auranofin, aurothioglucose, gold sodium thiomalate); immunosuppressives: (cyclosporine, tacrolimus (FK-506), sirolimus (rapamycin), azathioprine, mycophenolate mofetil); angiogenic agents: vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF); angiotensin receptor blockers; nitric oxide donors; antisense oligionucleotides and combinations thereof, cell cycle inhibitors, mTOR inhibitors, and growth factor receptor signal transduction kinase inhibitors; retenoids; cyclin/CDK inhibitors; HMG co-enzyme reductase inhibitors (statins); silver compound and protease inhibitors.
  • In some embodiments, the active pharmaceutical substance to be coated upon or impregnated in the pneumostoma vent 204 is selected from the group consisting of amino acids, anabolics, analgesics and antagonists, anaesthetics, anti-adrenergic agents, anti-asthmatics, anti-atherosclerotics, antibacterials, anticholesterolics, anti-coagulants, antidepressants, antidotes, anti-emetics, anti-epileptic drugs, anti-fibrinolytics, anti-inflammatory agents, antihypertensives, antimetabolites, antimigraine agents, antimycotics, antinauseants, antineoplastics, anti-obesity agents, antiprotozoals, antipsychotics, antirheumatics, antiseptics, antivertigo agents, antivirals, appetite stimulants, bacterial vaccines, bioflavonoids, calcium channel blockers, capillary stabilizing agents, coagulants, corticosteroids, detoxifying agents for cytostatic treatment, diagnostic agents (like contrast media, radiopaque agents and radioisotopes), electrolytes, enzymes, enzyme inhibitors, ferments, ferment inhibitors, gangliosides and ganglioside derivatives, hemostatics, hormones, hormone antagonists, hypnotics, immunomodulators, immunostimulants, immunosuppressants, minerals, muscle relaxants, neuromodulators, neurotransmitters and neurotrophins, osmotic diuretics, parasympatholytics, para-sympathomimetics, peptides, proteins, psychostimulants, respiratory stimulants, sedatives, serum lipid reducing agents, smooth muscle relaxants, sympatholytics, sympathomimetics, vasodilators, vasoprotectives, vectors for gene therapy, viral vaccines, viruses, vitamins, oligonucleotides and derivatives, saccharides, polysaccharides, glycoproteins, hyaluronic acid, and any excipient that can be used to stabilize a proteinaceous therapeutic
  • Hydrophobic filter 248 should be sufficiently porous to allow air to exit through the filter. Materials for hydrophobic filters are available commercially and filters can be fabricated from any suitable hydrophobic polymer, such as tetrafluoroethylene, PTFE, polyolefins, microglass, polyethylene and polypropylene or a mixture thereof. In preferred examples, the hydrophobic filter is a laminated tetrafluoroethylene e.g. TEFLON®, (E.I. du Pont de Nemours Co.) or GORE-TEX® (W.L. Gore, Inc.) of a controlled pore size. In other examples the hydrophobic filter may comprise a felted polypropylene; PTFE/polypropylene filter media. Hydrophobic filter 248 may additionally comprise an antimicrobial, an anti-bacterial, and/or an anti-viral material or agent.
  • Insertion tool 300 and removal tool 400 do not contact the pneumostoma. Thus, the materials of insertion tool 300 and removal tool 400 do not have to be biocompatible and implantable materials. Suitable materials for making insertion tool 300 and removal tool 400 include medical grade metals, plastics, acrylics and resins. In a preferred embodiment the insertion tool, removal tool and alignment tools may be made from ABS (Acrylonitrile-Butadiene-Styrene) plastic. In a preferred embodiment the insertion and removal tool are made of the same material as aperture plate 228 and cap 242.
  • Use of the Pneumostoma Management System
  • The pneumostoma management system is designed such that the system may be used by a patient in a sterile manner. After creating and healing of the pneumostoma the patient will be responsible for applying and removing the chest mount 202 and the insertion, removal and disposal of pneumostoma vent 204. The patient will exchange one pneumostoma vent 204 for another and dispose of the used pneumostoma vent 204. Pneumostoma vent 204 will be replaced periodically, such as daily, or when necessary. The patient will be provided with a supply of pneumostoma vent 204 by a medical practitioner or by prescription. Chest mount 202 will also be replaced periodically, such as weekly, or when necessary. The patient will also be provided with a supply of chest mount 202 by a medical practitioner or by prescription. A one week supply of pneumostoma vent 204 (such as seven pneumostoma vents 204) may be conveniently packaged together with one chest mount 202.
  • To use PMD 200, chest mount 202 is first positioned over a pneumostoma and secured with adhesive to the skin of the patient. In a preferred embodiment, the chest mount remains attached for up to a week thereby avoiding irritation of the skin caused by daily attachment and removal of a mount. FIG. 5A illustrates the positioning of chest mount 202 over pneumostoma 110 and pneumostoma 112 of FIG. 1A. As shown in FIG. 3A the low profile of chest mount 202 allows it to be inconspicuously positioned on the chest 100 of a patient in either the frontal 110 or lateral 112 locations. PMD 200 is designed so as not to interfere with the range of motion or clothing of the patient. This is of importance for a device such as PMD 200 which must be used continuously to be effective. Comfort and ease of use are important if patient compliance with treatment protocols is to be achieved. Chest mount may be positioned by the patient by manual alignment of the aperture 224 of chest mount 202 with the aperture of the pneumostoma. Alternatively a pneumostoma vent or an alignment tool may be used to align the chest mount.
  • In one embodiment, the chest mount 202 may be aligned with the pneumostoma 110 using a pneumostoma vent 204 and optionally an insertion tool 300. The chest mount 202 may be provided to the patient with the pneumostoma vent 204 and optional insertion tool as one assembly. Alternatively, the patient may insert the pneumostoma vent 204 into the chest mount 202 prior to applying chest mount 202 to the chest. The patient then manipulates the chest mount by the tabs 236 or insertion tool 300. The patient places the tip of pneumostoma vent 204 into the aperture 126 of the pneumostoma 110 and pushes the pneumostoma vent 204 gently and slowly into the pneumostoma 110. During insertion the patient lets the pneumostoma vent 204 align itself with the channel 120 of the pneumostoma 110 such that when the chest mount 202 contacts and adheres to the skin 114 of the chest 100, the aperture 224 of the chest mount 202 is perfectly aligned with the aperture 126 of the pneumostoma 110. If an insertion tool 300 was used, the patient then pulls gently on handle 360 to detach the alignment tool 300 from the pneumostoma vent 204, leaving the chest mount 202 and pneumostoma vent 204 in place on the chest 100 of the patient.
  • Alternatively, an alignment tool may be used during positioning of chest mount 202. FIGS. 5B and 5C show a chest mount alignment tool 560 which aids positioning a chest mount 202 and aligning the aperture 224 of the chest mount 202 with an aperture of a pneumostoma. The alignment tool 560 comprises a handle section 562 joined to a mount engagement section 564 joined to a pneumostoma alignment probe 566. The handle is designed to be gripped by the patient while applying the chest mount 202. The handle 562 allows the chest mount 202 to be manipulated without direct handling of the chest mount 202 by the patient. This reduces the risk of contaminating the chest mount 202 and pneumostoma 110. Mount engagement section 564 is shaped similarly to the cap of a pneumostoma vent 204 and is designed to fit into and engage the recess 226 of a chest mount 202. Like the cap of a pneumostoma vent, the mount engagement section 564 is too large to pass through the aperture 224 of an aperture plate 228 and thus cannot be inserted too far through the chest mount 202. However, the pneumostoma alignment probe 566 fits through aperture 224 and protrudes a short distance beyond the contact surface 232 of the flange 222. Pneumostoma alignment probe 566 is preferably small enough that it will be suitable for use with all patients. Preferably the length of pneumostoma alignment probe 566 is less than the length of the smallest available pneumostoma vent 204. Alignment tool 560 may be provided preassembled with a chest mount 202 as shown in FIG. 5B.
  • As shown in FIG. 5C, to apply the chest mount 202 the patient uses handle 562 to remove the chest mount 202 from its sterile packaging. The patient then removes any protective covering over the adhesive on the contact surface 232 of the chest mount 202. The patient then places the tip of pneumostoma alignment probe 566 into the aperture 126 of the pneumostoma 110 and pushes the probe gently and slowly into the pneumostoma 110. During insertion the patient lets the probe 566 align itself with the channel 120 of the pneumostoma 110 such that when the chest mount 202 contacts and adheres to the skin 114 of the chest 100, the aperture 224 of the chest mount 202 is perfectly aligned with the aperture 126 of the pneumostoma 110. The patient then pulls gently on handle 562 to remove the alignment tool 500, leaving the chest mount 202 in place on the chest 100 of the patient ready to receive a pneumostoma vent. The alignment tool 500 is preferably formed in one piece for ease of manufacturing and safety. The pneumostoma alignment probe 566 preferably has a atraumatic tip 568 which may be soft, and or rounded so as to avoid causing injury or irritation to the pneumostoma during insertion of the probe.
  • In an alternative embodiment, illustrated in FIG. 5D, an alignment tool 510 includes only the mount engagement section 564 and pneumostoma alignment probe 566. In this embodiment, the mount engagement section 564 has a recess similar to the recess in the proximal end of a pneumostoma tube 202 for engaging a removal tool 400 as shown in FIG. 4F. The alignment tool is supplied preassembled to a chest mount 202. To use this alignment tool 510, the patient first secures the removal tool 400 to the alignment tool 510. The patient then uses casing 340 or removal tool 400 to remove the chest mount 202 from its sterile packaging. The patient then removes any protective covering over the adhesive on the contact surface of the chest mount 202. The patient then guides the pneumostoma alignment probe into the pneumostoma channel 120 as before. When the chest mount 202 is positioned correctly and adhered to the skin of the chest, the patient removes the removal tool 400 and pneumostoma alignment tool 500 in one piece by pulling gently on the casing 340 of the removal tool 400 leaving the chest mount in position on the chest of the patient. The patient the discards the removal tool 400 and pneumostoma alignment tool 500 locked together as one unit.
  • FIG. 6A shows a pneumostoma vent 204 secured to an insertion tool 300. In a preferred embodiment, pneumostoma vents 204 are supplied to a patient in the configuration shown in FIG. 6A. Thus when pneumostoma vent 204 is removed from its sterile packaging by the patient, the patient only touches insertion tool 300 and does not touch the pneumostoma vent 204. Note that insertion tool 300 is in the locked configuration and insertion tool 300 is securely attached to cap 242 of pneumostoma vent 204 by the grasper 380.
  • FIG. 6B shows insertion of a pneumostoma vent 204 through a chest mount 202 into a pneumostoma. The patient grips insertion tool 300 and pushes tube 240 of pneumostoma vent 204 through the aperture in chest mount 202 in the direction of arrow 602 until the cap 242 of pneumostoma vent 204 engages the chest mount 202 as shown in FIG. 6C. In this position, cap 242 is secured by chest mount 202. The patient pulls handle 360 in the direction of arrow 604. This causes insertion tool 300 to change to its unlocked configuration. In the unlocked configuration, grasper 380 releases cap 242 of pneumostoma vent 204. (See FIGS. 3D-F). This allows insertion tool 300 to be removed leaving pneumostoma vent 204 in the correct position as shown in FIG. 6D. Insertion tool 300 is now fixed in the unlocked position and may be discarded.
  • FIG. 6D shows a sectional view through PMD 200 and pneumostoma 110 showing the interaction of the PMD 200 with the pneumostoma 110. Tube 240 of pneumostoma vent 204 fits snugly within channel 120 of pneumostoma 110. Pneumostoma vent 204 thus maintains the patency of channel 120. Tube 240 of pneumostoma vent 204 is sized and configured such that it penetrates through channel 120 into cavity 122 in the parenchymal tissue 132 of lung 130. Chest mount 202 is secured to the skin 114 of the patient. Aperture plate 228 engages cap 242 of pneumostoma vent 204 to prevent over insertion of pneumostoma vent 204 into the pneumostoma. Adhesive 234 contacts skin 114 holding PMD 200 in position on the chest 100 of the patient. Because of the snug fit of tube 240 of pneumostoma vent 204 within channel 120 and the contact between chest mount 202 and skin 114, PMD 200 effectively controls the movement of all material (including solids, liquids and gases) in and out of the pneumostoma. Air flows from cavity 122 of pneumostoma 110 into lumen 258 of tube 240 of pneumostoma vent 204 as shown by arrow 606. From lumen 258, exhaled air flows through hydrophobic filter 248 and vents to atmosphere as shown by arrow 608.
  • The pneumostoma vent 204 is left in position in chest mount 202. After a day (or if otherwise necessary) pneumostoma vent 204 may be removed from chest mount 202 using a removal tool 400. As shown in FIG. 6E, the patient inserts the grasper 380 of a removal tool 400 in the direction of arrow 610 into the cap 242 of the pneumostoma vent 204. When removal tool 400 is positioned as shown in FIG. 6F, the patient pushes in handle 460 in the direction shown by arrow 612. This causes removal tool 400 to change to the locked configuration in which grasper 380 is securely attached to the cap 242 of pneumostoma vent 204 as shown in FIG. 6G (see also FIGS. 4D-F).
  • The patient may now pull casing 340 of removal tool 400 in the direction of arrow 614 as shown in FIG. 6H. Because the grasper 380 of removal tool 400 is locked to the cap 242 of pneumostoma vent 204 the pneumostoma vent 204 is removed from the chest mount 202. Pneumostoma vent 204 is removed completely from the pneumostoma and remains locked to removal tool 400 as shown in FIG. 6I. Removal tool 400 and pneumostoma vent 204 may be discarded as a single unit and a new pneumostoma vent 204 may be inserted into the pneumostoma as shown beginning with FIG. 6A.
  • FIG. 7A provides a set of instructions for use (IFU) 720 for replacement of a chest mount according to an embodiment of the invention. At step 722, the patient obtains the replacement chest mount and verifies that it is the correct size for his/her pneumostoma. At step 724, the patient removes the prior chest mount and disposes of it as appropriate. At step 726 the patient removes a sterile cleaning swab from the chest mount package. At step 728 the patient cleans the area of the skin around the pneumostoma. The patient cleans in a direction radially out from the pneumostoma. At step 730 the patient inspects the tissue around the pneumostoma and the pneumostoma for inflammation or injury. If injury or inflammation is observed the patient should seek medical advice.
  • At step 732 the patient removes a new disposable (or sterilized reusable) chest mount from its packaging. At step 734 the patient removes the backing from the adhesive pad of the chest mount. Care is taken during steps 732 and 734 to handle the chest mount only by the tabs and not to touch the surface which will be in contact with the pneumostoma. In embodiments having a pneumostoma alignment tool, the patient can handle the chest mount using the alignment tool rather than using the tabs of the chest mount. At step 736 the patient applies the chest mount to the pneumostoma aligning the aperture of the chest mount with the aperture of the pneumostoma. Chest mount may be packaged with an alignment tool to assist in positioning chest mount correctly. If pain or injury is perceived during application the patient should seek medical advice. The steps of IFU 720 may also be performed by a caregiver or medical practitioner.
  • FIG. 7B provides a set of instruction for use (IFU) 740 for replacement of a pneumostoma vent according to an embodiment of the invention. At step 742, the patient obtains the replacement pneumostoma vent and verifies that it is the correct size for his/her pneumostoma. The packaging of the pneumostoma vent is clearly marked with the length of the pneumostoma vent. In addition the pneumostoma vent can be color coded either on the cap or tube such that a particular color indicates a particular length of pneumostoma vent. At step 744, the patient takes a removal tool, inserts the grasper of the removal tool into the cap of the used pneumostoma vent 204 and pushes in the handle to secure the removal tool to the used pneumostoma vent. At step 746 the patient removes the used pneumostoma vent by pulling on the casing of the removal tool. At step 748 the patient inspects the pneumostoma for inflammation or injury. The area around the pneumostoma and the aperture of the chest mount may be cleaned at this point if mucus or discharge is present. If injury or inflammation is observed the patient should seek medical advice.
  • At step 750 the patient removes a new pneumostoma vent from the packaging. Pneumostoma vent 204 is already attached to an insertion tool so patient does not directly touch the pneumostoma vent. Patient grips the casing of the insertion tool to install the new pneumostoma vent. At step 752 the patient aligns the tube of the new pneumostoma vent with the opening in the chest mount 202 and inserts the pneumostoma vent using the insertion tool until the cap snaps into place. Care is taken during steps 750 and 752 to handle the pneumostoma vent only by the insertion tool and not to touch the sterile pneumostoma tube. At step 754 the patient releases the insertion tool by pulling back on the handle to cause it to enter the unlocked configuration. At step 756 the patient removes the insertion tool and discards it. If pain or injury is perceived during insertion of pneumostoma vent the patient should seek medical advice. The steps of IFU 740 may also be performed by a caregiver or medical practitioner.
  • Packaging for Pneumostoma Management System
  • The components of the pneumostoma management system are preferably supplied to the patient in sterile packaging. In preferred embodiments the components are supplied in packaging that assists the patient in utilizing the components of the system in the correct sequence. FIGS. 8A and 8B show an example of packaging for a chest mount 202 and a pneumostoma vent 204 respectively.
  • Referring now to FIG. 8A which shows package 800 for chest mount 202. Package 800 comprises a tray 810 and a top cover 820. Tray 810 comprises a plurality of dimples 812, 814, 816 sized and configured to fit the components provided in the package. In this example, dimple 812 contains a first sterile cleaning swab 832, dimple 814 contains a second sterile cleaning swab 834, and dimple 816 contains the chest mount 202. The top cover 820 is secured to the surface of tray 810 with an adhesive seal that can be broken by a patient peeling the adhesive from the opening tabs 822, 824. The top cover may be printed with material that assists the patient in the appropriate sequence of the steps for using the enclosed components. For example, a patient opening the package shown in FIG. 8A in peeling top cover 820 from package 800 first exposes first sterile cleaning swab 832 for cleaning the pneumostoma, then second sterile cleaning swab 834 for cleaning the pneumostoma, and finally and chest mount 202 for application to the cleaned pneumostoma. Thus the package provides the components to the patient in the order required for use.
  • Referring now to FIG. 8B which shows package 850 for pneumostoma vent 204. Package 850 comprises a tray 860 and a top cover 880. Tray 860 comprises a plurality of dimples 862, 864 sized and configured to fit the components provided in the package. In this example, dimple 862 contains a removal tool 400, dimple 864 contains an insertion tool 300 assembled to a 65 mm pneumostoma vent 204. The top cover 870 is secured to the surface of tray 860 with an adhesive seal that can be broken by a patient pealing the adhesive from the opening tab 872. The top cover may be printed with material that assists the patient in the appropriate sequence of the steps for using the enclosed components. For example, a patient opening the package shown in FIG. 8A in peeling top cover 870 from package 800 first exposes removal tool 400 for removing the pneumostoma vent 204 to be replaced. The patient then exposes the insertion tool 300 and pneumostoma vent 204. Thus the package provides the components to the patient in the order required for use. Additionally, the insertion tool 300 is made accessible to the patient so that the patient does not handle pneumostoma vent 204 directly. Note that the top cover is clearly marked with a size indicator 874 so that patient may confirm that pneumostoma vent 204 is the correct size for their pneumostoma prior to commencing the replacement procedure.
  • As previously noted, it may be desirable to replace the chest mount 202 only every few days so as to avoid unnecessary irritation to the skin surrounding the pneumostoma. It may be desirable to replace the pneumostoma vent 204 every day. Thus, chest mount 204 is preferably provided in a separate sterile tray from the chest mount 202. In preferred embodiments a weekly kit may be provided having one chest mount 204 and seven pneumostoma vents 204. Thus, a weekly kit may be a single package including one of package 800 of FIG. 8A and seven of package 850 of FIG. 8B. Alternatively, the components may be provided as individual components separately packaged. For example, cleaning and moisturizing swabs may alternatively or additionally be packaged separately and provided to patient. The insertion tool, removal tool and pneumostoma vent may also be separately packaged.
  • Additional and Alternative Pneumostoma Management Device Features
  • It is not necessary that a flow-control device be used in a pneumostoma vent to form an airtight seal against the entry of air into the lung through the pneumostoma. Indeed, air may enter the lung through the pneumostoma between removal and reinsertion of the pneumostoma vent 204. The pleurodesis of the pneumostoma prevents the entry of air into the pleural cavity which would otherwise cause pneumothorax. However, it is sometimes desirable to restrict flow of air in through the pneumostoma so as to encourage a reduction in hyperinflation and to preclude the aspiration of solid, liquid or gas into the lung through the pneumostoma. Thus, in alternative embodiments a pneumostoma vent may be provided with a flow control device instead of, or in addition to, the hydrophobic filter 248. The flow-control device may comprise a one-way valve assembly such as a flapper valve, Heimlich valve, reed valve or the like for allowing air to be exhaled with very low resistance through the pneumostoma while restricting the flow of air or other matter into the pneumostoma from outside the body. A suitable flow-control device preferably includes only a small number of components for ease of manufacturing and reliability and should be designed such that it has no small parts which might be aspirated through the pneumostoma.
  • FIGS. 9A and 9B show the cap of a pneumostoma vent 910 which includes an integrated flow control device and hydrophobic filter. Pneumostoma vent 910 includes tube 912, cap 914, snap ring 916 and filter/valve plate 918. Tube 912 has an aperture 913 which is aligned with a non-porous region 917 of the filter/valve plate 918. Filter valve plate is free to move slightly within the cap 914 in response to air pressure. As shown in FIG. 9A, when the air pressure in tube 912 is higher than the air pressure outside of cap 914 the filter/valve plate 918 moves away from tube 912 and aperture 913 thus allowing air to pass out of tube 912 and through the porous hydrophobic filter region 919 of filter/valve plate 918 along path 908. As shown in FIG. 9B, when the air pressure outside cap 914 is higher than the air pressure inside tube 912 the filter/valve plate 918 moves towards tube 912 and aperture 913 thus blocking aperture 913 with non-porous region 917 of the filter/valve plate 918 and preventing air from entering tube 913 through the cap. Thus, the integrated flow control device and hydrophobic filter allows air to exit pneumostoma vent 910 via the filter but operates as a one-way valve to prevent entry of air through the pneumostoma vent 910. Note also that, as before, all parts of the cap and integrated valve/hydrophobic filter are too large to fit though the aperture of a chest mount to be used with the pneumostoma vent 910 thereby precluding any failure mode in which a part of the pneumostoma vent is aspirated into the lung.
  • Optionally the filter/valve plate 918 if FIGS. 9A and 9B may be biased closed with a light spring force that pushes the late into the closed position of FIG. 9B. The spring force is selected so that it is readily overcome by the exhalation air pressure allowing the filter/valve plate 918 to move to the position shown in FIG. 9A during exhalation. In an alternative embodiment, filter/valve plate 918 may be a flexible disc that is fixed at the edges. During exhalation the center of filter/valve plate 918 bows outwards away from aperture 913 allowing the escape of air. During inhalation, the external air pressure pushes filter/valve plate 918 flat against aperture 913 thus blocking aperture 913 with non-porous region 917 of the filter/valve plate 918 and preventing air from entering tube 913 through the cap.
  • FIG. 9C shows an alternative pneumostoma vent 920 which has features within tube 922 designed to encourage migration of discharge such as mucus and sputum out of the lung and prevent it from re-entering the lung. These features may include barbs/fins that preferentially allow discharge to travel along and out of the inner lumen of the tube. As shown in FIG. 9C the interior surface of tube 922 is covered with an array of barbs 925 which point away from the aperture 923 in the tube 922. Mucus and sputum that enters tube 922 through aperture 923 is pushed towards cap 924 by air flow during exhalation. When the patient inhales, some air may enter through cap 924 however the mucus and sputum is inhibited from traveling back towards aperture 923 by the shape of the barbs. Thus discharge is collected in tube 922. The discharge is removed and disposed of when pneumostoma vent 920 is replaced. Also shown in FIG. 9C are external feature 927 such as rings or ridges which may be utilized on a pneumostoma vent to make a better seal between the exterior of the pneumostoma vent and the interior of the channel of the pneumostoma.
  • FIG. 9D shows an alternative pneumostoma vent 930 which has a plurality of side apertures 935 in order to facilitate entry of gases and/or discharge from a pneumostoma into the lumen 938 of tube 932. One or more side openings 935 may be provided along tube 940 and/or close to the distal tip 934. The side openings 935 may be provided instead of, or in addition to, the opening 933 in the end of distal tip 933. The side openings 935 permit gases and/or discharge to enter lumen 938 even if one or more openings is occluded by tissue or other matter.
  • The tube of a pneumostoma vent such as tube 932 may be created from a porous material such that air may enter the lumen of the tube through the wall of the tube. The porous tube wall may be provided in addition to or instead of the presence of distal opening 933 or side opening 935. The tube of pneumostoma vent such as tube 932 may also be provided with features for maintaining the patency of the pneumostoma as shown in U.S. patent application Ser. No. 12/030,006 entitled “Variable Parietal/Visceral Pleural Coupling” which is incorporated herein by reference.
  • FIGS. 9E and 9F shows views of a pneumostoma plug 940 which may be used to protect the pneumostoma from the entry of foreign material during times or activities when a pneumostoma vent is not present in chest mount 202. Or when it is necessary or desirable to close the pneumostoma for activities such as, for example, spirometry testing of lung function or swimming. As shown in FIG. 9E, pneumostoma plug 940 includes a cover 942 for covering the external aperture in chest mount 202. The cover 242 preferably conforms to the outside surface 235 of chest mount 202 to form a functional seal of the aperture. If the exterior surface of cover 942 is subjected to increased pressure such as by water pressure when swimming, cover 942 is pushed into better contact with surface 235 making a better seal and precluding the entry of water.
  • Pneumostoma plug 940 has a recessed handle 946 or similar gripping mechanism to allow plug 240 to be grasped by the patient and removed from chest mount 202 when necessary. One or more tabs 948 may be provided on the periphery of cover 942 to allow the cover to be grasped by the patient to remove pneumostoma plug 940. Tabs 948 may be provided instead of or addition to handle 946. Plug 940 is however preferably low profile so as to avoid being caught and removed accidentally during an activity.
  • Below cover 942 is a chest mount engagement section 950 (shown in FIG. 9F) which is shaped similarly to the cap of a pneumostoma vent in order to engage the recess of the chest mount. Chest mount engagement section ensures that pneumostoma plug 940 snaps into place in chest mount 202 and remains there until removed by patient. Note that cover 942 and chest mount engagement section 950 are large enough to preclude pneumostoma plug 940 from passing through the aperture of the chest mount 202.
  • The only region of pneumostoma plug 940 that can pass through the aperture of the chest mount is stopple 952. Stopple 952 is sized and configured to penetrate through the aperture into the pneumostoma and to fill the pneumostoma tightly so as to prevent the entry or exit of material through the pneumostoma. Stopple 952 preferably has an atraumatic tip 954 which is soft, and or curved to facilitate insertion of stopple 952 and reduce irritation to the pneumostoma. Note that stopple 952 is relatively short compared to a pneumostoma vent such that stopple 952 preferably does not penetrate beyond the end of channel of pneumostoma. Stopple 952 preferably does not penetrate into cavity so as to preclude contact of stopple 952 with lung parenchymal tissue during vigorous activity. The surface of stopple 952 may also be provided with surface features such as ridges (not shown) to make a better seal of the pneumostoma.
  • FIGS. 9F and 9G illustrate an alternative pneumostoma plug 960 designed to operate in conjunction with a pneumostoma vent 204. Pneumostoma plug 960 comprises a cover 962 designed to engage the top surface 235 of a chest mount 202. Note that pneumostoma plug 960 is designed such that it will not fit through the aperture of chest mount 202 even if pneumostoma vent 204 is absent. Pneumostoma plug 960 is provided with a ring of releasable adhesive 964 to secure it to the top surface 235 of chest mount 202. Pneumostoma plug is provided with a handle 966 or tab 968 to facilitate application or removal of pneumostoma plug 960. Pneumostoma plug 960 is designed to fill the portion of the recess of chest mount 202 not filled by pneumostoma vent 204. Unlike the pneumostoma plug 940 of FIGS. 9E-F, pneumostoma plug 960 does not include a stopple 952. During use of plug 960, the channel of a pneumostoma will contain the tube 240 or pneumostoma vent 204. Pneumostoma plug 960 is non-porous and may be used to temporarily cover and/or seal a pneumostoma vent 204 during brief activities such as e.g. spirometry testing, showering or working in a dirty environment.
  • FIGS. 10A-D illustrate alternative configurations of adhesive on the contact surface 232 of a chest mount 202. Flanges 222 of each chest mount 202 have adhesive material 234 distributed thereon. Adhesive materials may be hydrocolloid adhesives which absorb moisture while retaining good adhesiveness. However, even the best adhesives may cause irritation of the skin during prolonged exposure. Tissue irritation may result from merely from build up of moisture on the skin behind PMD 200 regardless of the presence of any particular adhesive. However, the distribution of adhesive 234 may be controlled so as to help reduce irritation to the skin of the patient. One way to achieve this is by reducing the amount of time any particular portion of skin is in contact with adhesive and/or allowing the skin in regions behind PMD 200 to “breathe” when not in contact with adhesive 234. Thus, in some embodiments the adhesive may be provided in stripes or patches and absent in other stripes or patches. The adhesive areas may also be elevated slightly above the surface of flange 222 such that non adhesive areas of flange 222 do not contact the skin but leave a slight air gap through which air may circulate and/or moisture may escape. The adhesive patches themselves may comprise a breathable laminate and adhesive so that the prolonged attachment of the PMD does not irritate the skin. Furthermore, a chest mount may be provided with one or more tabs which are free of adhesive. These tabs allow a patient to get a purchase on the chest mount to gently peel the chest mount off the skin when it needs replacement. The adhesive patches may be arranged differently on different chest mounts so as to contact different regions of skin surrounding a pneumostoma. Alternatively the arrangement of adhesive patches may be the same on each chest mount but the registration of the patches may be changed by chance or deliberately each time a chest mount is replaced so that the adhesive patches contact different regions of skin surrounding a pneumostoma.
  • Referring now to FIG. 10A where the contact surface 232 of a flange 222 of a chest mount 1020 is shown. Adhesive pads 1034, 1035 are located on contact surface 232 around aperture 224. The adhesive is selected so as to help maintain the correct position of chest mount 1020 without causing undue irritation to the skin of the patient. As shown in FIG. 10A, adhesive pads 1034, 1035 are provided in two discrete spaced-apart regions. Each adhesive pad 1034, 1035 preferably comprises a laminate structure with an inner plastic, paper or foam layer (e.g., closed-cell polyethylene foam) sandwiched between layers of adhesive. The adhesive pads 1034, 1035 are elevated above contact surface 232 by the thickness of the inner layer. Thus, only some portions of skin around a pneumostoma will be in contact with adhesive each time chest mount 202 is changed. Different chest mounts may be provided with different arrangements of adhesive patches. For example a second chest mount may have adhesive patches located in the empty areas 1036, 1037 of contact surface 232 such that it will contact different areas of skin. FIG. 10B shows a sectional view of chest mount 1020 along line B-B. FIG. 10B shows that contact surface 232 is spaced apart from the skin of the patient when chest mount 1020 is applied. Air can circulate between the adhesive pads 1034, 1035. As previously described, the adhesive pads may be protected by a protector sheet that is removed prior to use of PMD 200.
  • Any medically approved water resistant pressure sensitive adhesive may be used to attach the chest mount to the skin of the patient, such as hydrocolloid adhesives, zinc oxide adhesives and hydrogel adhesives. Particularly effective adhesives in providing the desired adhesive properties to secure the chest mount to the skin of the wearer without irritation are formed from cross-linking polymers with a plasticizer to form a 3-dimensional matrix. Some useful adhesives are disclosed in WO 00/07637, WO 00/45866 WO 00/45766 and U.S. Pat. No. 5,543,151 which are incorporated herein by reference. The adhesive can be applied to the contact surface 232 of flange 222 by any means known in the art such as slot coating, spiral, or bead application or printing.
  • Referring now to FIG. 10C where a different distribution of adhesive on contact surface 232 of a chest mount 1040 is shown. As shown in FIG. 10C, adhesive pads may be distributed in small patches 1042. The adhesive patches 1042 may cover a less than 100% of the contact area 232. As shown in FIG. 10C, adhesive patches 1042 cover approximately half of the contact surface 232 of chest mount 1040. Adhesive patches preferably cover from 10% to 50% of contact surface 232. With the distribution pattern of FIG. 10C all chest mounts may have the same distribution of adhesive. Because patches 1042 are small and evenly distributed, variations of the orientation of placement of chest mount 1040 will randomize the location of the patches 1042 relative to the skin of the patient such that a particular region of skin is only in contact with adhesive for a percentage of time similar to the percentage of coverage.
  • FIG. 10D illustrates an alternative method for rotating the portions of skin around a pneumostoma that are in contact with adhesive. As shown in FIG. 10D, chest mount 1050 has eight radial adhesive patches 1052. The patches are arranged in a regular pattern such that the patches are interspersed with non-adhesive areas 1054. As shown in FIG. 10D, adhesive patches 1052 cover approximately half of the contact surface 232 of chest mount 1040. Adhesive patches preferably cover from 10% to 50% of contact surface 232. A tab 236 is aligned with one of the adhesive patches 1052. With the chest mount 1050 of FIG. 10D, the patient deliberately changes the orientation of tab 236 relative to the pneumostoma each time a chest mount is changed. By changing the rotation of the chest mount 1050 the patient can change which portions of skin are in contact with adhesive patches 1052.
  • The functional purpose of the chest mount is: providing an aperture; positioning the aperture in alignment with a pneumostoma; providing a contact surface with which to secure the chest mount to the patient; and providing a coupling to releasably receive a pneumostoma vent and secure the pneumostoma vent through the aperture into the pneumostoma. Thus, different designs of chest mount 1060 may be made without departing from the scope of the invention. FIG. 10E illustrates an alternative design of a chest mount 1060. Chest mount 1060 is formed in one piece and does not comprise separate flange 222 and aperture ring 228 components. As all the components of chest mount 1060 are made from the same material, the desired mechanical properties of portions of chest mount 1060 are achieved by changing design parameters. For example, the desired conformability is achieved in the flange region 1062 of chest mount 1060 by reducing the thickness of the material. Cavity 1064 allows for a reduced thickness of material while maintaining the overall shape of chest mount 1060. The material of chest mount 1060 is also thicker in region 1066 in the vicinity of aperture 224 so as to make the material around aperture stiffer in order to control the dimensions of aperture 224.
  • The foregoing description of preferred embodiments of the present invention has been provided for the purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise forms disclosed. Many embodiments were chosen and described in order to best explain the principles of the invention and its practical application, thereby enabling others skilled in the art to understand the invention for various embodiments and with various modifications that are suited to the particular use contemplated. It is intended that the scope of the invention be defined by the claims and their equivalents.

