US3039468A - Trocar and method of treating bloat - Google Patents

Trocar and method of treating bloat Download PDF

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US3039468A
US3039468A US78535559A US3039468A US 3039468 A US3039468 A US 3039468A US 78535559 A US78535559 A US 78535559A US 3039468 A US3039468 A US 3039468A
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cannula
cylinder
tube
mandrel
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Joseph L Price
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Joseph L Price
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61DVETERINARY INSTRUMENTS, IMPLEMENTS, TOOLS, OR METHODS
    • A61D1/00Surgical instruments for veterinary use
    • A61D1/14Devices for degassing animals' stomachs

Description

June 19, 1962 Filed Jan. '7, 1959 J. L. PRICE I TROCAR AND METHOD OF TREATING BLOAT 2 Sheets-Sheet l L INVENTOR.

/ JOSEPH L. Race.

0 BY 4 43 '4, J, W,

ATTOPNEJ S June 19, 1962 J. L. PRICE 3,039,463

TROCAR AND METHOD OF TREATING BLOAT Filed Jan. 7, 1959 2 Sheets-Sheet 2 25 7 q 3 2 l2 )1 i U 2;

25 13 INVENTOR. JOSE/ b L.P//E

A 7' TORNEVS United States Patent ()fiice Patented June 19, 1962 3,039,468 TROCAR AND METHOD OF TREATING BLOAT Joseph L. Price, 390 Rosemary Lane, Residing, Calif. Filed Jan. 7, 1959, Ser. No. 785,355 4 Claims. (31. 128-347) This invention relates to an improved trocar that is primarily intended for treating bloat in animals to release the gas accumulated in the stomach or intestines.

Where bloat occurs in cattle, it is usually necessary to take prompt steps to release the gas accumulated in the stomach of the animal that is suffering, or the condition may prove to be fatal. Failure to relieve the condition by employment of ordinary expedients has heretofore resulted in recourse to the use of a trocar which punctures the skin and stomach Wall and permits escape of the gas through the cannula, or tube that encloses the puncturing mandrel. Usually this procedure is adopted as a last resort due to the fact that the affected animal will be lost if the treatment is not successful, and the scant hope exists that fatal infection will not follow the treatment.

The usual reason for the fatal infection likely to follow the use of the conventional trocar is that a certain amount of the contents of the stomach is exhausted with the gas, and when the cannula is withdrawn, some of this material enters the peritoneal cavity resulting in the fatal infection.

One of the objects of the present invention is the provision of a trocar provided with means for drawing the stomach wall and the skin, or peritoneum together around the cannula when the latter extends into the stomach and through the outer hide or skin, and in holding the peritoneum and stomach wall together until they have become so united that the cannula may be withdrawn without their separating, so that no infection can take place in the peritoneal cavity clue to the entry therein of infection producing impurities from the stomach or elsewhere.

Another object of the invention is the provision of an improved method of treating a bloaded condition that substantially eliminates the likelihood of infection where the hide and stomach walls are pierced in order to exhause the gas and to relieve said condition.

Other objects and advantages will appear in the description and in the drawings.

In the drawings:

FIG. 1 is an isometric view of the trocar that is illustrative of the invention.

FIG. 1a is a partial view of a cow showing the location where the trocar is usually used in treating bloat.

FIG. 2 is an isometric view of the cannula including the means thereon, in expanded position, that is used to engage the inner surface of the stomach wall when the latter is drawn into close engagement with the peritoneum, or inner lining of the skin.

FIG. 3 is an isometric view of the puncturing mandrel removed from the cannula.

FIG. 4 illustrates the initial step in the treatment of bloat, in which the trocar extends through the skin and stomach wall and across the peritoneal cavity. The trocar is partly in section and partly in elevation.

FIG. 5 is a further step in use of the trocar in the present method, in which the adjacent sides of the stomach wall and the skin are drawn together and the mandrel is still in the cannula. The trocar is partly in section and partly in elevation.

FIG. 6 is similar to FIG. 5 in which the mandrel is removed.

FIG. 7 is a part sectional and part elevational view of a modification of the invention that is shown in the other views, but broken in length.

