WO1993000124A1 - Obturateur de tube de tracheostomie articule - Google Patents

Obturateur de tube de tracheostomie articule Download PDF

Info

Publication number
WO1993000124A1
WO1993000124A1 PCT/US1992/005278 US9205278W WO9300124A1 WO 1993000124 A1 WO1993000124 A1 WO 1993000124A1 US 9205278 W US9205278 W US 9205278W WO 9300124 A1 WO9300124 A1 WO 9300124A1
Authority
WO
WIPO (PCT)
Prior art keywords
obturator
cannula
shaft means
flexible
width
Prior art date
Application number
PCT/US1992/005278
Other languages
English (en)
Inventor
Ian R. Carr
Denis Labombard
Original Assignee
Smiths Industries Medical Systems, 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
Application filed by Smiths Industries Medical Systems, Inc. filed Critical Smiths Industries Medical Systems, Inc.
Priority to DE69227110T priority Critical patent/DE69227110T2/de
Priority to AU22686/92A priority patent/AU659375B2/en
Priority to JP5501610A priority patent/JP2916261B2/ja
Priority to EP92914974A priority patent/EP0590084B1/fr
Publication of WO1993000124A1 publication Critical patent/WO1993000124A1/fr

Links

Classifications

    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0465—Tracheostomy tubes; Devices for performing a tracheostomy; Accessories therefor, e.g. masks, filters
    • 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
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/04—Tracheal tubes
    • A61M16/0402—Special features for tracheal tubes not otherwise provided for
    • A61M16/0429—Special features for tracheal tubes not otherwise provided for with non-integrated distal obturators