Claims (24)

  1. 1. A method to control material entering and exiting a pneumostoma on a chest of a patient using a disposable pneumostoma management system having a chest mount and a pneumostoma vent wherein the method comprises:
    (a) securing the chest mount to the chest of the patient using an adhesive such that an aperture of the chest mount is aligned with the pneumostoma;
    (b) inserting the pneumostoma vent through the aperture of the chest mount into the pneumostoma and securing the pneumostoma vent to the chest mount;
    (c) removing the pneumostoma vent from the pneumostoma through the aperture of the chest mount and inserting a second pneumostoma vent through the aperture of the chest mount into the pneumostoma and securing the second pneumostoma vent to the chest mount.
  2. 2. The method of claim 1, further comprising the step of:
    (d) removing the chest mount from the chest of the patient after step (c) and no sooner than two days after securing the chest mount to the chest of the patient.
  3. 3. The method of claim 1, wherein approximately one day passes between step (b) and step (c).
  4. 4. The method of claim 1, wherein step (c) comprises:
    (c1) removing the pneumostoma vent from the pneumostoma through the aperture of the chest mount and inserting a second pneumostoma vent through the aperture of the chest mount into the pneumostoma and securing the second pneumostoma vent to the chest mount; and
    (c2) removing the second pneumostoma vent from the pneumostoma through the aperture of the chest mount and inserting a third pneumostoma vent through the aperture of the chest mount into the pneumostoma and securing the third pneumostoma vent to the chest mount.
  5. 5. The method of claim 4, wherein approximately one day passes between step (b) and step (c1) and between step (c1) and step (c2).
  6. 6. The method of claim 5, further comprising the step of:
    (d) removing the chest mount from the chest of the patient after step (c2) and no sooner than 3 days after securing the chest mount to the chest of the patient.
  7. 7. The method of claim 6, further comprising the step of:
    (e) replacing the chest mount with a second chest mount.
  8. 8. A method to control material entering and exiting a pneumostoma on a chest of a patient comprising:
    (a) selecting a pneumostoma management device wherein the pneumostoma management device comprises a chest mount and a pneumostoma vent,
    the chest mount having a first coupling adjacent an aperture in the chest mount,
    the pneumostoma vent having a tube connected to a flow control device positioned such that material passing through the tube must pass through the flow control device, and
    the pneumostoma vent having a second coupling adapted to releasably engage the first coupling;
    (b) securing the chest mount to the chest of the patient such that aperture is aligned with the pneumostoma;
    (c) inserting the tube of the pneumostoma vent through the aperture into the pneumostoma and engaging the first coupling with the second coupling such that the pneumostoma vent is secured in the pneumostoma and such that material entering or exiting the pneumostoma must pass through the tube and flow control device of the pneumostoma vent.
  9. 9. The method of claim 8, wherein the chest mount comprises an adhesive positioned to secure the chest mount to the chest of the patient and wherein step (b) comprises:
    (b) securing the flange of the pneumostoma management device to the chest of a patient with the adhesive such that aperture is aligned with the pneumostoma.
  10. 10. The method of claim 8, wherein the chest mount comprises a hydrocolloid adhesive positioned to secure the chest mount to the chest of the patient and wherein step (b) comprises:
    (b) securing the chest mount of the pneumostoma management device to the chest of a patient with a hydrocolloid adhesive such that aperture is aligned with the pneumostoma.
  11. 11. The method of claim 8, wherein the chest mount is adapted to conform to the chest of the patient and wherein step (b) comprises:
    (b) securing the chest mount of the pneumostoma management device to the chest of a patient by conforming the chest mount to the chest of the patient such that aperture is aligned with the pneumostoma.
  12. 12. The method of claim 8, further comprising:
    (d) disengaging the second coupling from the first coupling and removing the pneumostoma vent from the pneumostoma while leaving the chest mount secured to the chest of the patient.
  13. 13. The method of claim 8, further comprising:
    (d) disengaging the second coupling from the first coupling and removing the pneumostoma vent from the pneumostoma while leaving the chest mount secured to the chest of the patient; and
    (e) inserting a tube of a second pneumostoma vent through the aperture and engaging the first coupling with a second coupling of the second pneumostoma vent such that the second pneumostoma vent is secured in the pneumostoma and such that material entering or exiting the pneumostoma must pass through a tube and flow control device of the second pneumostoma vent.
  14. 14. The method of claim 12, further comprising the step of:
    (f) removing the chest mount from the chest of the patient after step (e) and no sooner than two days after securing the chest mount to the chest of the patient.
  15. 15. The method of claim 1, wherein approximately one day passes between step (c) and step (d) two or more times.
  16. 16. The method of claim 13, further comprising the step of repeating steps (d) and (e).
  17. 17. The method of claim 16, further comprising the step of:
    (f) removing the chest mount from the chest of the patient after said repeating of steps (d) and (e) and no sooner than three days after securing the chest mount to the chest of the patient.
  18. 18. The method of claim 17, further comprising the step of:
    (g) replacing the chest mount with a second chest mount.
  19. 19. A method to control material entering and exiting a pneumostoma on a chest of a patient comprising:
    (a) selecting a pneumostoma management device wherein the pneumostoma management device comprises a chest mount and a pneumostoma vent;
    the chest mount having a first coupling adjacent an aperture in a flange;
    the pneumostoma vent having a tube connected to a cap;
    the tube connected to a flow control device positioned such that material passing through the tube must pass through the flow control device;
    the cap having a second coupling that can be releasably engaged with the first coupling;
    (b) securing the flange to the chest of the patient such that aperture is aligned with the pneumostoma;
    (c) inserting the tube of the pneumostoma vent through the aperture and engaging the first coupling with the second coupling such that the pneumostoma vent is secured in the pneumostoma and such that material entering or exiting the pneumostoma must pass through the tube and flow control device of the pneumostoma vent.
  20. 20. The method of claim 19, wherein the flange comprises an adhesive positioned to secure the flange to the chest of the patient and wherein step (b) comprises:
    (b) securing the flange of the pneumostoma management device to the chest of a patient with the adhesive such that aperture is aligned with the pneumostoma.
  21. 21. The method of claim 19, wherein the flange comprises a hydrocolloid adhesive positioned to secure the flange to the chest of the patient and wherein step (b) comprises:
    (b) securing the flange of the pneumostoma management device to the chest of a patient with a hydrocolloid adhesive such that aperture is aligned with the pneumostoma.
  22. 22. The method of claim 19, wherein the flange is adapted to conform to the chest of the patient and wherein step (b) comprises:
    (b) securing the flange of the pneumostoma management device to the chest of a patient by conforming the flange to the chest of the patient such that aperture is aligned with the pneumostoma.
  23. 23. The method of claim 19, further comprising:
    (d) disengaging the second coupling from the first coupling and removing the pneumostoma vent from the pneumostoma while leaving the chest mount secured to the chest of the patient.
  24. 24. The method of claim 19, further comprising:
    (d) disengaging the second coupling from the first coupling and removing the pneumostoma vent from the pneumostoma while leaving the chest mount secured to the chest of the patient; and
    (e) inserting a tube of a second pneumostoma vent through the aperture and engaging the first coupling with a second coupling of the second pneumostoma vent such that the second pneumostoma vent is secured in the pneumostoma and such that material entering or exiting the pneumostoma must pass through a tube and flow control device of the second pneumostoma vent.
US12388451 2008-02-19 2009-02-18 Pneumostoma management method for the treatment of chronic obstructive pulmonary disease Abandoned US20090205645A1 (en)

Priority Applications (10)

Application Number Priority Date Filing Date Title
US2983008 true 2008-02-19 2008-02-19
US3287708 true 2008-02-29 2008-02-29
US3837108 true 2008-03-20 2008-03-20
US8289208 true 2008-07-23 2008-07-23
US8357308 true 2008-07-25 2008-07-25
US8455908 true 2008-07-29 2008-07-29
US8811808 true 2008-08-12 2008-08-12
US14329809 true 2009-01-08 2009-01-08
US15158109 true 2009-02-11 2009-02-11
US12388451 US20090205645A1 (en) 2008-02-19 2009-02-18 Pneumostoma management method for the treatment of chronic obstructive pulmonary disease

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US12388451 US20090205645A1 (en) 2008-02-19 2009-02-18 Pneumostoma management method for the treatment of chronic obstructive pulmonary disease

Publications (1)

Publication Number Publication Date
US20090205645A1 true true US20090205645A1 (en) 2009-08-20

Family

ID=40953964

Family Applications (23)

Application Number Title Priority Date Filing Date
US12388447 Expired - Fee Related US8453637B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system for treatment of chronic obstructive pulmonary disease
US12388466 Expired - Fee Related US8453638B2 (en) 2008-02-19 2009-02-18 One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388435 Abandoned US20090209856A1 (en) 2008-02-19 2009-02-18 Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388459 Abandoned US20090205665A1 (en) 2008-02-19 2009-02-18 Methods and devices for follow-up care and treatment of a pneumostoma
US12388465 Expired - Fee Related US7909803B2 (en) 2008-02-19 2009-02-18 Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US12388451 Abandoned US20090205645A1 (en) 2008-02-19 2009-02-18 Pneumostoma management method for the treatment of chronic obstructive pulmonary disease
US12388441 Expired - Fee Related US8491602B2 (en) 2008-02-19 2009-02-18 Single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388446 Abandoned US20090209909A1 (en) 2008-02-19 2009-02-18 Percutaneous single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388469 Expired - Fee Related US8474449B2 (en) 2008-02-19 2009-02-18 Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US12388461 Expired - Fee Related US8348906B2 (en) 2008-02-19 2009-02-18 Aspirator for pneumostoma management
US12388470 Expired - Fee Related US8021320B2 (en) 2008-02-19 2009-02-18 Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US12388455 Abandoned US20090205658A1 (en) 2008-02-19 2009-02-18 Devices and methods for delivery of a therapeutic agent through a pneumostoma
US12388453 Expired - Fee Related US8252003B2 (en) 2008-02-19 2009-02-18 Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US12388458 Expired - Fee Related US8430094B2 (en) 2008-02-19 2009-02-18 Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388468 Expired - Fee Related US8365722B2 (en) 2008-02-19 2009-02-18 Multi-layer pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388462 Expired - Fee Related US7927324B2 (en) 2008-02-19 2009-02-18 Aspirator and method for pneumostoma management
US12388438 Abandoned US20090205643A1 (en) 2008-02-19 2009-02-18 Accelerated two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388460 Expired - Fee Related US8464708B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system having a cosmetic and/or protective cover
US12388467 Expired - Fee Related US8347880B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system with secretion management features for treatment of chronic obstructive pulmonary disease
US13012962 Expired - Fee Related US8231581B2 (en) 2008-02-19 2011-01-25 Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US13213279 Expired - Fee Related US8273051B2 (en) 2008-02-19 2011-08-19 Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US13543588 Expired - Fee Related US8506577B2 (en) 2008-02-19 2012-07-06 Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US13851545 Abandoned US20130218134A1 (en) 2008-02-19 2013-03-27 Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US12388447 Expired - Fee Related US8453637B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system for treatment of chronic obstructive pulmonary disease
US12388466 Expired - Fee Related US8453638B2 (en) 2008-02-19 2009-02-18 One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388435 Abandoned US20090209856A1 (en) 2008-02-19 2009-02-18 Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388459 Abandoned US20090205665A1 (en) 2008-02-19 2009-02-18 Methods and devices for follow-up care and treatment of a pneumostoma
US12388465 Expired - Fee Related US7909803B2 (en) 2008-02-19 2009-02-18 Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease

Family Applications After (17)