In detail, the trocar herein illustrated comprises an outer, elongated, open-ended cylinder 1 (FIG. 4) having a collar 2 slidably supported thereon for movement axially of said cylinder and substantially from end to end of the latter. This collar 2 has a radially outwardly projecting annular flange 3 at one end thereof, and one axially facing side 4 of said collar (FIG. 1) is preferably slightly convex in cross sectional contour extending from the outer surface of the cylinder 1 to the outer edge of the flange in a direction away from the end of the cylinder toward which surface or side 4 faces. The outer edge 5 (FIG. 1) of the flange 3 is preferably relatively thin, but not of a cutting thinness or sharpness.

Collar 2 is provided with any suitable means for releasably looking or securing it to the cylinder 1. A set screw 6 having a finger engageable head for turning it is illustrated as one such means. It should be noted that collar 2 proects axially from the flange 3 in the form of a hub, and set screw 6 threadedly extends through such hub.

The end 7 of cylinder 1 that is nearest to the hub or collar 2 projects slightly radially outwardly of the portion of the cylinder that mounts collar 2, and is preferably exteriorly knurled (FIG. 5). Thus this end portion 7 functions as a stop to prevent the collar from sliding olf the cylinder 1.

The opposite end of the cylinder 1 is exteriorly threaded for an extension 8, that will later be described more in detail.

Telescopically slidable within cylinder 1 is an elongated cylindrical, open-ended tube 9.

This tube 9 is longer than the cylinder 1 and therefore projects axially therefrom at its opposite ends.

The inner end of the tube 9 is the end that projects from the exteriorly threaded end of the cylinder 1, while the opposite end of tube 9 will be designated the outer end.

The inner end of tube 9 is formed with a plurality of equally spaced openings 11 (FIG. 6). These openings are in an annular row extending circumferentially of the inner end of tube 9, and the side of each opening that is nearest the inner end of the tube is in the form of a bar 12 that is at said inner end. Each bar 12 extends substantially tangentially of the cylindrical inner surface of the tube 9, and is a pivot for pivotally supporting one end of an elongated finger 13. In the drawing four fingers 13 are shown.

Each of the fingers '13 is formed with a loop or partial loop at one end encircling each of the pivots or bars '12 so that said fingers can swing from positions extending axially of the tube 9 and outwardly of the latter (FIG. 4) to positions extending radially outwardly of the axis of said tube (FIG. 2).

The outer surfaces of fingers 13 are convex in direction transversely of the lengths of said fingers, and the convex curvature thereof is substantially the same as the cross sectional contour of the outer surface of tube 9. Also the outer surfaces of the fingers will be substantially aligned with the outer surface of the tube 3 when said fingers are in collapsed position extending axially of the tube 9 (FIG. 4).

The width of each finger 13 is greater than its thicknessso that a substantial outer convex surface is provided on the outer side of each finger for engagement with the inside of the stomach wall of an animal, as. will later be described in detail. Also fingers 13 are equally spaced around the inner end of tube 9.

The inner side of each finger 13 that is opposite to the above described convex outer surface, is adapted to face the axis of the tube 9 when the fingers are in collapsed position.

As best seen in FIG. 2 the inner side of each finger 13 is rabbeted along the longitudinally extending edges of each finger to form a central raised rib 15 extending longitudinally of each finger.

The outer ends of fingers 13 are undercut or transverse ly beveled on their inner sides to provide an inclined end surface 16 at the outer end that faces generally toward the axis of tube 9 when the fingers are in the collapsed position as seen in FIG. 4.

It should be noted that the outside diameter of the outer end portion of the tube 9 is slightly less than that of the remainder of the tube, thereby providing a slight shoulder at 18. The outer end portion of the cylinder 1 is of slightly reduced inside diameter where it slides on the outer end portion of the tube 9, and therefore it has a shoulder complementary to shoulder 18 that engages the latter to limit the movement of cylinder 1 in direction toward the inner end of fingers 13 or to limit the movement of the tube 9 in the reverse direction or toward the outer end of cylinder 1 (*FIG. 4).

Threadedly secured on the threaded inner end of cylinder 1 is a tubular extension 8. This extension is formed with an imperforate end portion 20 (FIG. 1) at its end that connects with the cylinder 1, which end portion is adapted to overlie the pivoted ends of fingers 13 when the latter are in col-lapsed position and when shoulder 18 is in engagement with the complementarily formed shoulder on the cylinder 1.

