US3613684A - Trocar catheters - Google Patents

Trocar catheters Download PDF

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Publication number
US3613684A
US3613684A US859413A US3613684DA US3613684A US 3613684 A US3613684 A US 3613684A US 859413 A US859413 A US 859413A US 3613684D A US3613684D A US 3613684DA US 3613684 A US3613684 A US 3613684A
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United States
Prior art keywords
catheter
rigid
distal end
plastic material
trocar
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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.)
Expired - Lifetime
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US859413A
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English (en)
Inventor
David S Sheridan
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Malco Inc
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Individual
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Assigned to MALLINCKRODT, INC. reassignment MALLINCKRODT, INC. CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: MALCO, INC.
Assigned to MALCO, INC., ST. LOUIS, MISSOURI A CORP. OF DE. reassignment MALCO, INC., ST. LOUIS, MISSOURI A CORP. OF DE. ASSIGNMENT OF ASSIGNORS INTEREST. Assignors: MALLINCKRODT, INC.
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Expired - Lifetime legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A61M25/09016—Guide wires with mandrils
    • A61M25/09033—Guide wires with mandrils with fixed mandrils, e.g. mandrils fixed to tip; Tensionable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/06066—Needles, e.g. needle tip configurations
    • A61B2017/06085—Needles, e.g. needle tip configurations having a blunt tip