Application Number Title Priority Date Filing Date
US12388441 Expired - Fee Related US8491602B2 (en) 2008-02-19 2009-02-18 Single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388446 Abandoned US20090209909A1 (en) 2008-02-19 2009-02-18 Percutaneous single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388469 Expired - Fee Related US8474449B2 (en) 2008-02-19 2009-02-18 Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US12388461 Expired - Fee Related US8348906B2 (en) 2008-02-19 2009-02-18 Aspirator for pneumostoma management
US12388470 Expired - Fee Related US8021320B2 (en) 2008-02-19 2009-02-18 Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US12388455 Abandoned US20090205658A1 (en) 2008-02-19 2009-02-18 Devices and methods for delivery of a therapeutic agent through a pneumostoma
US12388453 Expired - Fee Related US8252003B2 (en) 2008-02-19 2009-02-18 Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US12388458 Expired - Fee Related US8430094B2 (en) 2008-02-19 2009-02-18 Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388468 Expired - Fee Related US8365722B2 (en) 2008-02-19 2009-02-18 Multi-layer pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US12388462 Expired - Fee Related US7927324B2 (en) 2008-02-19 2009-02-18 Aspirator and method for pneumostoma management
US12388438 Abandoned US20090205643A1 (en) 2008-02-19 2009-02-18 Accelerated two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US12388460 Expired - Fee Related US8464708B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system having a cosmetic and/or protective cover
US12388467 Expired - Fee Related US8347880B2 (en) 2008-02-19 2009-02-18 Pneumostoma management system with secretion management features for treatment of chronic obstructive pulmonary disease
US13012962 Expired - Fee Related US8231581B2 (en) 2008-02-19 2011-01-25 Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US13213279 Expired - Fee Related US8273051B2 (en) 2008-02-19 2011-08-19 Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US13543588 Expired - Fee Related US8506577B2 (en) 2008-02-19 2012-07-06 Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US13851545 Abandoned US20130218134A1 (en) 2008-02-19 2013-03-27 Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease

Country Status (6)

Country Link
US (23) US8453637B2 (en)
EP (3) EP2242527A4 (en)
JP (2) JP2011512232A (en)
CN (1) CN102006904A (en)
CA (1) CA2752159A1 (en)
WO (4) WO2009105432A3 (en)

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7909803B2 (en) 2008-02-19 2011-03-22 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8323230B2 (en) 2003-07-15 2012-12-04 Portaero, Inc. Methods and devices to accelerate wound healing in thoracic anastomosis applications
US8336540B2 (en) 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8347881B2 (en) 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method
US8475389B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US8518053B2 (en) 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
CN104874084A (en) * 2014-02-28 2015-09-02 北京谊安医疗系统股份有限公司 Exhalation valve and respirator provided with same
US20150272718A1 (en) * 2014-03-31 2015-10-01 Boston Scientific Scimed, Inc. Devices for forming collateral channels and related methods of use
US10058332B2 (en) 2012-08-01 2018-08-28 Terumo Kabushiki Kaisha Method for treatment of chronic obstructive pulmonary disease

Families Citing this family (70)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6572588B1 (en) 2000-03-10 2003-06-03 Venetec International, Inc. Medical anchoring system
US7980001B2 (en) * 2004-02-27 2011-07-19 The Procter & Gamble Company Fabric conditioning dispenser and methods of use
WO2006050388A3 (en) * 2004-11-02 2007-05-24 Raanan Arens Respiratory volume/flow gating, monitoring, and spirometry system for mri
US9138560B2 (en) 2006-01-12 2015-09-22 Venetec International, Inc. Universal catheter securement device
US8074645B2 (en) 2006-04-10 2011-12-13 Somnetics Global Pte. Ltd. Apparatus and methods for providing humidity in respiratory therapy
JP5413816B2 (en) * 2008-06-18 2014-02-12 株式会社ニコン Inspection method and apparatus of the template, nanoimprint apparatus, nanoimprint system, and device manufacturing method
WO2010002393A1 (en) 2008-06-30 2010-01-07 Venetec International, Inc. Anchoring system for a medical article
US8882678B2 (en) 2009-03-13 2014-11-11 Atrium Medical Corporation Pleural drainage system and method of use
US8992493B2 (en) 2009-03-13 2015-03-31 Atrium Medical Corporation Chest drainage systems and methods
WO2010107597A1 (en) * 2009-03-19 2010-09-23 Illinois Tool Works Inc. One-way check valve
WO2011033333A1 (en) * 2009-09-18 2011-03-24 B-K Medical Aps Ultrasound probe
US9271640B2 (en) 2009-11-10 2016-03-01 Illumigyn Ltd. Optical speculum
US8638995B2 (en) * 2009-11-10 2014-01-28 Illumigyn Ltd. Optical speculum
US9877644B2 (en) 2009-11-10 2018-01-30 Illumigyn Ltd. Optical speculum
US20120271240A1 (en) * 2009-11-11 2012-10-25 Venetec International, Inc. Stabilizing device for an extension set
WO2011060201A1 (en) * 2009-11-11 2011-05-19 Innovative Pulmonary Solutions, Inc. Methods and systems for screening subjects
CN102712112B (en) * 2010-01-20 2015-11-25 凯希特许有限公司 Having a higher density foam wound and inserted into a higher region thereof, a wound dressing and a method
US9161778B2 (en) 2010-06-11 2015-10-20 Entourage Medical Technologies, Inc. System and method for transapical access and closure
US9044267B2 (en) 2010-06-11 2015-06-02 Entourage Medical Technologies, Inc. System and method for transapical access and closure
US9421032B2 (en) * 2010-06-16 2016-08-23 Covidien Lp Seal port with blood collector
WO2012029064A1 (en) 2010-09-02 2012-03-08 Sipnose Ltd A nasal delivary device
US20120089159A1 (en) 2010-09-20 2012-04-12 Shluzas Alan E System for tensioning a surgical closure
US8777900B2 (en) * 2010-12-14 2014-07-15 Kimberly-Clark Worldwide, Inc. Ambulatory enteral feeding system
US20120167879A1 (en) * 2011-01-03 2012-07-05 Bowman Bruce R Positive airway pressure therapy apparatus and methods
US20130178808A1 (en) * 2011-07-01 2013-07-11 Avita Corporation Body Fluid Sucking Device
US8486045B2 (en) * 2011-08-25 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical access device with adjustable cannula
US8439881B2 (en) * 2011-08-25 2013-05-14 Ethicon Endo-Surgery, Inc. Surgical access device with adjustable cannula
US8496633B2 (en) * 2011-08-25 2013-07-30 Ethicon Endo-Surgery, Inc. Surgical access device with adjustable cannula
US8496632B2 (en) * 2011-08-25 2013-07-30 Ethicon Endo-Surgery, Inc. Surgical access device with adjustable cannula
US8491545B2 (en) * 2011-08-25 2013-07-23 Ethicon Endo-Surgery, Inc. Surgical access device with adjustable cannula
US9561134B2 (en) * 2011-09-14 2017-02-07 Matthew T. Scholz Positive pressure medical dressings with valve and kits containing same
EP2583642A1 (en) * 2011-10-21 2013-04-24 Universitätsspital Basel Implantable stoma ring
WO2013111057A1 (en) * 2012-01-24 2013-08-01 Kimberly-Clark Worldwide, Inc. Drainage catheter system with cuff
EP2809385A4 (en) * 2012-02-01 2015-10-28 Hospi Corp Valved enteral administration assembly
US9078990B1 (en) * 2012-02-03 2015-07-14 Andrew Thomas Obst Devices and methods for treatment of fistulas and complex wounds
EP2814390A4 (en) * 2012-02-16 2015-10-14 Univ Nebraska System and method for monitoring pleural fluid
US9832980B2 (en) 2012-02-22 2017-12-05 Carter J. Kovarik Selectively bendable remote gripping tool
US9901245B2 (en) 2012-02-22 2018-02-27 Carter J. Kovarik Selectively bendable remote gripping tool
US9592066B2 (en) 2012-02-22 2017-03-14 Carter J. Kovarik Selectively bendable remote gripping tool
US9233015B2 (en) 2012-06-15 2016-01-12 Trivascular, Inc. Endovascular delivery system with an improved radiopaque marker scheme
WO2014011893A1 (en) * 2012-07-11 2014-01-16 Mercy Medical Research Institute Colorectal delivery device
JP2014028023A (en) * 2012-07-31 2014-02-13 Terumo Corp tube
EP2695581A1 (en) 2012-08-07 2014-02-12 Critical Innovations, LLC Device for simultaneously documenting and treating tension pneumothorax and/or hemothorax
WO2014031860A1 (en) * 2012-08-22 2014-02-27 Clemson University Research Foundation Percutaneous tube stabilization device
WO2014089223A1 (en) 2012-12-04 2014-06-12 Ino Therapeutics Llc Cannula for minimizing dilution of dosing during nitric oxide delivery
US9795756B2 (en) 2012-12-04 2017-10-24 Mallinckrodt Hospital Products IP Limited Cannula for minimizing dilution of dosing during nitric oxide delivery
US10039898B2 (en) * 2013-01-08 2018-08-07 Biosense Webster (Israel) Ltd. Catheter sheath introducer with directional retention damper
DE102013203116A1 (en) * 2013-02-26 2014-08-28 Robert Bosch Gmbh Abrasive device
WO2014145124A3 (en) 2013-03-15 2014-12-31 Ahluwalia Prabhat Content inflation and delivery system
US8920381B2 (en) * 2013-04-12 2014-12-30 Medtronic Minimed, Inc. Infusion set with improved bore configuration
CN103263703A (en) * 2013-05-03 2013-08-28 江苏亚华生物科技工程有限公司 Tension pneumothorax puncture component
US9144635B1 (en) 2013-07-01 2015-09-29 Ibiz Innovations, Llc Easily disinfected bulb-syringe
USD780547S1 (en) 2013-08-08 2017-03-07 Carter J. Kovarik Pick up device with flexible shaft portion
JP2016537162A (en) 2013-10-29 2016-12-01 アントラージュ メディカル テクノロジーズ,インコーポレイテッドEntourage Medical Technologies,Inc. System for providing surgical access
US9566443B2 (en) 2013-11-26 2017-02-14 Corquest Medical, Inc. System for treating heart valve malfunction including mitral regurgitation
US10046147B2 (en) 2013-12-26 2018-08-14 Critical Innovations, LLC Percutaneous access pathway system and method
EP3124968B8 (en) * 2014-03-26 2018-07-04 PHC Holdings Corporation Exhalation measuring device and method for controlling exhalation measuring device
US20150273156A1 (en) * 2014-03-26 2015-10-01 Boston Scientific Scimed, Inc. Devices for systemic drug delivery and related methods of use
CN106413601A (en) * 2014-04-30 2017-02-15 索菲亚医疗器械公司 Methods and devices for treating a hyper-inflated lung
US20150343139A1 (en) * 2014-05-30 2015-12-03 Boston Scientific Scimed, Inc. Implantable pumps and related methods of use
US20150351776A1 (en) * 2014-06-10 2015-12-10 Ethicon Endo-Surgery, Inc. Bronchus Sealants and Methods of Sealing Bronchial Tubes
US20160022878A1 (en) * 2014-07-22 2016-01-28 National Taiwan University Method of treating pleural abnormality
EP3188790A4 (en) 2014-09-04 2018-04-11 Atacor Medical, Inc. Cardiac pacing
US9636505B2 (en) 2014-11-24 2017-05-02 AtaCor Medical, Inc. Cardiac pacing sensing and control
US9788816B2 (en) * 2014-09-30 2017-10-17 Mackay Memorial Hospital Fluid withdrawing, expelling and filtering apparatus
JP2018500986A (en) * 2014-12-11 2018-01-18 ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. Medical device and method of use
US9717293B2 (en) 2015-06-11 2017-08-01 Michelle P. LIM Magnetic fastener for a garment
WO2017075595A1 (en) * 2015-10-30 2017-05-04 Soffio Medical Inc. Devices for access to hyper-inflated lung
EP3219343A1 (en) * 2016-03-18 2017-09-20 Nougimmo SPRL Assembly for handling a container
US20180085503A1 (en) * 2016-04-11 2018-03-29 Ulus Landon HUNT Device for drawing and expelling a liquid or powder