Definitions

  • the present invention relates to tracheostomy tube devices and more particularly to an improvement in guiding devices such as obturators that are used to assist in the insertion of a tracheostomy tube into a patient's trachea.
  • the obturator of the present invention is particularly designed for use with a tracheostomy tube which includes a non-constant radius cannula as a part of its configuration.
  • Tracheostomy tubes are widely used to supply air to the lungs of unconscious patients such as injured persons and patients undergoing surgery.
  • the tracheostomy tube In order for the tracheostomy tube to function as intended it must be properly applied to the trachea so that air can be directed through the tube and into the trachea. However, proper insertion of the tube represents a very difficult task and it is possible during the insertion procedure to miss the surgically prepared opening in the trachea and misguide the tracheostomy tube device into the surrounding tissue.
  • tracheal tube Failure to properly insert the tracheal tube can cause serious problems and incur dangerous consequences for the patient, otolaryngologists, Thoracic Surgeons, General Surgeons and other clinical professionals may experience difficulties in performing intubation procedures.
  • guides such as stylets or obturators are available to clinicians to guide and to assist the placement of such tubes in the patient's trachea.
  • the obturators are used to guide metal or polymeric tracheostomy tubes such as described, for example, in U.S. Patents 3,088,466 and 3,659,612 to Shiley et al.
  • the characteristic common feature of these tubes is a constant radius design of the cannula portion.
  • a constant radius cannula is defined herein as a cannula having a continuous curvature between its proximal and distal ends.
  • the obturator be not only easily insertable into the cannula, but also easily and safely removable after the intubating has been completed.
  • tracheostomy tubes used nowadays are designed to include a non-constant radius cannula.
  • a tracheostomy tube has at least two substantially straight cannula sections and a curved section located therebetween.
  • the arc of the curve may be designed as forming a right angle or approaching a right angle.
  • the straight sections may be of considerable length. The withdrawal of the obturator from the non-constant radius cannula presents a more difficult task.
  • U.S. Patent 4,471,776 to Cox describes an example of a tracheostomy tube including an obturator with an adjustable shape.
  • This obturator includes a malleable shaft which allows for the obturator placed inside the tube to be bent together with the tube to a desired curved configuration.
  • it is difficult to remove the obturator from the tracheostomy tube since the forces which maintain the curved geometry of the tube and the obturator have to be overcome.
  • the cannula maintains its shape and does not become occluded or distorted, such that an airway passway is maintained clear through the intubated cannula during and after the intubation procedure.
  • Another object of the present invention is to provide an obturator which is especially suitable for use with tracheostomy tubes which include a non-constant radius cannula.
  • a further object of the present invention is to provide an obturator which can be easily inserted and safely removed through straight and curved portions of the non-constant radius cannula.
  • Another object of the present invention is to provide an obturator which is highly flexible, but able to maintain the geometry of the cannula during the intubation procedure to prevent occlusion, collapse and distortion of the cannula, and to ensure an internal non- disturbed airway.
  • Still another object of the present invention is to provide an obturator which is highly flexible and will easily assume the preferred contour of the tracheostomy tube, and will maintain the internal geometry of the cannula during intubation.
  • Another object of the present invention is to provide a multi-component highly flexible obturator made as an integral, single piece member thereby eliminating possible failure of assembly points and enhancing safety of the device.
  • Still another object of the present invention is to provide a plastic obturator which has a simple structure and is inexpensive to manufacture.
  • a structure of the obturator for use in intubating tracheostomy tubes into a patient's trachea which includes a single-piece, flexible member having a distal end and a proximal end and a shaft means extending therebetween.
  • the shaft means is comprised of a substantially flat strip member and a plurality of segments substantially perpendicular to the flat strip member.
  • the flat strip forms a plurality of hinged portions alternating with the plurality of segments.
  • the flexible member has a grasping means formed at its proximal end and a tip member provided at its distal end.
  • the tip member has a bullet-like conical shape. A smooth transition zone is formed between the tip member and the outer diameter of the tracheostomy tube.
  • the single-piece, flexible obturator is made of polymeric material and the plurality of segments
  • protuberances are dimensioned such as to substantially correspond to the inner diameter of the cannula.
  • the present invention due to its structure and nature of the material, flexes easily at the hinged portions in the axis of the curved tube portion when it is being inserted or removed from the tracheostomy tube without applying forces which can cause changes in the cannula's shape.
  • the obturator when placed within the tube, substantially fills, with the plurality of segments, the interior of the cannula whereby maintaining geometry of the tube during the intubation. This, in turn, prevents occlusion or collapse of the tube during intubation and any distortion of the tube once in place in the patient's trachea, and ensures a non-disturbed airway through the tracheostomy tube device.
  • the structure of the present invention obturator is substantially resistant to compression forces, which typically in malleable wire-type stylet obturatprs or strap-like plastic current state of the art devices, because they do not fill the cannula completely, allow the obturator tip to push back and complicate the intubating procedure due to the lack of a smooth transition from the obturator tip to the tracheostomy tube outside the diameter.
  • the smooth transition is therefore secured between the tip member of the obturator and the outer diameter of the tracheostomy tube device to the present invention structure.
  • the single-piece obturator structure also increases the reliability of the tracheostomy tube assembly by eliminating additional possible failure points common to all devices of multicomponent configuration, an enhanced safety feature for both the clinician and the patient during intubation procedure.
  • Additional key features of the preferred embodiment of the present invention include a multi-geometry highly flexible single piece structure and polymeric material construction, resulting in a device that provides easier, more efficient and safer use during the intubation procedure increasing patient safety and comfort.
  • means are provided in the structure of the flexible obturator which prevent the tip of the obturator from being pushed up inside the tracheostomy tube, while the physician is placing the tube into the patient.
  • Figure 1 shows a perspective view of the first preferred embodiment of the present invention obturator
  • Figure 2 shows a side view of the embodiment of Figure
  • Figure 3 shows a cross-section of the first embodiment of the present invention obturator taken along lines 3'-3' in Figure 2;
  • Figure 4 shows a cross-section view of a non-constant radius tracheostomy tube with the obturator according to the present invention placed inside the tube;
  • Figure 5 shows a perspective view of the second preferred embodiment of the present invention obturator;
  • Figure 6 shows a cross-section view of the embodiment of Figure 5;
  • Figure 7 shows a perspective view of the third preferred embodiment of the present invention obturator;
  • Figure 8 shows a cross-section view of the embodiment of Figure 7 taken along lines 8-8• ;
  • Figure 9 shows a cross-sectional view of the embodiment of Figure 7 taken along lines 9-9• ;
  • Figure 10 shows a cross-sectional view of a non-constant radius tracheostomy tube with the obturator according to the third embodiment of the present invention inserted therein.
  • an obturator 10 which includes a single-piece member having a distal end 11, proximal end 12 and a shaft means 13 extending between the distal and proximal ends 11,12.
