WO2007018472A1 - Device and method for tracheotomy - Google Patents
Device and method for tracheotomy Download PDFInfo
- Publication number
- WO2007018472A1 WO2007018472A1 PCT/SE2006/050279 SE2006050279W WO2007018472A1 WO 2007018472 A1 WO2007018472 A1 WO 2007018472A1 SE 2006050279 W SE2006050279 W SE 2006050279W WO 2007018472 A1 WO2007018472 A1 WO 2007018472A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- branch
- receiving means
- trachea
- distal end
- sharp object
- Prior art date
Links
- 238000000034 method Methods 0.000 title claims description 50
- 210000003437 trachea Anatomy 0.000 claims abstract description 40
- 210000000867 larynx Anatomy 0.000 claims abstract description 8
- 238000005259 measurement Methods 0.000 claims description 15
- 210000001260 vocal cord Anatomy 0.000 claims description 13
- 238000004891 communication Methods 0.000 claims description 6
- 230000000149 penetrating effect Effects 0.000 claims description 5
- 238000009423 ventilation Methods 0.000 claims description 5
- 206010016717 Fistula Diseases 0.000 claims description 3
- 230000003890 fistula Effects 0.000 claims description 3
- 239000012530 fluid Substances 0.000 claims description 3
- 210000004072 lung Anatomy 0.000 claims description 2
- 230000003519 ventilatory effect Effects 0.000 claims 1
- 210000003739 neck Anatomy 0.000 description 15
- 206010002091 Anaesthesia Diseases 0.000 description 4
- 230000037005 anaesthesia Effects 0.000 description 4
- 230000035515 penetration Effects 0.000 description 4
- 210000001562 sternum Anatomy 0.000 description 4
- 206010052428 Wound Diseases 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 239000004033 plastic Substances 0.000 description 3
- 230000000241 respiratory effect Effects 0.000 description 3
- 208000004756 Respiratory Insufficiency Diseases 0.000 description 2
- 238000002690 local anesthesia Methods 0.000 description 2
- 201000003144 pneumothorax Diseases 0.000 description 2
- 239000004810 polytetrafluoroethylene Substances 0.000 description 2
- 229920001343 polytetrafluoroethylene Polymers 0.000 description 2
- 201000004193 respiratory failure Diseases 0.000 description 2
- 210000001685 thyroid gland Anatomy 0.000 description 2
- 238000002627 tracheal intubation Methods 0.000 description 2
- 206010018498 Goitre Diseases 0.000 description 1
- 208000032843 Hemorrhage Diseases 0.000 description 1
- 206010061307 Neck deformity Diseases 0.000 description 1
- 206010033799 Paralysis Diseases 0.000 description 1
- 241000223503 Platysma Species 0.000 description 1
- 208000010476 Respiratory Paralysis Diseases 0.000 description 1
- 206010042674 Swelling Diseases 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 208000034158 bleeding Diseases 0.000 description 1
- 231100000319 bleeding Toxicity 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
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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
- A61M16/0472—Devices for performing a tracheostomy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0493—Protective devices for suturing, i.e. for protecting the patient's organs or the operator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
- A61B2017/3405—Needle locating or guiding means using mechanical guide means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
Definitions
- the present invention pertains to the field of tracheotomy, i.e. creation of an opening in the windpipe (trachea) just below the larynx towards the surrounding air.
- Tracheotomy is one of the most common life saving operations that is done within medical care.
- a tracheotomy- involves opening a hole in the neck part of the trachea.
- the term tracheostomy is sometimes used interchangeably with tracheotomy. Strictly speaking, however, tracheostomy usually refers to the opening itself while a tracheotomy is the actual operation.
- Open tracheotomy is a surgical operation that is performed in an operating theatre by a surgical team that consists of an ear, nose and throat surgeon, and preferably an assisting surgeon, as well as a theatre nurse, an anesthesiologist, and an anesthesia nurse and also a nurse's assistant.
- a sterile sheet environment is necessary. It is preferred to perform the operation on an intubated patient in anesthesia together with supplementary local anesthesia in the surgical area.
- the surgical operation is performed with the patient awake, in local anesthesia.
- a horizontal incision is made in the skin above the breastbone (above the suprastenal notch) . Then, a cut is performed sharply through the platysma.
- the straight neck muscles are pulled aside.
- the thyroid gland isthmus should preferably be avoided, but if it is in the way, it is split and bound up.
- the trachea is then opened with a horizontal incision for adults and with a vertical incision for children.
- a tracheal tube is inserted and connected to a respirator. Then the wound is closed with sparse sutures and finally the tube is fixed with sutures and tracheal bands.
- percutaneous tracheotomy has been established. This technique became widely spread despite highly frequent complications . The frequency of complications could be reduced considerably by introducing an endoscopical guidance.
- the result of this development was that the indications for a tracheotomy changed and specialists who perform a tracheotomy, who earlier exclusively were ear, nose and throat specialist, include now even intensive care physicians .
- percutaneous tracheotomy was already described during the sixties, but was not accepted as a secure surgical operation before the eighties when the group of Ciaglia introduced dilatators .
- the surgical operation may be performed bedside on an intensive care unit in anesthesia by two trained physicians, whereof one carries out the surgical operation and the other inspects the trachea from the inside by means of a bronchoscope. Moreover, an anesthesia nurse is necessary.
- the surgical area is locally anesthetized and a horizontal incision is made in the skin.