Citations (92)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US953922A (en) * 1907-06-17 1910-04-05 John B Rogers Tracheal cannula or tube.
US2867213A (en) * 1957-06-12 1959-01-06 Jr Paul A Thomas Flutter valve for drainage of the pleural cavity
US2873742A (en) * 1954-07-14 1959-02-17 Research Corp Surgical instruments
US3556103A (en) * 1968-03-15 1971-01-19 Edward J Calhoun Tracheotomy instrument
US3638649A (en) * 1969-07-07 1972-02-01 Univ Minnesota Implantable prosthetic pass-through device
US3788326A (en) * 1970-07-29 1974-01-29 H Jacobs Distally perforated catheter for use in ventilating system
US4439189A (en) * 1981-06-18 1984-03-27 Bentley Laboratories, Inc. Pleural drainage system
US4502482A (en) * 1983-05-23 1985-03-05 Deluccia Victor C Endotracheal tube complex
US4527559A (en) * 1982-10-18 1985-07-09 Roxburg Dwight W Endotracheal tube anchoring mechanism
US4583977A (en) * 1984-08-15 1986-04-22 Vsesojuzny Nauchno-Issledovatelsky Institut Meditsiuskikh Polimerov Device for lengthy fixation of a tube introduced into the patient's body
US4799494A (en) * 1986-10-22 1989-01-24 Wang Ko P Percutaneous aspiration lung biopsy needle assembly
US4813929A (en) * 1987-02-19 1989-03-21 Neal Semrad Chest tube device and method of inserting device
US5004456A (en) * 1989-03-10 1991-04-02 Arrow International Investment Corporation In-dwelling catheter
US5078689A (en) * 1990-05-14 1992-01-07 Keller Alan M Device for removing body fluids
US5207652A (en) * 1991-10-23 1993-05-04 Bioderm Medical apparatus fixation and infection control device
US5389077A (en) * 1993-03-03 1995-02-14 Uresil Corporation Minimally invasive body cavity penetrating instruments
US5401262A (en) * 1990-07-20 1995-03-28 Atrium Medical Corporation Fluid recovery system
US5403264A (en) * 1992-09-04 1995-04-04 Ethicon, Inc. Endoscopic closure inspection device
US5484401A (en) * 1992-11-04 1996-01-16 Denver Biomaterials, Inc. Treatment method for pleural effusion
US5487382A (en) * 1991-10-30 1996-01-30 Robert Bezicot Tracheotomy filter for tracheotomy patients
US5496297A (en) * 1993-02-22 1996-03-05 Coloplast A/S Ostomy coupling
US5501677A (en) * 1993-06-25 1996-03-26 Jensen; Ole R. Two-piece ostomy appliance and low-profile coupling ring assembly
US5501678A (en) * 1991-08-30 1996-03-26 Coloplast A/S Adapter for use in connection with ostomy equipment
US5616131A (en) * 1992-09-23 1997-04-01 Lasersurge, Inc. Apparatus and method for anchoring surgical instrumentation
US5728066A (en) * 1995-12-13 1998-03-17 Daneshvar; Yousef Injection systems and methods
US5730735A (en) * 1996-03-12 1998-03-24 Hollister Incorporated Convex ostomy faceplate with floating flange and finger recess
US5738661A (en) * 1995-06-16 1998-04-14 Larice; Gennaro Medical device for holding a feeding tube and use thereof
US6174323B1 (en) * 1998-06-05 2001-01-16 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US6197010B1 (en) * 1998-06-11 2001-03-06 Hollister Incorporated Ostomy appliance faceplate with concealed coupling ring flange
US6200333B1 (en) * 1997-04-07 2001-03-13 Broncus Technologies, Inc. Bronchial stenter
US6334441B1 (en) * 1998-11-23 2002-01-01 Mallinckrodt Medical, Inc. Phonation valve for breathing tube
US6358269B1 (en) * 1998-11-02 2002-03-19 Ralph Aye Method of treating peripheral bronchopleural fistulas
US20030013935A1 (en) * 2001-07-10 2003-01-16 Spiration, Inc. Constriction device viewable under X ray fluoroscopy
US20030018344A1 (en) * 2001-07-19 2003-01-23 Olympus Optical Co., Ltd. Medical device and method of embolizing bronchus or bronchiole
US6514290B1 (en) * 2000-03-31 2003-02-04 Broncus Technologies, Inc. Lung elastic recoil restoring or tissue compressing device and method
US6517519B1 (en) * 1999-08-13 2003-02-11 The Johns Hopkins University Device and method for rapid chest tube insertion
US6520183B2 (en) * 2001-06-11 2003-02-18 Memorial Sloan-Kettering Cancer Center Double endobronchial catheter for one lung isolation anesthesia and surgery
US6527761B1 (en) * 2000-10-27 2003-03-04 Pulmonx, Inc. Methods and devices for obstructing and aspirating lung tissue segments
US20030050648A1 (en) * 2001-09-11 2003-03-13 Spiration, Inc. Removable lung reduction devices, systems, and methods
US20030051733A1 (en) * 2001-09-10 2003-03-20 Pulmonx Method and apparatus for endobronchial diagnosis
US20030055331A1 (en) * 2001-09-11 2003-03-20 Pulmonx Methods of endobronchial diagnosis using imaging
US20030225377A1 (en) * 2002-06-04 2003-12-04 Betty Hancock Waterproof venipuncture site cover
US20040010209A1 (en) * 2002-07-15 2004-01-15 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US20040010289A1 (en) * 2000-10-17 2004-01-15 Broncus Technologies, Inc. Control system and process for application of energy to airway walls and other mediums
US6679264B1 (en) * 2000-03-04 2004-01-20 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6682506B1 (en) * 1998-12-22 2004-01-27 Francis Navarro Device for maintaining at least a tube
US20040024356A1 (en) * 2002-07-31 2004-02-05 Don Tanaka Long term oxygen therapy system
US6692494B1 (en) * 1999-08-05 2004-02-17 Broncus Technologies, Inc. Methods and devices for creating collateral channels in the lungs
US20040031494A1 (en) * 1998-06-10 2004-02-19 Broncus Technologies, Inc. Methods of treating asthma
US6695791B2 (en) * 2002-01-04 2004-02-24 Spiration, Inc. System and method for capturing body tissue samples
US20040040555A1 (en) * 2002-08-28 2004-03-04 Don Tanaka Collateral ventilation bypass trap system
US20040047855A1 (en) * 2002-06-17 2004-03-11 Bistech, Inc., A Delaware Corporation Compositions and methods for reducing lung volume
US6709401B2 (en) * 1999-07-02 2004-03-23 Pulmonx Methods, systems, and kits for lung volume reduction
US20040059263A1 (en) * 2002-09-24 2004-03-25 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US20040055606A1 (en) * 2001-03-02 2004-03-25 Emphasys Medical, Inc. Bronchial flow control devices with membrane seal
US6712812B2 (en) * 1999-08-05 2004-03-30 Broncus Technologies, Inc. Devices for creating collateral channels
US6837906B2 (en) * 2001-08-03 2005-01-04 Ensure Medical, Inc. Lung assist apparatus and methods for use
US20050005936A1 (en) * 2003-06-18 2005-01-13 Wondka Anthony David Methods, systems and devices for improving ventilation in a lung area
US6843767B2 (en) * 2001-10-18 2005-01-18 Spiration, Inc. Constriction device including tear resistant structures
US6846292B2 (en) * 2002-02-19 2005-01-25 Mohamed Bakry Pleural biopsy and brushing needle
US6849061B2 (en) * 2002-10-21 2005-02-01 Robert B. Wagner Method and apparatus for pleural drainage
US20050025816A1 (en) * 2003-07-15 2005-02-03 Don Tanaka Methods and devices to accelerate wound healing in thoracic anastomosis applications
US20050022809A1 (en) * 2003-04-25 2005-02-03 Wondka Anthony David Methods, systems and devices for desufflating a lung area
US6852108B2 (en) * 2002-05-14 2005-02-08 Spiration, Inc. Apparatus and method for resecting and removing selected body tissue from a site inside a patient
US20050033344A1 (en) * 2002-05-17 2005-02-10 Dillard David H. One-way valve devices for anchored implantation in a lung
US20050043745A1 (en) * 2000-03-23 2005-02-24 Alferness Clifton A. Tissue resection device, system, and method
US20050043752A1 (en) * 2001-09-04 2005-02-24 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US20050043751A1 (en) * 2001-09-04 2005-02-24 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US20050060044A1 (en) * 1999-08-05 2005-03-17 Ed Roschak Methods and devices for maintaining patency of surgically created channels in a body organ
US20050060041A1 (en) * 2001-09-04 2005-03-17 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US20050056292A1 (en) * 1999-08-05 2005-03-17 Cooper Joel D. Devices for maintaining patency of surgically created channels in tissue
US20050060042A1 (en) * 2001-09-04 2005-03-17 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US20050061322A1 (en) * 2003-01-20 2005-03-24 Pulmonx Method and arrangement for reducing the volume of a lung
US20050066976A1 (en) * 2003-08-18 2005-03-31 Wondka Anthony D. Method and device for non-invasive ventilation with nasal interface
US20060004400A1 (en) * 2004-06-16 2006-01-05 Mcgurk Erin Method of treating a lung
US20060025815A1 (en) * 2004-07-08 2006-02-02 Mcgurk Erin Lung device with sealing features
US6997189B2 (en) * 1998-06-05 2006-02-14 Broncus Technologies, Inc. Method for lung volume reduction
US20060047291A1 (en) * 2004-08-20 2006-03-02 Uptake Medical Corporation Non-foreign occlusion of an airway and lung collapse
US7011094B2 (en) * 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US7014628B2 (en) * 1995-07-07 2006-03-21 Bousquet Gerald G Transcutaneous access device
US20060124126A1 (en) * 2004-12-10 2006-06-15 Don Tanaka Collateral ventilation device with chest tube/evacuation features
US20070005083A1 (en) * 1997-04-30 2007-01-04 Sabaratham Sabanathan Occlusion device
US20070027434A1 (en) * 2003-06-02 2007-02-01 Ole Pedersen Adhesive face plate for an ostomy appliance, an ostomy appliance and a method for cleaning a face plate
US7172581B2 (en) * 2001-09-24 2007-02-06 Coloplast A/S Ostomy appliance with a removable, washable and reusable sealing member
US7175644B2 (en) * 2001-02-14 2007-02-13 Broncus Technologies, Inc. Devices and methods for maintaining collateral channels in tissue
US20070043350A1 (en) * 2005-08-17 2007-02-22 Pulmonx Selective lung tissue ablation
US7182772B2 (en) * 2001-07-10 2007-02-27 Spiration, Inc. Constriction device including fixation structure
US20070055175A1 (en) * 2005-05-25 2007-03-08 Pulmosonix Pty Ltd Devices and methods for tissue analysis
US20070051372A1 (en) * 2005-08-23 2007-03-08 Don Tanaka Collateral ventilation bypass system with retention features
US7192420B2 (en) * 2003-08-08 2007-03-20 Whiteford Bruce W Ostomy adapter with multiple adhesives for reliable sealing
US7195017B2 (en) * 2003-07-03 2007-03-27 Cordis Corporation Collateral ventilation bypass trap system
US7195016B2 (en) * 2004-01-07 2007-03-27 E. Benson Hood Laboratories Transtracheal oxygen stent