  • the shaft means 13 is comprised of a substantially flat member 19 having a rectangular cross-section and having a plurality of segments or protuberances 14 disposed substantially perpendicular to the flat strip member 19.
  • the rectangular cross-section of the shaft means has a width and a thickness with the width substantially exceeding its thickness.
  • This flat strip member 19 forms a plurality of hinged portions (or spaces) 15 alternating with the segments 14.
  • the segments 14 are bead-like shaped.
  • the obturator 10 includes a grasping means 17 formed at its proximal end 12, and a tip member 16 provided at its distal end 11.
  • the obturator 10 is made as an integral, plastic, single- piece device.
  • Fig. 4 shows tracheostomy tube 100 including a non- constant radius curved cannula 20 lying substantially within a given plane and having straight portions 32 and 34 and curved portion 36 located therebetween.
  • the cannula 20 includes a proximal end 24 and a distal end 22.
  • a connector 26 is connected to the proximal end 24 of the straight portion 32.
  • the obturator 10 for use in intubating the tracheostomy tube 100 into the patient's trachea is shown in place within the tracheostomy tube 100.
  • the obturator shaft means 13 flexes at the hinged portions 15 in the axis of the curved cannula portion 36.
  • the grasping means 17 forming in the preferred embodiment, a handle projects beyond the end 30 of the connector 26.
  • the tip member 16 of the obturator 10 projects beyond the end 22 of the cannula 20.
  • the tip member 16 has a bullet-like conical shape which facilitates the guiding of the tracheostomy tube during the intubating procedure.
  • the diameters of the plurality of segments 14 substantially corresponds to the inner diameter of the cannula 20. Therefore, when placed within the tube, the obturator substantially spans the interior of the cannula 20 which allows it to maintain the shape of the tube during the intubation.
  • Such a structure of the obturator is very advantageous, since it substantially prevents occlusion or collapse and distortion of the tracheostomy tube, and ensures the existence of a non-disturbed airway.
  • Figures 5 and 6 show another embodiment of the present invention in which the shaft 13 is comprised of a plurality of substantially flat disc-like circular segments 40 which are substantially perpendicular to the hinged portions 15 of the strip member 19.
  • the diameter of circular segments 40 also substantially corresponds to the inner diameter of the cannula 20.
  • 10 is made of a polymeric material, such as for example polyolefins. However, other plastic materials can be used which are suitable for a multi-hinged geometry.
  • the obturator 10 Due to the multi-hinged structure and the nature of the plastic material, the obturator 10 easily flexes only in the radial direction of the cannula 20 in the axis of the curved tube portion 36, whereby it is easily insertable and removable from the tracheostomy tube 100. These features of the present invention are particularly important and advantageous during the withdrawal of the obturator from the non-constant radius cannula, because the forces necessary for the withdrawal of the obturator from the cannula are substantially decreased.
  • the structure of the present invention obturator with the shaft means including a substantially flat strip member forming hinged portions and a plurality of segments perpendicular to the strip member and alternating with hinged portions, is substantially resistant to compression forces, which typically in malleable wire-type stylets/obturators, allow the obturator tip member to push back towards the inside of the cannula. This, in turn, complicates the intubating procedure due to the lack of a smooth transition between the obturator tip and tracheostomy tube outside diameter.
  • the smooth transition is provided between the tip 16 and the outer diameter of the tracheostomy tube.
  • the multi- component obturator 10 of the present invention is made as an integral single-piece, plastic device.
  • the number of bead-like or circular disc-like segments and hinge portions is selected with respect to the length of the tracheostomy tube and the position of the curved section.
  • the hinge-like structure allows the obturator to be highly flexible in the axis of the tube curved section.
  • the plurality of segments of the obturator substantially fill up the tube's interior maintaining the integrity of the tracheostomy tube, but at the same time allowing easy flexing during insertion or removal of the obturator from the tracheostomy tube.
  • the obturator's tip is designed with a straight section which absorbs the deflection of the tube and obturator size tolerance without compromising the streamline tip profile.
  • the handle projecting beyond the connector facilitates the withdrawal of the obturator from the tracheostomy tube.
  • Figures 7 to 10 show still another embodiment of the present invention obturator. While the embodiments shown in Figures 1-6 can be especially advantageously used with, for example, flexible pediatric tracheostomy tubes, the obturator shown in Figures 7 to 10 is particularly adapted for use with adult rigid tracheostomy tubes having a curved cannula lying substantially within a given plane and having a non-constant radius.
  • this embodiment also includes a single-piece member 10 made of flexible material, preferably plastic, which includes a tip member 16 at the distal end 11 and grasping means 17, forming a handle at the proximal end 12.
  • Shaft means 13 extends between the proximal and distal ends 11,12. The shaft means 13 over a substantial portion of its length is dimensioned such as to impart sufficient rigidity both in the direction substantially perpendicular and substantially parallel to the given plane of its curvature corresponding to a given plane of the cannula's curvature.
  • the portion of the shaft means 13 having rigidity is divided into a first and second rigid sections 51 and 52.
  • the shaft means 13 further includes a flexible section 53 which is positioned adjacent the distal end of the obturator between substantially rigid sections 51 and 52.
  • the first flexible section 53 is of a substantially rectangular cross-section and has a width and thickness, with the width as measured perpendicular to the given plane substantially exceeding the thickness.
  • the shaft means 13 is easily flexible along its length in the given plane of its curvature at the first flexible portion 53, but substantially stiff in a direction perpendicular to the given plane because of the greater width of its cross-section.
  • the rigid sections 51 and 52 include a first flat member 54 which has a rectangular cross-section corresponding to that of the flexible section 53 and is continuous therewith and also includes a web-like member 55 which is substantially perpendicular to the width of the first member 54.
  • the flexible section 53 includes at least one protuberance 57 positioned substantially perpendicular to the width of the flexible section 53 and spaced from the first and second rigid sections 51,52. Accordingly, the obturator flexes at the spaces between the protuberance and the first and second sections.
  • the flexible section 53 may include more protuberances spaced apart, such that the obturator would flex also at the space between the protuberances. This would be advantageous for obturators having an extended length.
  • the protuberances may have different shapes, such as, for example, circular discs, and bead ⁇ like members similar to those discussed with respect to embodiments shown in Figures 1-6.
  • the obturator is also provided with a second portion 58 which is provided behind the irst flexible portion 53 as seen along the length of the obturator 10 in the direction of its proximal end 12.
  • the second portion 58 is constituted by a raised fin member provided on the web-like member 55 of the first rigid section of the shaft means 13 and is so dimensioned that when the obturator 10 is inserted into the tracheostomy tube 100 it contacts in the inner wall of the cannula 20 preventing the obturator from collapsing inside the cannula and also preventing the distal tip end of the obturator from receding into the cannula.
  • This feature is extremely important since it prevents the tip of the obturator from being pushed up inside the tracheostomy tube while the physician is placing the tube into the patient.
  • the provision of a flexible section within the obturator design allows the physician to withdraw the obturator from the tube without necessarily following the line of curvature of the tube.