This extension 19 is formed with axially elongated openings 2.1 that correspond in positions with the positions of fingers K13 and the beveled outer ends of the fingers partially extend over the complementarily beveled outer end surfaces 22 (FIGS. 1, 4) of the outer ends of openings 21. Thus the tube 9 is held by fingers 13 against rotation relative to the cylinder 1 and its extension 19, and the fingers 13 will lie spaced within the confines of the outer cylindrical surface of the extension 8. However, if the tube 9 is moved inwardly relative to the cylinder 1, the fingers will slide over the slanted end surfaces 22 to the radially extending positions seen in FIG. and will be held in this position against the material of the extension 8 at the inner ends of openings 21. The outer end of the cylinder 1 carries a set screw 23 that is adapted to releasably lock the cylinder 1 relative to tube 9 when the fingers 13 are in expanded position as seen in FIG. 5.

At this point it should be noted that the inside diameter of the extension 8 is approximately that of the inside diameter of tube 9.

Telescopically extending through the tube 9 and extension 19 is a puncturing mandrel 24 (FIGS. 3, 4). This mandrel has a sharply pointed inner end portion 25 that projects from the extension 19, and the outer surface of the extension 19 extending from openings 21 are slanted at a relatively slight angle with respect to the axis of the extension so as to be substantially a continuation of the inclined surfaces of the mandrel that define the sides of the pointed end portion 25 thereof. The degree to which mandrel 24 may project from the extension 8 may be manually regulated.

The terminating inner end of the extension 8 meets the mandrel in a relatively sharp end edge so that the mandrel and the extension coact to form a pointed end on the trocar.

The sides of the mandrel are formed with grooves 26 extending longitudinally thereof in which the ribs on the fingers 13 are adapted to be received and to fit when the fingers are in collapsed position. The outer end of the mandrel is provided with an end piece 27 adapted to be grasped by the hand and to also fit the palm of the hand for pushing the trocar and the mandrel.

The outer end of the tube 9 is provided with collar 28 4 that is recessed at its outer end to receive the hub 29 of the end piece 27 on the mandrel (FIG. 4).

In FIG. 1a the trocar is generally designated 36 in the approximate position on an animal 31 where it would be used to relieve a bloated condition.

In operation, the trocar may be initially in the condition seen in FIG. 1 in which the set screws 6 and 23 are tight with the fingers 13 collapsed within the extension 8 and the hub 29 seated in collar 28 that is on tube 9. The pointed end of the trocar is then thrust into the animal 31 passing through the skin 32 and stomach wall 33 (FIG. 4). The fingers *13 will be carried on the trocar into the stomach in collapsed position as seen in FIG. 1.

The next step would be to loosen the nut 23 that locks cylinder 1 and tube 9 together, and by firmly gripping the enlargement 7 on cylinder -1 and holding it, and urging the tube 9 inwardly or in a direction into the stomach, the fingers 13 will automatically spread to expanded position within the somach as shown in FIG. 2. After the fingers are so expanded, the tube 9 is again locked or secured to cylinder 1 so there can be no relative movement between them, and the collar or hub carrying flange 3 is forced against the outer surface of the skin 32 while the tube 9 and cylinder 1 may be pulled outwardly so that the skin 32 and stomach wall 33 are tight together, at which point the set screw 6 is tigtened and the mandrel 24 is completely withdrawn from the device (FIGS. 2, 6) thereby permitting the gas to escape. Obviously the mandrel may be employed in the event the bore in the device should become obstructed for any reason.

It will be seen from FIG. 6 that the cannula with the present device comprises the extension 8 and the cylinder 1. Since the skin and stomach wall or in some instances a wall of the intestine, are tightly sealed around the cannula, no infection can occur in the peritoneal cavity from material discharged from the somach.

The device as shown in FIG. 6 may be left in place for a sufiicient time to enable the walls 32, 33 to become permanently adhered, which occurs in a relatively short time. If desired, of course, the bore in the cannula may be closed by any suitable means.

Once the walls 32, 33 have become permanently adhered to each other, the device may be removed, and within a relatively short time thereafter the opening made by the device will close and heal.

The removal of the device of FIG. 6 is accomplished by loosening the set screw 23 and moving the tube 9 outwardly so that the fingers 13 will swing inwardly to collapsed position. It is obvious that the mandrel 24 may be inserted before collapse of the fingers if so desired, but the latter will move to collapsed position whether or not the mandrel is in the device.