Family Cites Families (284)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US733152A (en) 1902-08-30 1903-07-07 Murdoch Chisholm Empyema drainage device.
US753922A (en) * 1903-05-23 1904-03-08 John Scheidler Fence-post.
US1596754A (en) * 1923-10-30 1926-08-17 Judson D Moschelle Reenforced tubing
US2206687A (en) 1937-11-29 1940-07-02 Martha F Mckesson Pleural diagnosis and treatment
US2599521A (en) * 1949-06-02 1952-06-03 Robert A Berman Respiratory device
US2991787A (en) 1957-04-11 1961-07-11 Sierra Eng Co Tracheotomy instrument
GB862795A (en) 1958-06-12 1961-03-15 Bodin Girin & Cie Tissus Ind Tubular members provided with corrugated walls and method for producing same
NL279576A (en) * 1961-06-13
FR1322998A (en) * 1962-02-23 1963-04-05 Improvements to devices for producing aerosols
NL108491C (en) 1962-11-12
US3253594A (en) 1963-07-30 1966-05-31 Frank E Matthews Peritoneal cannula
US3463159A (en) 1965-02-16 1969-08-26 Henry J Heimlich Instrument for drainage of the chest
US3294355A (en) 1965-02-23 1966-12-27 Louis Rolnick Wall hangers
US3707146A (en) 1967-03-07 1972-12-26 Prod Res & Chem Corp Means to inject a plastic into a cavity to produce a replica thereof
US3511243A (en) 1967-07-18 1970-05-12 Frederic J Toy Apparatus for providing a breathing conduit communicating with the trachea at the base of the neck
US3688773A (en) 1970-04-16 1972-09-05 Sol Weiss Device for performing a tracheostomy and other surgical procedures
US3682166A (en) 1970-07-29 1972-08-08 Harvey Barry Jacobs Emergency percutaneous trans-tracheal high flow oxygen catheter-type resuscitator for restoration of breathing in non-breathing patients
US3777757A (en) * 1971-01-08 1973-12-11 R Gray Sucking wound plug and chest aspirator
US3766920A (en) 1971-07-21 1973-10-23 Ezem Co Enemata administering device
US3817250A (en) 1972-10-24 1974-06-18 Int Medical Devices Inc Instrument for performing a tracheostomy and other surgical procedures
US3916903A (en) 1973-07-20 1975-11-04 Reta M H Pozzi Cricothyroid puncture apparatus
US3924637A (en) * 1974-12-23 1975-12-09 Arthur H Swanson Tracheotomy tube
US4312992A (en) * 1976-12-03 1982-01-26 International Business Machines Corporation Substituted heterofulvalenes
US4153058A (en) 1977-07-05 1979-05-08 Nehme Alexander E Pleural decompression catheter
US4188946A (en) * 1977-10-07 1980-02-19 Rayburn Robert L Controllable partial rebreathing anesthesia circuit and respiratory assist device
DE2750447C2 (en) * 1977-11-11 1986-04-17 Max-Planck-Gesellschaft Zur Foerderung Der Wissenschaften E.V., 3400 Goettingen, De
US4291694A (en) 1979-10-29 1981-09-29 Chai S Apparatus and method for performing a thoracic operation
US4395260A (en) * 1981-06-01 1983-07-26 Sorenson Research Co., Inc. Drip chamber
US4465062A (en) 1982-05-14 1984-08-14 Gina Versaggi Noninvasive seal for a sucking chest wound
US4872869A (en) 1982-06-09 1989-10-10 Smith & Nephew (Latin America), Inc. Low profile ostomy device
DE3371864D1 (en) * 1982-10-02 1987-07-09 Smith & Nephew Ass Surgical dressing
FR2538705B1 (en) * 1982-12-29 1987-12-31 Vincent Michel An apparatus for medical exsufflation of pneumothorax
US4513739A (en) * 1983-02-15 1985-04-30 Howmedica, Inc. Wound dressing
JPH0340266Y2 (en) 1984-07-28 1991-08-23
DK151044C (en) 1984-12-07 1988-05-16 Coloplast As An ostomy equipment consisting of a dressing, an ostomy bag and a ring coupling, and the coupling plate and the bag coupling for use therein
US4664660A (en) 1985-04-01 1987-05-12 Becton, Dickinson And Company Chest drainage apparatus with ambient air sealing
US4717385A (en) * 1985-04-12 1988-01-05 The Beth Israel Hospital Association Surgical tube anchoring device and method for using same
DK158827C (en) 1986-09-04 1991-01-14 Coloplast As Re-usable coupling means for securing the ostomy bag and the disposable bag and ostomy bag system for use in connection with the
JPH0412143B2 (en) 1986-09-16 1992-03-03 Edowaado Emu Goorudobaagu
US4889534A (en) 1986-12-04 1989-12-26 Hollister Incorporated Ostomy appliance with three-lement coupling ring assembly
GB8629424D0 (en) 1986-12-09 1987-01-21 Craig Med Prod Ltd Ostomy bag coupling
US4944724A (en) * 1987-06-05 1990-07-31 Uresil Corporation Apparatus for locating body cavities having signaling indicator
US5356386A (en) 1987-06-05 1994-10-18 Uresil Corporation Apparatus for locating body cavities
US5199424A (en) 1987-06-26 1993-04-06 Sullivan Colin E Device for monitoring breathing during sleep and control of CPAP treatment that is patient controlled
US4869717A (en) 1988-04-25 1989-09-26 Adair Edwin Lloyd Gas insufflation needle with instrument port
US4959054A (en) 1988-11-23 1990-09-25 Clemson University Pharmaceutically protected percutaneous devices
US5006401A (en) * 1988-11-23 1991-04-09 E. R. Squibb & Sons, Inc. Composite compression and support dressing
US4976688A (en) 1989-02-03 1990-12-11 Rosenblum Jeffrey L Position-adjustable thoracic catheter
US4905694A (en) 1989-04-04 1990-03-06 Ethicon, Inc. Intracorporeal temporary wound closure
US5141516A (en) 1989-07-26 1992-08-25 Detweiler Mark B Dissolvable anastomosis stent and method for using the same
US5217441A (en) 1989-08-15 1993-06-08 United States Surgical Corporation Trocar guide tube positioning device
US5336206A (en) 1989-08-15 1994-08-09 United States Surgical Corporation Trocar penetration depth indicator and guide tube positioning device
CA2028618C (en) 1989-11-17 2001-12-11 Peter Leslie Steer Ostomy coupling
US5281204A (en) * 1989-12-26 1994-01-25 Nissho Corporation Device for forming an inserting hole and method of using and making the same
US5060645A (en) 1990-08-14 1991-10-29 Russell David N Tracheostomy tube assembly
US5178138A (en) * 1990-09-11 1993-01-12 Walstrom Dennis R Drug delivery device
US5073169A (en) 1990-10-02 1991-12-17 Steve Raiken Trocar support
US5218957A (en) 1990-10-19 1993-06-15 Ballard Medical Products Multi-layered transtracheal catheter
US5230332A (en) 1990-10-22 1993-07-27 Ballard Medical Products Methods and apparatus for a micro-tracheal catheter hub assembly
US5137509A (en) 1991-04-17 1992-08-11 Dexide, Inc. Surgical insufflation instrument
US5139485A (en) 1991-05-03 1992-08-18 Ethicon, Inc. Verress needle with enhanced acoustical means
US5230350A (en) 1991-05-29 1993-07-27 Tabex Industries, Inc. Moisture barrier for indwelling catheters and the like
US6461296B1 (en) * 1998-06-26 2002-10-08 2000 Injectx, Inc. Method and apparatus for delivery of genes, enzymes and biological agents to tissue cells
US5376376A (en) 1992-01-13 1994-12-27 Li; Shu-Tung Resorbable vascular wound dressings
JPH07275252A (en) * 1992-06-30 1995-10-24 Ethicon Inc Flexible endoscopic surgical port
GB9214716D0 (en) * 1992-07-10 1992-08-19 Emmark Technology Tracheostomy filter
US5263939A (en) 1992-10-09 1993-11-23 Surgin Surgical Instrumentation, Inc. Retainer for laparoscopic cannula
US5357946A (en) * 1992-10-19 1994-10-25 Sherwood Medical Company Ventilator manifold with accessory access port and adaptors therefore
US5344410A (en) 1992-11-17 1994-09-06 Kolkin Yakov G Device for draining the pleural cavity
US5407433A (en) 1993-02-10 1995-04-18 Origin Medsystems, Inc. Gas-tight seal accommodating surgical instruments with a wide range of diameters
US5315992A (en) 1993-03-10 1994-05-31 Dalton William J Triple cuff endobronchial tube with selective multiple outlets served by a single airflow passage
US5312331A (en) 1993-04-15 1994-05-17 Knoepfler Dennis J Method and apparatus for talc pleurodesis
US5318523A (en) * 1993-07-13 1994-06-07 Lu Jieh Shan Drug-feeder for children
US5366478A (en) 1993-07-27 1994-11-22 Ethicon, Inc. Endoscopic surgical sealing device
WO1995018642A1 (en) 1994-01-07 1995-07-13 Omar Omirana Adhesive surgical retaining device
US5354283A (en) 1994-01-07 1994-10-11 Little Rapids Corporation Trocar retention apparatus
US5478333A (en) 1994-03-04 1995-12-26 Asherman, Jr.; Richard E. Medical dressing for treating open chest injuries
US5431633A (en) 1994-05-06 1995-07-11 Global Fury, Inc. Noninvasive device for preventing pressure build-up in pleural space and reducing possibility of development of a tension pneumothorax from an open pneumothorax
US5685859A (en) * 1994-06-02 1997-11-11 Nikomed Aps Device for fixating a drainage tube and a drainage tube assembly
US6056744A (en) * 1994-06-24 2000-05-02 Conway Stuart Medical, Inc. Sphincter treatment apparatus
JP3394327B2 (en) * 1994-07-11 2003-04-07 テルモ株式会社 Inner surface processing method of the tube
US5947914A (en) * 1995-02-21 1999-09-07 Augustine Medical, Inc. Wound covering
US5695504A (en) 1995-02-24 1997-12-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
GB9507666D0 (en) 1995-04-13 1995-05-31 Squibb & Sons Inc Ostomy coupling
US5634937A (en) 1995-05-19 1997-06-03 General Surgical Innovations, Inc. Skin seal with inflatable membrane
US5588424A (en) 1995-06-28 1996-12-31 The Cleveland Clinic Foundation Bronchial blocker endotracheal apparatus
JPH0928666A (en) * 1995-07-21 1997-02-04 Olympus Optical Co Ltd Trocar
US5660175A (en) 1995-08-21 1997-08-26 Dayal; Bimal Endotracheal device
JP3229809B2 (en) * 1995-08-31 2001-11-19 三洋電機株式会社 Semiconductor device
JP3024069U (en) * 1995-09-13 1996-05-17 富士システムズ株式会社 Thoracoscope insertion aid
US5836311A (en) 1995-09-20 1998-11-17 Medtronic, Inc. Method and apparatus for temporarily immobilizing a local area of tissue
US5735661A (en) * 1995-10-31 1998-04-07 Nynex Science & Technology, Inc. Transporter for storing and carrying multiple articles, such as coin collection boxes
WO1997021459A1 (en) * 1995-12-13 1997-06-19 Nikomed Aps A device for fixating a drainage tube
US6273912B1 (en) 1996-02-28 2001-08-14 Impra, Inc. Flanged graft for end-to-side anastomosis
US5951588A (en) 1996-02-29 1999-09-14 Moenning; Stephen P. Apparatus and method for protecting a port site opening in the wall of a body cavity
US5931821A (en) 1996-03-05 1999-08-03 Tyco Group S.A.R.L. Chest drainage unit with controlled automatic excess negativity relief feature
US5736661A (en) * 1996-03-12 1998-04-07 Armstrong; Paul R. System and method for tuning an instrument to a meantone temperament
US5755709A (en) * 1996-04-25 1998-05-26 Cuppy; Michael J. Catheter system for percutaneously introducing a liquid
CA2186656C (en) 1996-08-20 2007-11-06 Peter Leslie Steer An ostomy coupling
US6355034B2 (en) * 1996-09-20 2002-03-12 Ioan Cosmescu Multifunctional telescopic monopolar/bipolar surgical device and method therefor
DE69737110T2 (en) 1996-10-25 2007-07-12 Robinson, Gavin, Joseph, Brian, Burwood A method and apparatus for measuring pulmonary blutstromung in the course of the exchange of oxygen and an inert gas in the pulmonary blood
US5807341A (en) 1996-12-11 1998-09-15 Team Medical Llc Medical catheter dressing device
US5779649A (en) * 1996-12-17 1998-07-14 Pabban Development, Inc. Surgical suction wand with filter
WO1998027878A1 (en) * 1996-12-20 1998-07-02 Fundação E.J. Zerbini A prosthesis for thoracostomy and method for its implantation
WO1998032380A1 (en) * 1997-01-24 1998-07-30 University Of Massachusetts Auxiliary thoracic endoscope for minimally invasive surgery
JPH10309321A (en) 1997-03-11 1998-11-24 San Medical Gijutsu Kenkyusho:Kk Skin button
US5743053A (en) * 1997-03-25 1998-04-28 Somerville; Ronald E. Protective barrier for arresting the fall of a person on a stairway
US5961090A (en) 1997-04-03 1999-10-05 Parkin; Emanuel Mounting device
US6273907B1 (en) 1997-04-07 2001-08-14 Broncus Technologies, Inc. Bronchial stenter
US6083255A (en) 1997-04-07 2000-07-04 Broncus Technologies, Inc. Bronchial stenter
US5972026A (en) 1997-04-07 1999-10-26 Broncus Technologies, Inc. Bronchial stenter having diametrically adjustable electrodes
US6488673B1 (en) 1997-04-07 2002-12-03 Broncus Technologies, Inc. Method of increasing gas exchange of a lung
US6283988B1 (en) 1997-04-07 2001-09-04 Broncus Technologies, Inc. Bronchial stenter having expandable electrodes
US6411852B1 (en) 1997-04-07 2002-06-25 Broncus Technologies, Inc. Modification of airways by application of energy
US5891159A (en) * 1997-05-02 1999-04-06 Cardiothoratic Systems, Inc. Automatic purse string suture device
US6222090B1 (en) * 1997-05-05 2001-04-24 Shower-Seal, Inc. Waterproof injection port cover
US6736797B1 (en) 1998-06-19 2004-05-18 Unomedical A/S Subcutaneous infusion set
US5954636A (en) 1997-07-15 1999-09-21 Schwartz; Roy E. Pediatric endotracheal tube with bronchial blocker and method for selectively blocking respiratory airflow to a pediatric patient's lung
US20060239930A1 (en) * 1997-08-04 2006-10-26 Herbert Lamche Process for nebulizing aqueous compositions containing highly concentrated insulin
ES2235361T3 (en) 1997-08-26 2005-07-01 Absolute Closure Innovations, Inc. Closing device for creating a waterproof seal between fabrics and other materials.
US5954766A (en) 1997-09-16 1999-09-21 Zadno-Azizi; Gholam-Reza Body fluid flow control device
US20040199202A1 (en) * 1997-11-12 2004-10-07 Genesis Technologies Llc Biological passageway occlusion removal
DE69836764T2 (en) * 1997-11-14 2007-10-04 Boston Scientific Ltd., St. Michael Catheter with multiple cases for the introduction of a prosthesis
US6014972A (en) * 1997-12-11 2000-01-18 Thayer Medical Corporation Dry drug particle delivery system and method for ventilator circuits
US6651670B2 (en) * 1998-02-13 2003-11-25 Ventrica, Inc. Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication
US5997509A (en) * 1998-03-06 1999-12-07 Cornell Research Foundation, Inc. Minimally invasive gene therapy delivery device and method
US6330882B1 (en) 1998-03-06 2001-12-18 Ronald French Emergency apparatus for evacuating air from the body cavity
WO1999045990A1 (en) 1998-03-11 1999-09-16 Oldfield Family Holdings Pty. Limited Endotracheal tube for selective bronchial occlusion
US6106495A (en) * 1998-05-20 2000-08-22 Howmedica Inc. Methods and apparatus for delivering antibiotic powders into the femoral canal for the reduction of orthopaedic sepsis during total hip arthroplasty
US6599311B1 (en) 1998-06-05 2003-07-29 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US6293930B1 (en) 1998-06-11 2001-09-25 Hollister Incorporated Low-profile ostomy faceplate with recessed coupling ring
JP2000060862A (en) * 1998-08-20 2000-02-29 Sumitomo Bakelite Co Ltd Pallial tube for insertion of thoracoscope with cuff
US6135111A (en) * 1998-08-31 2000-10-24 Vital Signs Inc. Tracheostomy tube with removable inner cannula
JP4422339B2 (en) 1998-09-02 2010-02-24 アローロ・メディカル・アーベー Device for removing the gas discharged from the patient supplies suction gas to a patient
DE19852848C1 (en) 1998-11-11 2000-08-24 Klaus Affeld A method of forming an infection protective sleeve for the execution of a channel through the skin into the body and apparatus therefor
JP2000197706A (en) * 1999-01-06 2000-07-18 Hideo Horii Supporsitor insertion tool
US6028255A (en) * 1999-02-16 2000-02-22 Myronyk; Charles E. Detachable neck for a guitar
US9814869B1 (en) 1999-06-15 2017-11-14 C.R. Bard, Inc. Graft-catheter vascular access system
CA2377559A1 (en) 1999-06-18 2000-12-28 Powerlung,Inc Pulmonary exercise device
US20050137611A1 (en) 2001-09-04 2005-06-23 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US8002740B2 (en) 2003-07-18 2011-08-23 Broncus Technologies, Inc. Devices for maintaining patency of surgically created channels in tissue
US20040073155A1 (en) 2000-01-14 2004-04-15 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in tissue
US6749606B2 (en) 1999-08-05 2004-06-15 Thomas Keast Devices for creating collateral channels
US20030130657A1 (en) 1999-08-05 2003-07-10 Tom Curtis P. Devices for applying energy to tissue
US20050177144A1 (en) 1999-08-05 2005-08-11 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US20060280772A1 (en) 2001-09-04 2006-12-14 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US20050137715A1 (en) 1999-08-05 2005-06-23 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US7022088B2 (en) * 1999-08-05 2006-04-04 Broncus Technologies, Inc. Devices for applying energy to tissue
