US2675002A

US2675002A - Colostomy appliance

Info

Publication number: US2675002A
Application number: US229786A
Authority: US
Inventors: Dominec J Cesare
Original assignee: Individual
Current assignee: Individual
Priority date: 1951-06-04
Filing date: 1951-06-04
Publication date: 1954-04-13
Anticipated expiration: 1971-04-13

Description

April 13, 1954 D. J. CESARE COLOSTOMYAPPLIANCE Filed June 4, 1951 C m M 5 Patented Apr. 13, 1954 UNITED STATE S PATENT OFFICE Thi invention relates to an appliance for use by persons who have undergone a colostomy or ileostomy. More specifically it has reference to a device for protecting the stoma against injury and prolapse, and to provide support for the stoma.

Where, in the following description and claims, I employ the word colostomy, I intend the same to refer also to an ileostomy, the medical distinction between the terms not being regarded as significant insofar as the invention is concerned.

Frequently the stoma protrudes a substantial distance exteriorly of the abdomen, sometimes as much as several inches, and in a suspended position. Accordingly, if the individual rolls over while asleep the stoma may be injured or subjected to painful pressure. Even the action of coughing has the effect of agitating the stoma and with consequent pain. Moreover, a vigorous cough, sneezing or extraordinary physical exertion may cause prolapse of the stoma.

It will be understood that individuals who are obliged to defecate through a segment of the colon or ilium which protrudes through the abdominal wall are required to wear constantly a bag or pouch, and that such bag is supported upon a belt. Most common of these is that form of bag which is provided at its upper open end with a rubber covered, rigid, annular member through the opening of which the stoma is positioned for emptying into the bag. The annular member is maintained in sealed contact with the persons body by means of a belt linked with hooks forming part of a retaining ring juxtaposed to the member. However in this form of appliance, as well as others less commonly used, the stoma has no protection beyond that afforded by the rubber or plastic material composing the bag, and such material being completely flexible is of no value in protecting the stoma against in jury or prolapse.

It is therefore one of the principal objects of the invention to provide a rigid member adapted to be mounted in conjunction with the bag, and so arranged as to guard the stoma against inury.

Another object is to provide a guard as aforesaid which is instrumental also in arresting prolapse.

A further object is to provide a guard as noted which includes a rigid part to protect the stoma from injury due to pressure exerted from without and yieldable means which, while supporting the stoma, will permit necessary normal movementthereof, as in emptying of the bowel.

12 Claims. (01. 128-283) 1 Still another object is to provide a device as aforesaid in which the yieldable means is so constructed and arranged, as to provide support for the stoma and additionally to protect the I same without blocking the opening thereof.

Another object is to provide yieldable means as stated which is adjustable for different individuals in whom the stoma is variously disposed.

An additional object resides in providing, in

one form of an appliance as aforesaid, means by which the force exerted by the spring is readily adjustable depending upon the characteristics of the stoma.

Generally regarded, the invention, in one prewferred embodiment, contemplates the provision of a rigid member arranged to be retained in predetermined relation with the bag and so coniormed as to provide a bridge over the stoma. Mounted on the bridge is a hinged element together with bias means normally to position the element for protecting the stoma while allowing normal movements thereof. Additionally the relatively fixed part of the hinged element may be carried pivotally on another axis to permit lateral arcuate adjustment of the element in accordance with the disposition of the stoma. In another aspect the, invention may take the form ofa simple cup-shaped element adapted to bear gently but firmly on the stoma and influenced into such position by a compression spring secured at one end to the element and at the other end to the bridge.

,In the drawing, which depicts certain forms which the invention may assume in practice;

; Fig. l is a front elevational view of the bag and of the invention improvement in operative relation therewith;

Fig. 2 is a longitudinal cross-sectional view taken on the line 2--2 of Fig. 1, and on an enlarged scale;

Fig. 3 is a side elevational view showing details of the invention;

Fig. 4 is a transverse cross section taken along the line 4-4 of Fig. 1; and

Fig. 5 is a plan view of a modified form of the invention.

Referring to Figs. 1 to 4, the bag unit proper Ill is indicated as being positioned on the persons body H, while the stoma is shown at I12. Inasmuch as the bag in general is the same as that disclosed for example in United States Letters Patent No. 2,048,392, the same will not be elab orated upon beyond pointing out those parts thereof with which the invention device is intended to cooperate. i l

Serving as a supporting means for the bag I is a rigid annular member 15 having a pair of laterally opposed hooks Iii-I6 for receiving the links lll7 at the ends of the body-embracing belt 18. Arranged to be received intermediate the annulus l and links it are the two cars i9l9 of a bridge member 22. If desired the abutting faces of the annulus I5 and ears l9-I9 may be correspondingly deformed, as by dimpling, to increase frictional engagement therebetween.