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  • Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Emergency Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne une combinaison constituée d'un tube de trachéostomie (100) comprenant une canule incurvée (20) sensiblement dans un plan donné et ayant un rayon non constant, et de moyen obturateur (10) pouvant s'introduire dans la canule pour guider l'intubation du tube de trachéostomie dans la canule. L'obturateur comprend un élément en une seule pièce constitué de matière résiliente et flexible et pouvant s'incurver lorsqu'on l'introduit dans la canule de rayon non constant et se trouvant dans le plan donné, cet élément en une seule pièce ayant des extrémités proximale (12) et distale (11) et une tige (13) s'étendant entre les deux extrémités, la dimension de la tige sur une bonne partie de sa longueur étant telle que sa rigidité est suffisante tant perpendiculairement que parallèlement au plan donné. La tige comprend également une première partie flexible de section sensiblement rectangulaire dont la largeur est supérieure à l'épaisseur, lorsque mesurée perpendiculairement au plan donné.
PCT/US1992/005278 1988-09-30 1992-06-19 Obturateur de tube de tracheostomie articule WO1993000124A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
DE69227110T DE69227110T2 (de) 1991-06-21 1992-06-19 Kombination eines obturators und einer luftröhrenkanüle
AU22686/92A AU659375B2 (en) 1991-06-21 1992-06-19 Hinged tracheostomy tube obturator
JP5501610A JP2916261B2 (ja) 1991-06-21 1992-06-19 気管切開管と閉塞具の組合せ
EP92914974A EP0590084B1 (fr) 1988-09-30 1992-06-19 Combination d'obturateur et de tube de tracheostomie