WO2006014732A3 (en) 2004-07-19 2006-03-30 Broncus Tech Inc Methods and devices for maintaining patency of surgically created channels in a body organ
US6179804B1 (en) * 1999-08-18 2001-01-30 Oxypatch, Llc Treatment apparatus for wounds
US6293951B1 (en) 1999-08-24 2001-09-25 Spiration, Inc. Lung reduction device, system, and method
US6416554B1 (en) 1999-08-24 2002-07-09 Spiration, Inc. Lung reduction apparatus and method
JP4006612B2 (en) * 1999-09-27 2007-11-14 ソニー株式会社 Data processing apparatus and data processing method, recording medium, and recording and reproducing method in a digital broadcast receiving apparatus and a digital broadcast receiving apparatus
US6402754B1 (en) 1999-10-20 2002-06-11 Spiration, Inc. Apparatus for expanding the thorax
US6398775B1 (en) 1999-10-21 2002-06-04 Pulmonx Apparatus and method for isolated lung access
WO2001045568A1 (en) 1999-12-20 2001-06-28 Dexterity Surgical, Inc. Adjustable surgical wound protector and retractor
US6904909B2 (en) 2000-03-04 2005-06-14 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6770070B1 (en) * 2000-03-17 2004-08-03 Rita Medical Systems, Inc. Lung treatment apparatus and method
US6945969B1 (en) 2000-03-31 2005-09-20 Medtronic, Inc. Catheter for target specific drug delivery
US6701928B2 (en) * 2000-04-06 2004-03-09 Wake Forest University Inhaler dispensing system adapters for laryngectomized subjects and associated methods
US6274787B1 (en) * 2000-04-30 2001-08-14 Eric Downing Transparent, span-over-the-wound bandage
US6459917B1 (en) * 2000-05-22 2002-10-01 Ashok Gowda Apparatus for access to interstitial fluid, blood, or blood plasma components
US6719749B1 (en) * 2000-06-01 2004-04-13 Medical Components, Inc. Multilumen catheter assembly and methods for making and inserting the same
US6363932B1 (en) * 2000-07-06 2002-04-02 Clinical Technologies, Inc. Aerosol enhancement device
WO2002005879A1 (en) * 2000-07-15 2002-01-24 Glaxo Group Limited Medicament dispenser
US7297106B2 (en) 2001-07-18 2007-11-20 Sumitomo Bakelite Co., Ltd. Medical treating instrument
US6443156B1 (en) 2000-08-02 2002-09-03 Laura E. Niklason Separable double lumen endotracheal tube
US6569121B1 (en) * 2000-10-12 2003-05-27 Benjamin Warren Purow Sheath device with dressing for prevention of pneumothorax
US7198635B2 (en) 2000-10-17 2007-04-03 Asthmatx, Inc. Modification of airways by application of energy
US6585639B1 (en) 2000-10-27 2003-07-01 Pulmonx Sheath and method for reconfiguring lung viewing scope
US20060135947A1 (en) 2000-10-27 2006-06-22 Pulmonx Occlusal stent and methods for its use
US6692449B1 (en) * 2000-12-15 2004-02-17 Northwestern University Methods and system for assessing limb position sense during movement
CA2433458A1 (en) 2001-01-08 2002-10-03 Human Genome Sciences, Inc. Keratinocyte growth factor-2
WO2002056794A3 (en) 2001-01-18 2002-11-07 Brigham & Womens Hospital Prosthetic device for respiratory patients
US20020112729A1 (en) 2001-02-21 2002-08-22 Spiration, Inc. Intra-bronchial obstructing device that controls biological interaction with the patient
US9132253B2 (en) * 2001-02-23 2015-09-15 Lawrence A. Lynn Asthma resuscitation system and method
US6609521B1 (en) 2001-04-09 2003-08-26 Regents Of The University Of Minnesota Endotracheal tube
US6969373B2 (en) * 2001-04-13 2005-11-29 Tricardia, Llc Syringe system
RU2192185C1 (en) 2001-05-04 2002-11-10 Фатихов Рашит Габдуллович Pleural cavity drainage apparatus
US6871228B2 (en) * 2001-06-29 2005-03-22 International Business Machines Corporation Methods and apparatus in distributed remote logging system for remote adhoc data analysis customized with multilevel hierarchical logger tree
US6638253B2 (en) 2001-07-17 2003-10-28 Eugene Michael Breznock Method and apparatus for chest drainage
US7364565B2 (en) 2001-07-27 2008-04-29 Ramot At Tel Aviv University Ltd. Controlled enzymatic removal and retrieval of cells
US7883471B2 (en) 2001-09-10 2011-02-08 Pulmonx Corporation Minimally invasive determination of collateral ventilation in lungs
US20070142742A1 (en) 2005-07-13 2007-06-21 Pulmonx Methods and systems for segmental lung diagnostics
US6632239B2 (en) 2001-10-02 2003-10-14 Spiration, Inc. Constriction device including reinforced suture holes
JP4446739B2 (en) 2001-10-11 2010-04-07 パルモンクス・コーポレイションPulmonx Corporation Using bronchial flow control device and the device
US6592594B2 (en) 2001-10-25 2003-07-15 Spiration, Inc. Bronchial obstruction device deployment system and method
WO2003041779A9 (en) 2001-11-14 2004-03-11 Emphasys Medical Inc Active pump bronchial implant and methods of use thereof
US6840242B1 (en) * 2002-01-23 2005-01-11 Mccoy Stephen Craig Tracheostomy aspiration suction tube
US6827086B2 (en) 2002-02-01 2004-12-07 Spiration, Inc. Device and method of isolating deleterious body tissue located within healthy body tissue
US20030154576A1 (en) 2002-02-20 2003-08-21 Eddia Mirharooni Eddia cuff link
US6929637B2 (en) 2002-02-21 2005-08-16 Spiration, Inc. Device and method for intra-bronchial provision of a therapeutic agent
US20030154988A1 (en) 2002-02-21 2003-08-21 Spiration, Inc. Intra-bronchial device that provides a medicant intra-bronchially to the patient
US20060235432A1 (en) 2002-02-21 2006-10-19 Devore Lauri J Intra-bronchial obstructing device that controls biological interaction with the patient
US7041083B2 (en) * 2002-02-26 2006-05-09 Scimed Life Systems, Inc. Medical catheter assembly including a removable inner sleeve and method of using the same
EP1482863A1 (en) 2002-03-08 2004-12-08 Emphasys Medical, Inc. Methods and devices for inducing collapse in lung regions fed by collateral pathways
US20030181356A1 (en) 2002-03-11 2003-09-25 Edward Ingenito Compositions and methods for treating emphysema
US20030181922A1 (en) 2002-03-20 2003-09-25 Spiration, Inc. Removable anchored lung volume reduction devices and methods
US7001367B2 (en) * 2002-04-16 2006-02-21 Arkinstall William W Valved ostomy drainage device
US20030195511A1 (en) 2002-04-16 2003-10-16 Spiration, Inc. Device for and method of removing deleterious body tissue from a site within a patient
US20030195385A1 (en) 2002-04-16 2003-10-16 Spiration, Inc. Removable anchored lung volume reduction devices and methods
WO2003088820A3 (en) 2002-04-19 2004-12-29 Broncus Tech Inc Devices for maintaining surgically created openings
US6770063B2 (en) 2002-04-23 2004-08-03 Uresil, L.P. Thoracic vent kit
CA2452338C (en) 2002-04-26 2009-02-24 Taut, Inc. Floating seal assembly for a trocar
US7207946B2 (en) 2002-05-09 2007-04-24 Spiration, Inc. Automated provision of information related to air evacuation from a chest cavity
EP1501432B1 (en) * 2002-05-09 2012-07-11 Tyco Healthcare Group LP Adjustable balloon anchoring trocar
US20030212412A1 (en) 2002-05-09 2003-11-13 Spiration, Inc. Intra-bronchial obstructing device that permits mucus transport
DE10225281C1 (en) * 2002-06-07 2003-11-06 Dornier Gmbh Structure element for a portable container, as a working space, has outer reinforced plastics claddings with rib spacers, to take insulation layers between them for a light weight with high mechanical strength
WO2003103493A1 (en) 2002-06-11 2003-12-18 Politecnico Di Milano System and method for the automatic detection of the expiratory flow limitation
US7819908B2 (en) 2002-06-17 2010-10-26 Aeris Therapeutics, Inc. Compositions and methods for reducing lung volume
US7422584B2 (en) 2002-07-05 2008-09-09 Broncus Technologies, Inc. Extrapleural airway device and method
US7134273B2 (en) * 2002-09-04 2006-11-14 Ford Global Technologies, Llc Exhaust emission control and diagnostics
US6905484B2 (en) * 2002-09-30 2005-06-14 Damage Control Surgical Technologies, Inc. Method and apparatus for rapid deployment chest drainage
US7135010B2 (en) 2003-09-30 2006-11-14 Damage Control Surgical Technologies, Inc. Method and apparatus for rapid deployment chest drainage
US20040073241A1 (en) 2002-10-11 2004-04-15 Spiration, Inc. Implantable tissue constriction device and method for suppressing leakage of fluid from resectioned body tissue
US6890295B2 (en) 2002-10-31 2005-05-10 Medtronic, Inc. Anatomical space access tools and methods
US20040144387A1 (en) 2003-01-28 2004-07-29 David Amar Double-balloon endobronchial catheter for one lung isolation anesthesia and surgery
US20040210248A1 (en) 2003-03-12 2004-10-21 Spiration, Inc. Apparatus, method and assembly for delivery of intra-bronchial devices
US7100616B2 (en) 2003-04-08 2006-09-05 Spiration, Inc. Bronchoscopic lung volume reduction method
US7811274B2 (en) * 2003-05-07 2010-10-12 Portaero, Inc. Method for treating chronic obstructive pulmonary disease
US7426929B2 (en) * 2003-05-20 2008-09-23 Portaero, Inc. Intra/extra-thoracic collateral ventilation bypass system and method
US7533667B2 (en) 2003-05-29 2009-05-19 Portaero, Inc. Methods and devices to assist pulmonary decompression
US6916310B2 (en) * 2003-05-30 2005-07-12 Codman & Shurtleff, Inc. Percutaneous access device
US7252086B2 (en) * 2003-06-03 2007-08-07 Cordis Corporation Lung reduction system
US7377278B2 (en) * 2003-06-05 2008-05-27 Portaero, Inc. Intra-thoracic collateral ventilation bypass system and method
US8308682B2 (en) 2003-07-18 2012-11-13 Broncus Medical Inc. Devices for maintaining patency of surgically created channels in tissue
US20050103340A1 (en) 2003-08-20 2005-05-19 Wondka Anthony D. Methods, systems & devices for endobronchial ventilation and drug delivery
US20050066041A1 (en) * 2003-09-19 2005-03-24 Chin Kwan Wu Setting up a name resolution system for home-to-home communications
US20050171396A1 (en) 2003-10-20 2005-08-04 Cyberheart, Inc. Method for non-invasive lung treatment
WO2005046426A3 (en) 2003-11-17 2006-01-26 Spirojet Medical Ltd Spirometer
US7036509B2 (en) 2003-12-04 2006-05-02 Emphasys Medical, Inc. Multiple seal port anesthesia adapter
US20050178389A1 (en) 2004-01-27 2005-08-18 Shaw David P. Disease indications for selective endobronchial lung region isolation
US7121280B2 (en) 2004-03-17 2006-10-17 Cook Critical Care Incorporated Medical devices and methods of selectively and alternately isolating bronchi or lungs
US20060142790A1 (en) * 2004-03-23 2006-06-29 Michael Gertner Methods and devices to facilitate connections between body lumens
US20070179426A1 (en) 2004-05-11 2007-08-02 Selden Nathan R Interfacial stent and method of maintaining patency of surgical fenestrations
US7448385B2 (en) * 2004-06-07 2008-11-11 Purepharm Inc. Nasal adaptation of an oral inhaler device
JP4767252B2 (en) 2004-06-14 2011-09-07 ヌームアールエックス・インコーポレーテッド Lung of an access device
US7608579B2 (en) 2004-06-16 2009-10-27 Pneumrx, Inc. Lung volume reduction using glue compositions
US7678767B2 (en) 2004-06-16 2010-03-16 Pneumrx, Inc. Glue compositions for lung volume reduction
US7553810B2 (en) 2004-06-16 2009-06-30 Pneumrx, Inc. Lung volume reduction using glue composition
US7468350B2 (en) 2004-06-16 2008-12-23 Pneumrx, Inc. Glue composition for lung volume reduction
WO2006014431A3 (en) * 2004-07-07 2006-08-24 Egret Medical Products Inc Suction catheter assembly
US7766938B2 (en) * 2004-07-08 2010-08-03 Pneumrx, Inc. Pleural effusion treatment device, method and material
US20060130830A1 (en) 2004-09-07 2006-06-22 Uptake Medical Corporation Intra-bronchial implants for improved attachment
US7460941B2 (en) * 2004-09-29 2008-12-02 Caterpillar Inc. Slope-limited retarding control for a propelled machine
US20060079845A1 (en) * 2004-10-08 2006-04-13 Eben Howard And Pamela A. Howard Movable inflatable anchor for medical devices
US20060079838A1 (en) 2004-10-08 2006-04-13 Walker Steven C Movable Balloon anchor for medical devices
CA2587909C (en) 2004-11-16 2016-01-05 Robert L. Barry Device and method for lung treatment
US20060162731A1 (en) 2004-11-16 2006-07-27 Pulmonx Pulmonary occlusal stent delivery catheter, loading system and methods of use
US20060118126A1 (en) 2004-11-19 2006-06-08 Don Tanaka Methods and devices for controlling collateral ventilation
US7398782B2 (en) 2004-11-19 2008-07-15 Portaero, Inc. Method for pulmonary drug delivery
US8220460B2 (en) 2004-11-19 2012-07-17 Portaero, Inc. Evacuation device and method for creating a localized pleurodesis
US7832394B2 (en) * 2004-12-22 2010-11-16 Schechter Alan M Apparatus for dispensing pressurized contents
US20060137681A1 (en) * 2004-12-28 2006-06-29 Ric Investments, Llc. Actuator for a metered dose inhaler
US7731651B2 (en) 2005-03-17 2010-06-08 Spiration, Inc. Device to deploy a resilient sleeve to constrict on body tissue
US7268096B2 (en) * 2005-07-21 2007-09-11 Chevron Phillips Chemical Company Lp Diimine metal complexes, methods of synthesis, and methods of using in oligomerization and polymerization
US20070038177A1 (en) 2005-08-12 2007-02-15 Sinha Anil K Self securing chest tubes and methods
KR20080075494A (en) 2005-09-21 2008-08-18 다스크 테크날러지, 엘엘씨 Methods and compositions for organ and tissue functionality
US7594914B2 (en) 2005-10-07 2009-09-29 Pablo Cristian Luchetti Incision and closure surgical device
EP1774932B1 (en) 2005-10-11 2015-08-26 ConvaTec Technologies Inc. Ostomy coupling
DE102005050902A1 (en) * 2005-10-21 2007-05-03 Khs Ag Device for aligning containers, as well as labeling with such a device
US20070186932A1 (en) 2006-01-06 2007-08-16 Pulmonx Collateral pathway treatment using agent entrained by aspiration flow current
US7406963B2 (en) * 2006-01-17 2008-08-05 Portaero, Inc. Variable resistance pulmonary ventilation bypass valve and method
US20070186933A1 (en) 2006-01-17 2007-08-16 Pulmonx Systems and methods for delivering flow restrictive element to airway in lungs
EP1815821A1 (en) 2006-02-02 2007-08-08 Dr. Karel Volenec - ELLA - CS Stent delivery system
US20070256688A1 (en) * 2006-04-21 2007-11-08 Aradigm Corporation Mechanical single dose intrapulmonary drug delivery devices
US20080234660A2 (en) 2006-05-16 2008-09-25 Sarah Cumming Steerable Catheter Using Flat Pull Wires and Method of Making Same
WO2007142812A3 (en) * 2006-05-18 2008-10-16 Breathe Technologies Inc Tracheotomy method and device
US8911750B2 (en) * 2007-04-03 2014-12-16 Larry W. Tsai Lung volume reduction therapy using crosslinked biopolymers
US20080281151A1 (en) 2007-05-11 2008-11-13 Portaero, Inc. Pulmonary pleural stabilizer
US7931641B2 (en) 2007-05-11 2011-04-26 Portaero, Inc. Visceral pleura ring connector
US8163034B2 (en) 2007-05-11 2012-04-24 Portaero, Inc. Methods and devices to create a chemically and/or mechanically localized pleurodesis
US20080283065A1 (en) 2007-05-15 2008-11-20 Portaero, Inc. Methods and devices to maintain patency of a lumen in parenchymal tissue of the lung
US20080287878A1 (en) 2007-05-15 2008-11-20 Portaero, Inc. Pulmonary visceral pleura anastomosis reinforcement
US8062315B2 (en) * 2007-05-17 2011-11-22 Portaero, Inc. Variable parietal/visceral pleural coupling
US20080295829A1 (en) 2007-05-30 2008-12-04 Portaero, Inc. Bridge element for lung implant
US8181651B2 (en) * 2007-07-24 2012-05-22 Passy-Muir, Inc. Hand powered suction device with mucus trap and suction catheter for tracheostomy tubes
EP2244757A4 (en) * 2007-10-18 2013-11-20 Convatec Technologies Inc Aspiration system for removing liquid discharged by the human body, and liquid sensor therefor
CN102112139A (en) * 2007-10-30 2011-06-29 乌第有限合伙公司 Method and system for sustained-release of sclerosing agent
EP2242527A4 (en) 2008-02-19 2011-07-13 Portaero Inc Devices and methods for delivery of a therapeutic agent through a pneumostoma
US8475389B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US8518053B2 (en) * 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US8336540B2 (en) 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8347881B2 (en) 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method