It will be seen that the bridge 22, which is preferably of stiff metal, is curved outwardly, in lateral aspect, to form an arch 23, andv that in anterior aspect the arch 23 is of arcuate configuration to define an area therebelow for the parts to be described. The degree to which the arch is offset at its point of greatest forward displacement will depend upon the individual case, but in any event will be sufiiciently curved so as not to present any firm surface against which the stoma may be pressed, as might occur if the wearer were to roll over While in bed. Moreover the upward arcuity will also contribute in providing clearance for normal movement of the stoma.

Mounted for swinging movement upon a pivot 26 secured to the arch 23 is a hinge part or guard 21. To permit manual adjustment of the part 27 without the use of tools and to maintain such selected position frictionally a wave washer or dished washer 29 may be interposed. Alternatively the part 27 may be arranged in simple contiguous relation with a central, flattened portion of the arch 23 and friction between the contactihg surfaces depended upon to maintain the set ting. Additionally serrations or an equivalent expedient may be provided on the opposed faces toimplement the frictional engagement, or a setting once made may be permanently maintained by riveting or other fastening.

Hinge part 27 is provided with a pair of apertured lugs 3l-3i through which a pin 32 is secured as by peening over its ends. In turn the movable hinged part 34 is provided with lugs 35-45 also pivotally engaging the pin 32.. For biasing part 34 posteriorly there is provided a torsion spring 36 coaxial with the pin 32 and having its radially extending ends engaging the two hinge parts as will be understood. Springs is so designed as to furnish just sufficient force to prevent prolapse of the stoma and to yield with movements thereof, but not of a degree to cause annoyance or pain to the person.

Hinge member 34- is preferably of the form shown in order to perform itsintended functions, and preferably comprises a somewhat cup-shaped. elementhaving an arouate forward wall it, and an arcuate lower wall 42, in order to conform as closely as possible to the contour of the depending stoma. Of particular importance is to so conform the. member 34 as to provide proper support without interference with elimination. I have found that the arcuate. bottom and front walls offer a fully acceptable configuration, the sloping side edges of the. front wall allowing the material exiting from the stoma to find passages at both sides of the guard 34 or at the bottom thereof. From. Fig-2 it will be observed that the posterior biasing of the guard may, to some extent press together the walls of the bag l0. However if this should occur, and delivery intothe bag, impeded slightly, the; manner in which the walls of the bag may be foldedwillstill, pro

vide channels at both sides of the guard, and as will be clear from Fig. 4.

In use, any induced movement of the stoma, such as would be induced by exertion, coughing, sneezing, elimination or otherwise will simply cause hingingmovement of the guard 34 against bias of the spring, and without sacrificing the continuous support the guard is intended to provide. Furthermore, any inclination of the stoma to prolapse will be effectively counteracted. Additionally the guard will tend to limit the protrusion of the stoma beyond the abdominal wall. It will be understood that excessive protrusion 1 thereof will expose more of the tissues to possible injury.

Of importance is the function of the guard in decelerating the elimination process, which when diarrheal in nature, is debilitating.

By mounting the invention improvement exteriorly of the bag no metal may touch the stoma to cause irritation, whereas the interposed relatively soft and pliable material of the bag presents a cushion between the guard and flesh. Thus the annoyance of cleaning the device. at frequent intervals is avoided. Moreover any necessary folding of the bag as at 5|5I to permitadaptation of the invention improvement is caught under the bridge 22, and therefore is incapable of adding unsightly bulk to the appliance as a whole.

Alternatively the spring 35 and the hinging' of, the member 34 may be dispensed with, and the latter rigidly secured to the bridge 22, and with or without means for lateral angular adjust- 'ment thereof.

A modified form of the invention, particularly adapted to stomas which protrude without depending, is i-llustrated' in Fig.. 5, and, for clarity, is shown as disassociated from the bag proper. In this case the bridge 22a. is so conformed as to present a central point, regarded in a vertical sense, substantially opposite the approximate end of the stoma. At such central point a rivet 55 secures a button 56 to which the smaller end of a. conical compression spring is secured. At its larger end the spring carries a dished element 51 which is secured to the spring by means of struckout lugs thereof or otherwise. It will be comprehended that the stoma is constrained. by the element 51 in ananterior-posterior sense as well as a, lateral sense. Preferably the element 51 is suitably perforated so as not toblock elimination.