Definitions

  • a trocar catheter is formed with a rigid shaftlike stylet and an encircling catheter made of plastic material.
  • the catheter has a molded rigid distal end member with a conical shape, a closed rounded tip fixed to a flexible tube, and at least one fluid opening through the side.
  • the rigid distal end member has an interior that conforms to the shape of the stylet tip.
  • the device may be used in emergency cases where the catheter is forced through the chest wall of a patient over the stylet which is then withdrawn to let fluid pass through the catheter or for suprapubic cystostomy procedures.
  • the present invention relates to trocar catheters which are designed primarily for insertion through a chest or stomach wall of a patient in order to allow fluid within a body cavity of the patient to bewithdrawn.
  • a procedure of this type is especially important in emergency cases where patients may require the withdrawal of blood, air or other fluid in the pleural cavity'because of an accident such as an automobile collision, assault by a firearm or the like.
  • suprapubic cystostomy penetration of the stomach wall may be necessary for drainage of the bladder when urethal catherization cannot be performed or for the taking of sterile urine samples.
  • trocar catheters are generally of an emergency nature requiring prompt relief of the patient's critical condition which may include a collapsed lung, air or fluid in'the pleural cavity or similar conditions which require creation of a fluid channel directly through the chest or stomach wall of the patient.
  • catheters of this type must be designed for reliability, but of simple and highly effective construction.
  • the trocar catheter must be capable of insertion through the chest or stomach wall of the patient without flexing or deviation from the desired path, e.g., passage between a pair of ribs.
  • the penetration of the catheter must be accomplished with a minimum of injury to nerves or vessels and without inflicting trauma on the expanding lung or collapsing bladder.
  • it is desirable for the catheter device to permit anyone using the catheter upon the patient to estimate the approximate position within the patient of the distal end of the catheter and to give some indication as to when the distal end of the catheter has entered the pleural area or bladder.
  • trocars As instruments for treatment of both human and animal bodies, trocars are well known. For example, they are widely used in embalming (see U.S. Pat. No. 2,639,484). Although they more generally are employed to introduce or withdraw fluids from a body, they may be used to extract tissue such as in a biopsy (see U.S. Pat. No. 2,541,542).
  • Trocar catheters may be of a single element construction such as a catheter of rigid or semirigid material with a pointed end capable of penetrating a body (see U.S. Pat. No. 1,273,542).
  • stylets with catheters to provide the catheter which is of flexible construction to obtain a sufficient degree of rigidity to permit the catheter to be properly placed within a patients body (see U.S. Pat. No. 2,118,631).
  • the combination of a rigid stylet and an encircling catheter has been used in the past in the creation of catheter devices of the general type to which the present invention pertains, namely, trocar catheters.
  • trocar catheters include means for insuring correct, effective or nontraumatic insertion of the catheter through the chest or stomach wall of a patient and means to insure the catheter penetrates to a required depth without overpenetration which can cause severe injury to the patient.
  • a principal object of this invention is the provision of new improvements in construction of trocar catheters.
  • Trocar catheter devices which prevent the catheter upon insertion 6 in a patient from penetrating beyond a required depth.
  • Such improved catheters which give the surgeon or physician using the device a visual indication as to when the distal end has entered the pleural cavity, bladder or other desired body cavity. 7
  • Trocar catheters whichwhen inserted in a patient, fill the entire body puncture, creating effective sealing of the catheter in the body to reduce possibility of infection and provide for proper functioning of the catheter.
  • A. a rigid stylet including:
  • a catheter formed of plastic material including:
  • a rigid distal end member molded of rigid plastic material with a smooth, close conical-shaped tip
  • said proximal end portion and central body portion being formed of flexible plastic material, the interior of said distal end member being molded to conform in shape to the tip of said rigid stylet, and
  • the interior of said central body portion being formed to closely encircle the surface of said rigid shaft.
  • the rigid stylet which constitutes the inner element of the new catheter devices has a square tip and the stylet is made of metal.
  • the preferred new catheters have a distal end member which has an outside surface of the same circumference as the circumference of the central body portion of the catheter and both of these are made of plastic material that is transparent.
  • a depth-penetration-limit means which movably embraces the outer surface of the central body portion of the catheter.
  • this comprises a slotted tubular member having a slotted radially extending collar affixed upon one end.
  • Such tubular member may be molded in two complementary half-sections of plastic material. Alternatively, it may be a singular element having a longitudinal slot pennitting the member to be compressed inwardly to grip the outer surface of the central body portion of the catheter.
  • FIG. 1 is a fragmentary top elevational view of a preferred embodiment of a trocar catheter in accordance with the invention.
  • FIG. 2 is an enlarged fragmentary side view partially in section of the distal and proximal end portions of the catheter of FIG. 1.
  • FIG. 3 is an enlarged top exploded view illustrating components used in making one embodiment of the new trocar catheter.
  • FIG. 4 is a reduced top elevational view of the catheter of FIG. 1 showing the depth of penetration limit means of the catheter device embracing the outer surface of the catheter.
  • FIG. 5 is a diagrammatic view illustrating placement of the catheter through the chest wall of a patient.
  • FIG. 7 is an enlarged, fragmentary side view of the distal end portion of a trocar catheter in accordance with the invention.
  • FIG. 8 is an end elevational view of one form of depth penetration limit means of the catheter devices in accordance with the invention.
  • FIG. 9 is an end elevational view of a modified form of depth penetration limit means.
  • a preferred embodiment of a trocar catheter 2 in accordance with the invention comprises a rigid stylet 4 and a catheter 6 formed of plastic material.
  • the tip 12 of the stylet 4 has a square tip 18.
  • the end 24 is formed of rigid plastic material while the remainder of the catheter 6 is formed of flexible plastic material.
  • this construction is attained by placing a cylindrical piece of rigid plastic in a heated mold and then forcing a flexible plastic tube in back of the rigid piece. The combination of heat and pressure softens the rigid piece, shapes the free end into a rounded tip 26 and welds the other end of the piece to the tube in a smooth junction.
  • One or more fluid openings 28 extend through the sidewall 30.