Patent Citations (103)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US953922A (en) * 1907-06-17 1910-04-05 John B Rogers Tracheal cannula or tube.
US2873742A (en) * 1954-07-14 1959-02-17 Research Corp Surgical instruments
US2867213A (en) * 1957-06-12 1959-01-06 Jr Paul A Thomas Flutter valve for drainage of the pleural cavity
US3556103A (en) * 1968-03-15 1971-01-19 Edward J Calhoun Tracheotomy instrument
US3638649A (en) * 1969-07-07 1972-02-01 Univ Minnesota Implantable prosthetic pass-through device
US3788326A (en) * 1970-07-29 1974-01-29 H Jacobs Distally perforated catheter for use in ventilating system
US4439189A (en) * 1981-06-18 1984-03-27 Bentley Laboratories, Inc. Pleural drainage system
US4527559A (en) * 1982-10-18 1985-07-09 Roxburg Dwight W Endotracheal tube anchoring mechanism
US4502482A (en) * 1983-05-23 1985-03-05 Deluccia Victor C Endotracheal tube complex
US4583977A (en) * 1984-08-15 1986-04-22 Vsesojuzny Nauchno-Issledovatelsky Institut Meditsiuskikh Polimerov Device for lengthy fixation of a tube introduced into the patient's body
US4799494A (en) * 1986-10-22 1989-01-24 Wang Ko P Percutaneous aspiration lung biopsy needle assembly
US4813929A (en) * 1987-02-19 1989-03-21 Neal Semrad Chest tube device and method of inserting device
US5004456A (en) * 1989-03-10 1991-04-02 Arrow International Investment Corporation In-dwelling catheter
US5078689A (en) * 1990-05-14 1992-01-07 Keller Alan M Device for removing body fluids
US5401262A (en) * 1990-07-20 1995-03-28 Atrium Medical Corporation Fluid recovery system
US5501678A (en) * 1991-08-30 1996-03-26 Coloplast A/S Adapter for use in connection with ostomy equipment
US5207652A (en) * 1991-10-23 1993-05-04 Bioderm Medical apparatus fixation and infection control device
US5487382A (en) * 1991-10-30 1996-01-30 Robert Bezicot Tracheotomy filter for tracheotomy patients
US5403264A (en) * 1992-09-04 1995-04-04 Ethicon, Inc. Endoscopic closure inspection device
US5616131A (en) * 1992-09-23 1997-04-01 Lasersurge, Inc. Apparatus and method for anchoring surgical instrumentation
US5484401A (en) * 1992-11-04 1996-01-16 Denver Biomaterials, Inc. Treatment method for pleural effusion
US5496297A (en) * 1993-02-22 1996-03-05 Coloplast A/S Ostomy coupling
US5389077A (en) * 1993-03-03 1995-02-14 Uresil Corporation Minimally invasive body cavity penetrating instruments
US5501677A (en) * 1993-06-25 1996-03-26 Jensen; Ole R. Two-piece ostomy appliance and low-profile coupling ring assembly
US5738661A (en) * 1995-06-16 1998-04-14 Larice; Gennaro Medical device for holding a feeding tube and use thereof
US7014628B2 (en) * 1995-07-07 2006-03-21 Bousquet Gerald G Transcutaneous access device
US5728066A (en) * 1995-12-13 1998-03-17 Daneshvar; Yousef Injection systems and methods
US5730735A (en) * 1996-03-12 1998-03-24 Hollister Incorporated Convex ostomy faceplate with floating flange and finger recess
US6200333B1 (en) * 1997-04-07 2001-03-13 Broncus Technologies, Inc. Bronchial stenter
US20070005083A1 (en) * 1997-04-30 2007-01-04 Sabaratham Sabanathan Occlusion device
US6997189B2 (en) * 1998-06-05 2006-02-14 Broncus Technologies, Inc. Method for lung volume reduction
US6174323B1 (en) * 1998-06-05 2001-01-16 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US20040031494A1 (en) * 1998-06-10 2004-02-19 Broncus Technologies, Inc. Methods of treating asthma
US6197010B1 (en) * 1998-06-11 2001-03-06 Hollister Incorporated Ostomy appliance faceplate with concealed coupling ring flange
US6358269B1 (en) * 1998-11-02 2002-03-19 Ralph Aye Method of treating peripheral bronchopleural fistulas
US6334441B1 (en) * 1998-11-23 2002-01-01 Mallinckrodt Medical, Inc. Phonation valve for breathing tube
US6682506B1 (en) * 1998-12-22 2004-01-27 Francis Navarro Device for maintaining at least a tube
US20050015106A1 (en) * 1999-07-02 2005-01-20 Pulmonx Methods, systems, and kits for lung volume reduction
US6709401B2 (en) * 1999-07-02 2004-03-23 Pulmonx Methods, systems, and kits for lung volume reduction
US7186259B2 (en) * 1999-07-02 2007-03-06 Pulmonx Methods, systems, and kits for lung volume reduction
US6712812B2 (en) * 1999-08-05 2004-03-30 Broncus Technologies, Inc. Devices for creating collateral channels
US20050060044A1 (en) * 1999-08-05 2005-03-17 Ed Roschak Methods and devices for maintaining patency of surgically created channels in a body organ
US20050049615A1 (en) * 1999-08-05 2005-03-03 Broncus Technologies, Inc. Methods for treating chronic obstructive pulmonary disease
US20050056292A1 (en) * 1999-08-05 2005-03-17 Cooper Joel D. Devices for maintaining patency of surgically created channels in tissue
US6692494B1 (en) * 1999-08-05 2004-02-17 Broncus Technologies, Inc. Methods and devices for creating collateral channels in the lungs
US6517519B1 (en) * 1999-08-13 2003-02-11 The Johns Hopkins University Device and method for rapid chest tube insertion
US6679264B1 (en) * 2000-03-04 2004-01-20 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US20040016435A1 (en) * 2000-03-04 2004-01-29 Deem Mark E. Methods and devices for use in performing pulmonary procedures
US6694979B2 (en) * 2000-03-04 2004-02-24 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US7165548B2 (en) * 2000-03-04 2007-01-23 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6840243B2 (en) * 2000-03-04 2005-01-11 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US20050043745A1 (en) * 2000-03-23 2005-02-24 Alferness Clifton A. Tissue resection device, system, and method
US6514290B1 (en) * 2000-03-31 2003-02-04 Broncus Technologies, Inc. Lung elastic recoil restoring or tissue compressing device and method
US20040010289A1 (en) * 2000-10-17 2004-01-15 Broncus Technologies, Inc. Control system and process for application of energy to airway walls and other mediums
US6997918B2 (en) * 2000-10-27 2006-02-14 Pulmonx Methods and devices for obstructing and aspirating lung tissue segments
US6527761B1 (en) * 2000-10-27 2003-03-04 Pulmonx, Inc. Methods and devices for obstructing and aspirating lung tissue segments
US7175644B2 (en) * 2001-02-14 2007-02-13 Broncus Technologies, Inc. Devices and methods for maintaining collateral channels in tissue
US20040055606A1 (en) * 2001-03-02 2004-03-25 Emphasys Medical, Inc. Bronchial flow control devices with membrane seal
US7011094B2 (en) * 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US6520183B2 (en) * 2001-06-11 2003-02-18 Memorial Sloan-Kettering Cancer Center Double endobronchial catheter for one lung isolation anesthesia and surgery
US7182772B2 (en) * 2001-07-10 2007-02-27 Spiration, Inc. Constriction device including fixation structure
US20030013935A1 (en) * 2001-07-10 2003-01-16 Spiration, Inc. Constriction device viewable under X ray fluoroscopy
US6860847B2 (en) * 2001-07-10 2005-03-01 Spiration, Inc. Constriction device viewable under X ray fluoroscopy
US20030018344A1 (en) * 2001-07-19 2003-01-23 Olympus Optical Co., Ltd. Medical device and method of embolizing bronchus or bronchiole
US6837906B2 (en) * 2001-08-03 2005-01-04 Ensure Medical, Inc. Lung assist apparatus and methods for use
US20050043752A1 (en) * 2001-09-04 2005-02-24 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US20050043751A1 (en) * 2001-09-04 2005-02-24 Broncus Technologies, Inc. Methods and devices for maintaining patency of surgically created channels in a body organ
US20050060041A1 (en) * 2001-09-04 2005-03-17 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US20050060042A1 (en) * 2001-09-04 2005-03-17 Broncus Technologies, Inc. Methods and devices for maintaining surgically created channels in a body organ
US20030051733A1 (en) * 2001-09-10 2003-03-20 Pulmonx Method and apparatus for endobronchial diagnosis
US20030050648A1 (en) * 2001-09-11 2003-03-13 Spiration, Inc. Removable lung reduction devices, systems, and methods
US20030055331A1 (en) * 2001-09-11 2003-03-20 Pulmonx Methods of endobronchial diagnosis using imaging
US20050033310A1 (en) * 2001-09-11 2005-02-10 Alferness Clifton A. Intra-bronchial valve devices
US7172581B2 (en) * 2001-09-24 2007-02-06 Coloplast A/S Ostomy appliance with a removable, washable and reusable sealing member
US6843767B2 (en) * 2001-10-18 2005-01-18 Spiration, Inc. Constriction device including tear resistant structures
US6695791B2 (en) * 2002-01-04 2004-02-24 Spiration, Inc. System and method for capturing body tissue samples
US6846292B2 (en) * 2002-02-19 2005-01-25 Mohamed Bakry Pleural biopsy and brushing needle
US6852108B2 (en) * 2002-05-14 2005-02-08 Spiration, Inc. Apparatus and method for resecting and removing selected body tissue from a site inside a patient
US20050033344A1 (en) * 2002-05-17 2005-02-10 Dillard David H. One-way valve devices for anchored implantation in a lung
US20030225377A1 (en) * 2002-06-04 2003-12-04 Betty Hancock Waterproof venipuncture site cover
US20040047855A1 (en) * 2002-06-17 2004-03-11 Bistech, Inc., A Delaware Corporation Compositions and methods for reducing lung volume
US20040010209A1 (en) * 2002-07-15 2004-01-15 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US20040024356A1 (en) * 2002-07-31 2004-02-05 Don Tanaka Long term oxygen therapy system
US20040040555A1 (en) * 2002-08-28 2004-03-04 Don Tanaka Collateral ventilation bypass trap system
US20040059263A1 (en) * 2002-09-24 2004-03-25 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US6849061B2 (en) * 2002-10-21 2005-02-01 Robert B. Wagner Method and apparatus for pleural drainage
US20050061322A1 (en) * 2003-01-20 2005-03-24 Pulmonx Method and arrangement for reducing the volume of a lung
US20050022809A1 (en) * 2003-04-25 2005-02-03 Wondka Anthony David Methods, systems and devices for desufflating a lung area
US20070027434A1 (en) * 2003-06-02 2007-02-01 Ole Pedersen Adhesive face plate for an ostomy appliance, an ostomy appliance and a method for cleaning a face plate
US20050005936A1 (en) * 2003-06-18 2005-01-13 Wondka Anthony David Methods, systems and devices for improving ventilation in a lung area
US7195017B2 (en) * 2003-07-03 2007-03-27 Cordis Corporation Collateral ventilation bypass trap system
US20050025816A1 (en) * 2003-07-15 2005-02-03 Don Tanaka Methods and devices to accelerate wound healing in thoracic anastomosis applications
US7192420B2 (en) * 2003-08-08 2007-03-20 Whiteford Bruce W Ostomy adapter with multiple adhesives for reliable sealing
US20050066976A1 (en) * 2003-08-18 2005-03-31 Wondka Anthony D. Method and device for non-invasive ventilation with nasal interface
US7195016B2 (en) * 2004-01-07 2007-03-27 E. Benson Hood Laboratories Transtracheal oxygen stent
US20060004400A1 (en) * 2004-06-16 2006-01-05 Mcgurk Erin Method of treating a lung
US20060009748A1 (en) * 2004-06-16 2006-01-12 Mathis Mark L Method of compressing a portion of a lung
US20060025815A1 (en) * 2004-07-08 2006-02-02 Mcgurk Erin Lung device with sealing features
US20060047291A1 (en) * 2004-08-20 2006-03-02 Uptake Medical Corporation Non-foreign occlusion of an airway and lung collapse
US20060124126A1 (en) * 2004-12-10 2006-06-15 Don Tanaka Collateral ventilation device with chest tube/evacuation features
US20070055175A1 (en) * 2005-05-25 2007-03-08 Pulmosonix Pty Ltd Devices and methods for tissue analysis
US20070043350A1 (en) * 2005-08-17 2007-02-22 Pulmonx Selective lung tissue ablation
US20070051372A1 (en) * 2005-08-23 2007-03-08 Don Tanaka Collateral ventilation bypass system with retention features