WhileIhave-shown particular embodiments of my invention, it will be understood, of course, that I do not wish to be limited thereto, since many modifications may be made, and I. therefore contemplate by the appended claims tocover any such modifications as fall within, the true spirit and scope. of my invention.

Having thus described my invention, what. I claim. and desire to secure by Letters Patent is:

l. A colostomy appliance for the purpose described and adapted for use with a colostomy bag having means for supporting the bag on the body of the wearer comprising a member conformed to bridge over the stoma and including means for association with the bag-supporting means for maintaining the member in a predetermined relation to the stoma, and arigid cup-shaped element resiliently supported on said member including a substantially segmentally cylindrical portion having its axis substantially vertical and 'asubstantially segmentally spherical floor portion opening; upwardly and cojoined thereto together, and so conformed and positioned as to receive the weight and to oppose the prolapsive tendency of the stoma for maintaining a comfortable disposition thereof and to protect the same against injury.

A colostomy appliance for the purpose described and adapted for use with a colostomy bag having means for supporting the bag on the body of the wearer comprising a member conformed to bridge over the stoma and including means for association with the bag-supporting means for maintaining the member in predetermined relation to the stoma, a cup-shaped element including a substantially segmentally cylindrical portion having its axis substantially vertical and a substantially segmentally spherical floor portion opening upwardly and cojoined thereto together adapted to receive the weight and to oppose the prolapsive tendency of the stoma to support and protect the same against injury, and hinge means interconnecting said element member.

3. A colostomy appliance as recited in claim 2 further characterized by the provision of resili ent means intermediate said member and element for biasing said element into operative relation with the stoma.

4. A colostomy appliance for the purpose described and adapted for use with a colostomy bag having means for supporting the bag on the body of the wearer comprising a member conformed to bridge over the stoma and including means for association with the bag-supporting means for maintaining the member in predetermined relation to the stoma, a guard member adapted to bear against the stoma for supporting the same and for protecting the same against injury, and pin and aperture means for connecting said guard member to said bridging member for lateral pivotal adjustment of said guard member relative to said bridging member.

5. A colostomy appliance as recited in claim 4 further characterized in that said connecting means is also provided with a friction device for preserving a selected position of said guard memher.

6. A colostomy appliance for the purpose described and adapted for use with a colostomy bag having a rigid part for contact with the wearer and a flexible bag carried by said part and which part is provided with a pair of opposed hooks for engagement with a belt which encircles the body of the wearer comprising a member exteriorly of the bag having opposed portions for engagement with the hooks and belt for retaining the member in a predetermined position relative to the stoma, said member hav ing an arched configuration to overlie and protect the stoma, an element supported by said member positioned contiguous to the stoma, and resilient means for urging said element against the stoma.

7. A colostomy appliance as recited in claim 6 in which the support for said element includes a hinge intermediate said member and element and said resilient means includes a spring intermediate said member and element.

8. A colostomy appliance as recited in claim 6 in which the support for said element comprises a pivotal connection between said member and element for angular adjustment of said element about an anterior-posterior axis.

9. A colostomy appliance as recited in claim 6 in which the support for said element comprises a pivotal connection between said member and element for angular adjustment of said element about an anterior-posterior axis and hinge means for angular movement of said element about a lateral axis.

10. A colostomy appliance as recited in claim 9 in which the resilient means comprises a torsion spring incorporated with the hinge means and co-axial with the hinge axis.

11. A colostomy appliance for the purpose described and adapted to be supported jointly with a colostomy bag upon the body-embracing belt associated with the bag comprising arcuate member having portions for engagement with the belt, said arcuate member having a configuration such as to bridge the stoma and to protect the same against injury, an element carried on said member by pin and aperture means for movement about a laterally-extending axis, said element having a cup-shaped portion including a substantially segmentally cylindrical portion having its axis substantially vertical and a substantially segmentally spherical floor portion opening upwardly and cojoined thereto together adapted for receiving the stoma and for additional protection thereof, and resilient means intermediate said member and element for urging said portion against the stoma.

12. A colostomy appliance for the purpose described and adapted to be supported jointly with a colostomy bag upon the body-embracing belt associated with the bag comprising a member having portions for engagement with the belt, said member having an arched configuration to overlie and protect the stoma, a cup-shaped element carried by said member including a substantially segmentally cylindrical portion having its axis substantially vertical and a substantially segmentally spherical floor portion opening upwardly and cojoined thereto together adapted to apply pressure against the stoma to retain the same in a predetermined position, and resilient means intermediate said member and element for cushioning the stoma against the natural reflex movements thereof.

References Cited in the file of this patent (1st addition to No. 661,442)