  • the catheter 6 comprises a rigid distal end member 32 having a smooth conicalshaped tip 34.
  • the member 24 is preferably molded, such as by injection molding, compression molding, centrifugal casting or the'like, of rigid or semirigid plastic material, e.g., nylon, polyvinyl chloride, or equivalent plastic materials.
  • the end member 24 may be formed of metal such as stainless steel by any suitable metalworking technique. Use of transparent rigid or semirigid plastic material for forming the distal end member 24 is preferred.
  • the preformed member 32 is fixed to the tube 36 by cementing, friction wielding or in any other suitable manner.
  • the catheter also comprises the central body portion 38 of cylindrical shape formed integrally with a proximal end portion 40.
  • These are preferably formed of flexible transparent plastic material by extrusion although other plastic-forming methods such as dipping, injection molding, centrifugal casting or the like can be used to form these portions of the catheter.
  • Unpigmented plasticized polyvinyl chloride is an advantageous type of plastic material to use in forming elements 38 and 40 although other flexible materials such as vinyl ester polymers, e.g., E.V.A., and the like may be used and, if desired, these may include pigments or fillers so that the tube is translucent or opaque rather than being transparent.
  • Such pigments may include X-ray opaque material so that part or all of the plastic catheter is opaque to X-rays permitting it position within a patients body to be readily determined by X-ray examination.
  • the central body portion 38 and proximal end portion 40 are made of uniform wall thickness and constant diameter throughout.
  • the catheter maybe formed with variation in diameter and wall thickness, lumen or the like, e.g., the proximal end 40 may be formed with heavier wall thickness, with a funnel construction 42 to provide a female connector end or with a male connector construction 45 to permit the catheter to be attached to auxiliary equipment which may be necessary or desirable in conducting operations on the patient in accordance with recognized surgical or clinical practice, e.g., as used with standard thoracic catheters.
  • the length of the rigid distal end member 24 or 32 is not critical although a short length of about 0.5 to 2 cm. is preferred so that maximum length of flexibility in the catheter can be obtained.
  • the distal end member 24 or 32 has a circumference identical to the circumference of the central body portion 38, particularly at the joint between these two elements.
  • the interior surface 44 of the distal end member 24 is molded to confonn in shape to the tip 12 of the rigid stylet 4.
  • the tip 12 of the stylet 4 is square ended and the distal end member 24 has an interior shape to accommodate this square ended stylet.
  • the catheter 2 preferably includes a depth penetration limit means 48.
  • This may assume various forms but advantageously comprises a tubular member 50 having a longitudinal slot 52 and a radially extending collar 54 which is similarily slotted.
  • the tubular member 50 may have more than one slot and as seen in FIG. 9 a pair of slots 52a and 52b may be used thereby dividing the tubular member 50 into a pair of complementary half-sections 50a an 50b
  • the tubular member 50 has only a single slot 52.
  • Such limit means can be molded of plastic material such as polyvinyl chloride, polystyrene, nylon or the like or alternatively, it may be cast, machined or otherwise formed of metal.
  • FIGS. 6 and 7 An alternative method of forming the new trocar catheters is shown in FIGS. 6 and 7.
  • a cylindrical plug 60 of rigid plastic material is placed in the end 62 of the tube 64 made of a flexible formulation of polyvinyl chloride.
  • This assembly is then placed in a mold (not shown) of the desired shape and is heated to a temperature, e.g., 250350 F that melts the plastic and the tube 64 is pushed into the mold to provide pressure to make the softened plastic take the shape of the mold.
  • the openings or holes 28 may be formed by known cutting or punching methods before or after the molding operations as described.
  • the method of use of the catheter is illustrated in FIG. 5 in an intercostal penetration to the pleural cavity.
  • the surgeon or other user estimates the distance along the central body portion 38 that penetration into the pleural cavity 72 of the patient, the catheter is to be inserted. A slight incision is made with a scapula or knife in the skin.
  • the penetration limit member 48 is then placed along the catheter so that the collar 54 is located at this critical position on the catheter 6. The user then grasps the penetration limit member 48 in one hand 74, exerting sufficient pressure on the unit 48 so that it tightly grasps the outer surface of the catheter 6.
  • the proximal end ball 16 is then palmed in the other hand 76 of the operator and the rounded point 24 of the catheter 6 is then placed in the skin incision positioned between a pair of ribs 78 and 80 of the patient in known manner so that the intercostal penetration can be made. This is accomplished by exerting simultaneous force through the hands 74 and 7.6 until the distal end member 24 of the catheter 6 penetrates the chest wall 82 of the patient and enters the pleural cavity 72. Once the skin is cut, the slightly blunted tip of the new trocar is quite easily forced through the rest of the tissue into the body cavity. Accidental overpenetration is prevented by the collar 54 of limit means 48 coming to rest against the skin on the chest of the patient.
  • a visual indication is given to the surgeon or other operator that the distal end opening 28 has entered the pleural area since blood or other fluid appears at the proximal end of the catheter by passing along the channel 10. This is not essential, however, and the channel 10 may be omitted in the construction of the stylet.
  • the stylet 4 is partially withdrawn from the interior of the catheter. The catheter is then clamped off and the stylet is completely withdrawn.
  • the proximal end 40 of the catheter will be connected to a closed underwater seal system or any other auxiliary equipment required for the patient under the particular circumstances and the patients injury or disease and the clamp is removed.
  • the smooth rigid tip construction of the new trocar catheters permits necessary penetration of the chest or stomach wall to be accomplished without inflicting trauma on the expanding lung or collapsing bladder. Further, with sharp pointed needles or trocar of prior types there is always the danger of puncturing the far wall of the bladder or the lung during the thorocotomy. This is obviated by the rounded rigid tip of the new catheters. Also, where the catheter must dwell in the patient for an extended period, the rounded tip mitigates possibility of puncture or other trauma.
  • A. a rigid stylet including:
  • a catheter formed of plastic material including:
  • central body portion of cylindrical shape integral with said proximal end portion and joined to said distal end member, c. said central body portion being formed of transparent flexible plastic material, the interior of said distal end member being molded to conform in shape to the square tip of said rigid stylet, and
  • the interior of said central body portion being formed to closely encircle the surface of said rigid shaft
  • depth penetration limit means including:

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Pulmonology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
US859413A 1969-09-19 1969-09-19 Trocar catheters Expired - Lifetime US3613684A (en)

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US85941369A 1969-09-19 1969-09-19

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US4318401A (en) * 1980-04-24 1982-03-09 President And Fellows Of Harvard College Percutaneous vascular access portal and catheter
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USD320857S (en) 1989-04-07 1991-10-15 United States Surgical Corporation Surgical bariatric trocar tip
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US5186168A (en) * 1984-11-21 1993-02-16 Spofford Bryan T Transtracheal catheter system and method
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US5279285A (en) * 1989-12-11 1994-01-18 Griggs William M Tracheostomy method and apparatus
US5297546A (en) * 1984-11-21 1994-03-29 Bryan T. Spofford Transtracheal catheter system and method
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USD354562S (en) 1993-02-22 1995-01-17 Richard-Allan Medical Industries, Inc. Trocar site stabilizer
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US5391178A (en) * 1994-02-14 1995-02-21 Yapor; Wesley Cerebral dilator
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USD364924S (en) 1993-02-22 1995-12-05 Richard-Allan Medical Industries, Inc. Trocar
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US5509909A (en) * 1994-10-06 1996-04-23 Moy; Grant G. Bent chest tube assembly
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US5618270A (en) * 1995-05-26 1997-04-08 Orejola; Wilmo C. Transthoracic aortic sleeve
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USD878597S1 (en) * 2017-03-29 2020-03-17 Jinfang Xiao Lung isolation catheter for equilibrium ventilation
USD885580S1 (en) * 2017-03-29 2020-05-26 Jinfang Xiao Lung isolation catheter for equilibrium ventilation
CN111820975A (zh) * 2019-04-16 2020-10-27 柯惠Lp公司 用于外科用缝合仪器的配接器组件的套管针组件
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JP2021515602A (ja) * 2017-12-28 2021-06-24 アヴェント インコーポレイテッド 切開トンネラ
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US4586921A (en) * 1983-08-17 1986-05-06 Daniel Berson Method of applying a local anesthetic agent to a wound
US4627838A (en) * 1983-12-09 1986-12-09 Bard Limited Stylet actuated winged catheter
DE3421170C2 (de) * 1984-06-07 1986-04-30 B. Braun Melsungen Ag, 3508 Melsungen Katheterbesteck für die Pleurapunktion
DE4416976C2 (de) * 1994-05-13 1996-06-05 Axel Arnold Spieß zum transcutanen Durchziehen eines Drainageschlauches
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CA945861A (en) 1974-04-23
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