Cited By (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8323230B2 (en) 2003-07-15 2012-12-04 Portaero, Inc. Methods and devices to accelerate wound healing in thoracic anastomosis applications
US8491602B2 (en) 2008-02-19 2013-07-23 Portaero, Inc. Single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US8021320B2 (en) 2008-02-19 2011-09-20 Portaero, Inc. Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US8231581B2 (en) 2008-02-19 2012-07-31 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8252003B2 (en) 2008-02-19 2012-08-28 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US7927324B2 (en) 2008-02-19 2011-04-19 Portaero, Inc. Aspirator and method for pneumostoma management
US8336540B2 (en) 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8506577B2 (en) 2008-02-19 2013-08-13 Portaero, Inc. Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US8347880B2 (en) 2008-02-19 2013-01-08 Potaero, Inc. Pneumostoma management system with secretion management features for treatment of chronic obstructive pulmonary disease
US8348906B2 (en) 2008-02-19 2013-01-08 Portaero, Inc. Aspirator for pneumostoma management
US8365722B2 (en) 2008-02-19 2013-02-05 Portaero, Inc. Multi-layer pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8430094B2 (en) 2008-02-19 2013-04-30 Portaero, Inc. Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8453637B2 (en) 2008-02-19 2013-06-04 Portaero, Inc. Pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8453638B2 (en) 2008-02-19 2013-06-04 Portaero, Inc. One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8464708B2 (en) 2008-02-19 2013-06-18 Portaero, Inc. Pneumostoma management system having a cosmetic and/or protective cover
US8474449B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8475389B2 (en) 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US7909803B2 (en) 2008-02-19 2011-03-22 Portaero, Inc. Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8347881B2 (en) 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method
US8518053B2 (en) 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US10058332B2 (en) 2012-08-01 2018-08-28 Terumo Kabushiki Kaisha Method for treatment of chronic obstructive pulmonary disease
CN104874084A (en) * 2014-02-28 2015-09-02 北京谊安医疗系统股份有限公司 Exhalation valve and respirator provided with same
US20150272718A1 (en) * 2014-03-31 2015-10-01 Boston Scientific Scimed, Inc. Devices for forming collateral channels and related methods of use
US9693854B2 (en) * 2014-03-31 2017-07-04 Boston Scientific Scimed, Inc. Devices for forming collateral channels and related methods of use

Also Published As

Publication number Publication date Type
US8430094B2 (en) 2013-04-30 grant
WO2009105455A3 (en) 2009-10-22 application
US20090205649A1 (en) 2009-08-20 application
US20090209971A1 (en) 2009-08-20 application
EP2242527A4 (en) 2011-07-13 application
US20090209906A1 (en) 2009-08-20 application
US20110118669A1 (en) 2011-05-19 application
WO2009105458A3 (en) 2009-11-12 application
WO2009105432A2 (en) 2009-08-27 application
EP2242530A4 (en) 2011-10-05 application
US20110306935A1 (en) 2011-12-15 application
US20090205651A1 (en) 2009-08-20 application
US20090209917A1 (en) 2009-08-20 application
JP2011512232A (en) 2011-04-21 application
US20090205648A1 (en) 2009-08-20 application
US20090205646A1 (en) 2009-08-20 application
US20090205644A1 (en) 2009-08-20 application
US8231581B2 (en) 2012-07-31 grant
US20090205658A1 (en) 2009-08-20 application
US8474449B2 (en) 2013-07-02 grant
CA2752159A1 (en) 2009-08-27 application
US8273051B2 (en) 2012-09-25 grant
EP2242529A4 (en) 2011-07-20 application
US8348906B2 (en) 2013-01-08 grant
US20090209909A1 (en) 2009-08-20 application
US20090209970A1 (en) 2009-08-20 application
US20090205647A1 (en) 2009-08-20 application
EP2242530A2 (en) 2010-10-27 application
US8506577B2 (en) 2013-08-13 grant
US20090209856A1 (en) 2009-08-20 application
EP2242527A2 (en) 2010-10-27 application
WO2009105455A2 (en) 2009-08-27 application
US8365722B2 (en) 2013-02-05 grant
US20120277584A1 (en) 2012-11-01 application
WO2009105473A3 (en) 2010-01-21 application
US8347880B2 (en) 2013-01-08 grant
US20090209924A1 (en) 2009-08-20 application
US7927324B2 (en) 2011-04-19 grant
WO2009105458A2 (en) 2009-08-27 application
JP2011512233A (en) 2011-04-21 application
US8491602B2 (en) 2013-07-23 grant
US8453637B2 (en) 2013-06-04 grant
WO2009105458A9 (en) 2010-12-23 application
CN102006904A (en) 2011-04-06 application
US20090205643A1 (en) 2009-08-20 application
WO2009105432A3 (en) 2009-12-03 application
US20090209936A1 (en) 2009-08-20 application
US20090205650A1 (en) 2009-08-20 application
US8252003B2 (en) 2012-08-28 grant
US20090205665A1 (en) 2009-08-20 application
US20130218134A1 (en) 2013-08-22 application
WO2009105473A2 (en) 2009-08-27 application
US8021320B2 (en) 2011-09-20 grant
EP2242529A2 (en) 2010-10-27 application
US8453638B2 (en) 2013-06-04 grant
US8464708B2 (en) 2013-06-18 grant
US7909803B2 (en) 2011-03-22 grant
WO2009105473A9 (en) 2010-03-11 application

Similar Documents

Publication Publication Date Title
US5676133A (en) Expiratory scavenging method and apparatus and oxygen control system for post anesthesia care patients
US20050166924A1 (en) Multiple cannula systems and methods
US20030116163A1 (en) Nasal ventilation interface
US7422584B2 (en) Extrapleural airway device and method
US20130030249A1 (en) Visualized endotracheal tube placement systems
US20050025816A1 (en) Methods and devices to accelerate wound healing in thoracic anastomosis applications
US20070227542A1 (en) Nose Filter
US5533505A (en) Disposable inhaler
US5660169A (en) Disposable inhaler with pull-off seal
US5871693A (en) Modular blood treatment cartridge
US20070051372A1 (en) Collateral ventilation bypass system with retention features
US6929637B2 (en) Device and method for intra-bronchial provision of a therapeutic agent
US20050161040A1 (en) Collateral ventilation bypass trap system
US20090281526A1 (en) Negative Pressure Wound Therapy Apparatus Including a Fluid Line Coupling
US5478333A (en) Medical dressing for treating open chest injuries
US20080287892A1 (en) Wound treatment system
US5099833A (en) High efficiency nebulizer having a flexible reservoir
US7802572B2 (en) Face mask
US20060118125A1 (en) Pulmonary drug delivery
US20040244803A1 (en) Intra-thoracic collateral ventilation bypass system
US7252086B2 (en) Lung reduction system
US7344512B2 (en) Protector and blood pump system
US7406963B2 (en) Variable resistance pulmonary ventilation bypass valve and method
US7083569B2 (en) Ostomy cartridge
US7506649B2 (en) Nasal devices

Legal Events

Date Code Title Description
AS Assignment

Owner name: PORTAERO, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:TANAKA, DON;WIESMAN, JOSHUA P.;PLOUGH, DAVID C.;AND OTHERS;REEL/FRAME:022295/0844

Effective date: 20090217