The fact that the face 4 of the flange 3 is convex and terminates in a relatively thin outer peripheral edge is desirable in eifecting a tight seal between the skin and the stomach wall at the outer side of the cannula or extension 8. If the surface 4 were flat, the seal would be less effective around the device because of the large area of equal pressure, instead of the greatest pressure being localized around the cannula.

It is to be understood that various modifications may be made in the trocar without departing from the spirit of the invention. In its broadest aspect, the present trocar provides means for pressing the peritoneum and stomach walls together around an enclosed passageway that communicates between the interior of the stomach or intestine and the atmosphere, thereby enabling gas within the stomach or intestine, together with solids, to be discharged into the atmosphere free from contaminating the peritoneal cavity. The use of the term stomach and stomach wall is intended to include any portion of the digestive tract, or other cavity in the body, where the device may be used to accomplish similar results, or to remove fluid of any kind from such cavity.

One of the modifications is shown in FIG. 7 in which the cannula is shown at 40 and the mandrel 41 having the end piece 42 at one end thereof slidably fits in the bore 43 of said cannula, the said bore being unbroken and continuous from end to end.

The pointed end 44 of the mandrel 41 projects from the end of the cannula that is to be thrust into the animal and the outer surface 45 of the cannula from which the pointed end 44 projects is tapered similarly to the surfaces forming the sides of said pointed end.

Adjacent to the end surface 45, the cannula is formed with an annular outwardly opening recess 46 that forms an air chamber, the outer side of which is closed by an elastic diaphragm 47 of rubber or the like. This rubber diaphragm when in collapsed position is preferably at least within the confines of the axially projected cylindrical contour of the outer surface of the cannula 40 so as not to project therefrom.

A duct 50 extends axially of the wall of the cannula to a point adjacent to the end thereof that is opposite to the pointed end of the device, and at said point it communicates with a conventional filling valve 51 having the usual releasable check valve therein to admit air under pressure into the duct 50 for passage to air chamber 46, and from which duct and air chamber the air may be released by manual manipulation of the valve. A conventional valve of the type used in tires and tubes would be suitable for valve 51.

Mounted on the cannula for movement axially thereof is a collar having a radially outwardly projecting flange 53 that is the same as flange 3 in FIG. 1 and that has a surface 54 adapted to engage the outer surface of the hide or skin of an animal, such as the skin 32 in FIG. 4. The collar may be moved axially along the cannula for securing firmly thereto in any desired position therealong by a set screw 55.

In operation, the device as shown in FIG. 7 is first thrust through the hide 32 and stomach wall 33 of an animal suffering from a bloated condition. Air is then pumped through valve 51 and duct 50 into air chamber 46 causing the diaphragm 47 to expand radially outwardly to the desired degree, such as to position 56 or to even a greater degree. The marginal portions of diaphragm 47 are firmly vulcanized to the metal of the cannula, hence there will be no leakage, and the pump or other source of air under pressure can be detached from valve 51 with the diaphragm retained in its expanded position.

The collar 53 is then moved to firmly engage the outer surface of the skin at the same time as the diaphragm 47 firmly engages and seals off the opening caused by the cannula and the walls of the skin and stomach may be drawn together in the same manner as indicated in FIG. 5.

The mandrel is then withdrawn and the gas and other material in the stomach is expelled through the bore 43 Without danger of entering the peritoneal cavity.

The diaphragm may be deflated when the skin and stomach walls are attached, and the cannula Withdrawn, leaving the opening to close and heal as it will quickly do.

I claim:

1. A trocar including an elongated cannula and a mandrel removably supported therein coaxial with the longitudinal axis of said cannula, said trocar being adapted for insertion, longitudinally thereof, through the skin of an animal and through the enclosing wall of an internal cavity within such animal to a position with the opposite end portions of said cannula respectively projecting outwardly of said skin and into said cavity, expandable means carried by said trocar at the end portion of said cannula that is adapted to extend into said cavity movable from a collapsed position substantially disposed within the confines of the outer cross sectional outline of said end portion to an expanded position projecting radially outwardly of said cannula, a manually manipulatable means connected with said expandable means and projecting outwardly of the end portion of said cannula that is adapted to project outwardly of said skin for grasping by the fingers of a hand for moving said expandable means from said expanded position to said collapsed position when said expandable means is in said cavity, a collar supported on said last-mentioned end portion of said cannula for movement therealong axially thereof and a radially outwardly projecting flange rigid with said collar, means on said collar for securing the latter rigid with said cannula at any desired point along the latter, said flange being adapted to engage said skin for holding said skin and said enclosing wall together when said collar is moved toward said expandable means and when the latter is expanded within said internal cavity.