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US25209988A 1988-09-30 1988-09-30
US717,828 1991-06-21

Publications (1)

Publication Number Publication Date
WO1993000124A1 true WO1993000124A1 (fr) 1993-01-07

Family

ID=22954602

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1992/005278 WO1993000124A1 (fr) 1988-09-30 1992-06-19 Obturateur de tube de tracheostomie articule

Country Status (9)

Country Link
JP (1) JPH02174858A (fr)
AU (1) AU620152B2 (fr)
CA (1) CA1313101C (fr)
DE (1) DE3932598A1 (fr)
FR (1) FR2637187B1 (fr)
GB (1) GB2224213B (fr)
IL (1) IL91777A (fr)
SE (1) SE502532C2 (fr)
WO (1) WO1993000124A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9808604B2 (en) 2013-04-01 2017-11-07 Terumo Kabushiki Kaisha Guide wire

Families Citing this family (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CA2111861C (fr) * 1988-09-30 1995-10-10 Ian R. Carr Obturateur articule d'une canule de tracheotomie
DE4232082A1 (de) * 1992-09-25 1994-03-31 Ruesch Willy Ag Absperrhahn
DE19513831C1 (de) * 1995-04-12 1996-05-02 Tracoe Medizine Ges Fuer Tracheostomiekanüle
DE19534652A1 (de) * 1995-09-19 1997-03-20 Goran Dr Skoljarev Hilfsmittel zum Einführen eines Endotrachealtubuses in die Luftröhre bei den geänderten anatomischen Verhältnissen im Hypopharyngs oder Kehlkopf, wenn eine Darstellung des Kehlkopfeinganges mit Hilfe eines Laryngoskops nicht, oder nur teilweise möglich ist
GB9617545D0 (en) 1996-08-21 1996-10-02 Smiths Industries Ltd Medical tube assemblies
GB9908136D0 (en) * 1999-04-12 1999-06-02 Smiths Industries Plc Obturators and tube assemblies
US7243653B2 (en) * 2003-06-06 2007-07-17 Radlyn Llc Intubation device
US11464403B2 (en) 2017-01-23 2022-10-11 Teikyo University Tracheal tube insertion aid kit
US11033714B2 (en) * 2017-12-15 2021-06-15 Biosense Webster (Israel) Ltd. Catheter with biased and discrete deflection characteristics and related methods
GB202104206D0 (en) 2021-03-25 2021-05-12 Smiths Medical International Ltd Obturators and tube assemblies

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3794041A (en) * 1971-11-30 1974-02-26 Yeda Res & Dev Gastrointestinal catheter
US4231365A (en) * 1978-01-30 1980-11-04 Scarberry Eugene N Emergency resuscitation apparatus

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US3334631A (en) * 1964-09-11 1967-08-08 Dow Corning Tracheal tube assembly
FR1442810A (fr) * 1965-07-29 1966-06-17 Dow Corning Assemblage de tubes pouvant s'adapter dans la trachée
US3753439A (en) * 1971-08-24 1973-08-21 Elias & Brugarolas General purpose surgical drain
US3802440A (en) * 1972-12-19 1974-04-09 M Salem Intubation guide
GB1528279A (en) * 1976-08-26 1978-10-11 Khoury F Tracheobronchial sampler device
US4278081A (en) * 1978-02-21 1981-07-14 Jones James W Tracheal tube
US4244362A (en) * 1978-11-29 1981-01-13 Anderson Charles C Endotracheal tube control device
US4340046A (en) * 1980-12-08 1982-07-20 Cox Everard F Static tracheostomy tube
US4471776A (en) * 1980-12-08 1984-09-18 Cox Everard F Static tracheostomy tube
US4520810A (en) * 1981-10-02 1985-06-04 Sol Weiss Apparatus for performing an emergency cricothyrotomy
US4459984A (en) * 1982-09-15 1984-07-17 Liegner Kenneth B Speaking tracheostomy tube
US4612340A (en) * 1983-03-09 1986-09-16 Yoshinori Ohachi Medical device
JPS60135063A (ja) * 1983-12-09 1985-07-18 ジエイムス・アール・ヒユーレン 腸供給管
DE3400872A1 (de) * 1984-01-12 1985-07-25 Christian Prof. Dr.med. 2400 Lübeck Krüger Instrument zum freihalten der oberen atemwege und zur durchfuehrung von intubationen

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3794041A (en) * 1971-11-30 1974-02-26 Yeda Res & Dev Gastrointestinal catheter
US4231365A (en) * 1978-01-30 1980-11-04 Scarberry Eugene N Emergency resuscitation apparatus

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9808604B2 (en) 2013-04-01 2017-11-07 Terumo Kabushiki Kaisha Guide wire

Also Published As

Publication number Publication date
AU4230789A (en) 1990-04-05
IL91777A (en) 1993-05-13
GB8921600D0 (en) 1989-11-08
CA1313101C (fr) 1993-01-26
GB2224213B (en) 1992-04-01
GB2224213A (en) 1990-05-02
SE502532C2 (sv) 1995-11-06
SE8903146D0 (sv) 1989-09-25
AU620152B2 (en) 1992-02-13
JPH0565199B2 (fr) 1993-09-17
SE8903146L (sv) 1990-03-31
FR2637187B1 (fr) 1994-02-04
DE3932598A1 (de) 1990-04-05
FR2637187A1 (fr) 1990-04-06
JPH02174858A (ja) 1990-07-06
IL91777A0 (en) 1990-06-10
DE3932598C2 (fr) 1992-08-27

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