2. A trocar comprising an elongated cannula and a mandrel removably supported therein coaxial with the longitudinal axis of said cannula, said cannula comprising an outer cylinder having an inner end portion and an outer end portion and a tube telescopically supported within said cylinder having an outer end portion projecting outwardly of the outer end portion of said cylinder and an inher end portion terminating within the inner end portion of said cylinder, said mandrel projecting at one end from the said outer end portion of said tube and projecting at the other end thereof from the inner end portion of said cylinder, a collar mounted on said cylinder for movement axially thereof having a radially outwardly projecting flange rigid therewith, and means on said collar for rigidly securing it on said cylinder at any desired point along the latter, said mandrel being sli-dable longitudinally of said tube and cylinder out of the projecting end portion of said tube, and the outer sides of said other end of said mandrel being slanted to a point on its axis, the outer sides of said cylinder at the inner end thereof from which said mandrel projects being slanted similar to the slanted sides of said other end of said mandrel to facilitate thrusting said mandrel and cylinder through the skin and the stomach wall of an animal to a position with said skin in engagement with said flange and with said inner end portions of said cylinder and said tube within said stomach, and means on said inner end portion of siad tube swingable from a collapsed position within the confines of the outer outline of said cylinder to an expanded position projecting radially outwardly of said cylinder for engagement with the inner surface of said stomach wall, said inner end portion of said cylinder being formed with openings through which said fingers are adapted to move to said expanded position, said fingers being movable from said collapsed position to said expanded position upon moving said tube axially thereof relative to said cylinder in one direction and said fingers being movable from said expanded position to said collapsed position upon moving said tube axially relative to said cylinder in an opposite direction, means for releasably securing said cylinder and said tube rigidly together at one end or the other of said relative movement.

3. A trocar comprising: an elongated tubular cannula; a mandrel extending through said cannula projecting from opposite ends thereof; one projecting end of said mandrel at one end of said cannula having tapered sides terminating in a sharp point and a handle on the other projecting end of said mandrel for manual engagement for forcing the pointed end of said mandrel, in succession, through the skin of an animal and through a wall of its stomach forming openings therein; said mandrel being supported Within said cannula for withdrawal from the end of the latter that is adjacent to said handle; the outer surface of said cannula being cylindrical and substantially in continuation of said tapered sides whereby said skin and stomach wall will successively slide onto said outer surface with the edges of said openings in close sealing relation thereto upon continued movement of said mandrel and cannula into the animal after penetration of said skin and wall by said pointed end; wall engaging means on said cannula adjacent to its pointed end expandable radially outwardly thereof for engagement with the inner side of said stomach Wall after said means is moved to a position inside said stomach; means accessible to the hand of an operator at a point adjacent to said handle and connected with said wall engaging means for effecting said expansion of said wall engaging means; skin engaging means supported on said cannula at the end thereof adjacent to said handle for free movement toward said wall engaging means difierent distances sufiicient to tightly urge said skin and stomach Wall together in face to face relation when said stomach wall is against said wall engaging means and the latter is in expanded position, means for securing skin engaging means rigid with said cannula at any of said distances, and said mandrel being removable from said cannula from the end of the latter adjacent to said handle.

4. The method of treating an animal for bloat that comprises the steps of; forming a pair of substantially aligned openings in the outer skin and stomach wall of an animal, in succession and positioning a conduit in said openings extending from one to the other, in full sealing relation to the edges thereof as each opening is formed to preclude material from Within the stomach entering the cavity between said outer skin and said stomach wall; then drawing said skin and the wall of said stomach around said respective openings in tight engagement with each other, then opening said conduit to discharge of material within said stomach through said conduit.

References Cited in the file of this patent UNITED STATES PATENTS 1,213,001 Philips Jan. 16, 1917 1,434,964 Rose Nov. 7, 1922 1,863,057 Innes June 14, 1932 2,638,901 Sugarbaker May 19, 1953 2,779,335 Hausser Ian. 29, 1957 2,799,273 Oddo July 16, 1957 FOREIGN PATENTS 11,277 Great Britain 1907 179,842 Austria Oct. 11, 1954 748,666 France July 7, 1933

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