- a cuffed endotracheal tube is pulled up against the vocal cords.
- the tracheal wall is, under inspection via a bronchoscope, punctured with a needle through the endotracheal tube.
- a guidewire is introduced.
- a dilatator having increasing gauge is then introduced.
- a tracheal tube which is slipped on a dilatator, is introduced into the tracheostoma that is produced. The dilatator is withdrawn and the tracheal tube is positioned.
- the method does not leave any wounds that have to be sutured, and the tracheal tube is fixed in the same manner as with open technique.
- the patient's head must be kept centered, such that the puncture does not end up aside of the trachea.
- the position of the percutaneous tracheotomy- is also located 2cm above the breastbone.
- the surgical operation necessitates staff that is acquainted with this technique. A number of surgical operations under experienced supervision are necessary before it can be performed independently. The frequency of complications is rather high and comprises amongst others pneumothorax, perforation of the rear tracheal wall and oesophagus, as well as bleedings. The procedure is complicated with patients who have a short and thick neck, and patients having enlarged thyroid gland. It is not recommended for children.
- the percutaneous technique has eliminated drawbacks that an open tracheotomy involves, including the need of an operation theatre and staff intensive effort, and that it leaves an open wound that can become an infection site. Furthermore, it also puts heavy demands on surgical skill training. Moreover, the open technique is burdened with the risk of surgical complications. Hence, there is a need for an improved tracheotomy technique. In particular a device and method allowing for increased flexibility, cost-effectiveness, as well as patient safety and comfort would be advantageous .
- the present invention preferably seeks to mitigate, alleviate or eliminate, amongst others, one or more of the above-identified, or other, deficiencies and disadvantages in the art, singly or in any combination, and solves for instance the above mentioned problems at least partly by providing a device and a method according to the appended patent claims .
- a method is provided according to claim 14.
- the method of carrying out a tracheotomy comprises introducing a first branch of a device for facilitating tracheotomy down a trachea of a patient, such that the distal end thereof is located below the larynx, and arranging a second branch of the device on the outside of the neck with the distal end thereof located adjacent to the site that is intended for a tracheostoma, wherein the distal end of one of the first and second branches comprises a guide for a sharp object, and the distal end of the other branch comprises a receiving means, and wherein the first and second branch are joined to each other in such a manner that the guide is directed towards the receiving means, as well as penetrating the skin and tracheal wall with said sharp object in order to carry out the tracheotomy by directing the sharp object towards the receiving means though said guiding device.
- Figure 1 is a schematic illustration of a device that is configured to be used during creation of a tracheostomy in form of a forceps according to an embodiment
- Figure 2 is a schematic illustration of a device for facilitating tracheotomy in form of two connectable branches according to an embodiment
- Figure 3 is a schematic illustration of a device similar to Figure 1 having a measurement device fastened between its branches according to an embodiment
- FIGS 4, 5, 6 and 7 are schematic illustrations of a forceps based tracheotomy
- Figure 8 is a schematic illustration of a further embodiment of a device for facilitating tracheotomy
- Figure 9A and 9B are schematic illustrations of a further device for facilitating tracheotomy in two different states;
- Figure 1OA and 1OB are schematic illustrations illustrating the release of a locking mechanism of the device shown in Figures 9A and 9B;
- Figure 11 is a schematic illustration illustrating the two states shown in Figure 9A and 9B, respectively, with an alternative locking mechanism
- Figure 12A and 12B are detailed illustrations of an end region of one of the branches of the device of Figure 10.
- the endotracheal tube In order to be able to use the light source in practice as a point of identification, the endotracheal tube firstly has to be pulled up, in such a manner that the tip of the bronchoscope appears outside of the tubes' bottom edge. This necessitates a certain degree of caution in order not to extubate the patient.
- a device similar to a pair of pliers/forceps is used, having a first branch that is designed to be introduced down into the trachea, and a second branch that is located on the outside of the neck, opposite to the first branch.
- the first branch terminates in a protecting plate, and the other branch is provided with a guiding tube for a tracheal puncturing device, such as an obturator with a sharp tip or a needle.
- a tracheal puncturing device such as an obturator with a sharp tip or a needle.
- the first branch is introduced down into the trachea through an endotracheal tube.
- an inner branch of the device is introduced through the endotracheal tube, while the end of the outer branch during the process indicates the position of the end of the inner branch.
- the inner branch of certain embodiments of the tracheotomy facilitating device may has a scale, e.g. centimeter scale, similar to that found on endotracheal tubes. A reading is made on this scale how far below the end of the tracheal tube the tip of the inner branch or the receiving plate, respectively, is introduced. Thus a measure is provided that facilitates the whole tracheotomy process, as for instance a bronchoscopic surveillance of the process is omittable .
- the design of the forceps guarantees that the puncture is made correctly with regard to height, due to the angle of the guide at the tip of the outer branch.
- a sharp object like an obturator or a needle, and optionally a dilatator, is guided through the tip of the outer branch and is always directed towards a receiving device of the inner branch at a well defined location within the trachea, e.g. facing towards a bowl formed plate of the inner branch after penetration.
- the sharp object may engage the receiving device or it may be arranged so that it stops at the end of penetration a certain distance from the receiving device. For instance, the tip of the sharp object may be stopped by a suitable seat in the guiding means of the outer branch, e.g. as shown guide 96.
- tracheotomy it is important that the outer wall of the trachea is penetrated in order to create the tracheostoma.
- the dilatator When the dilatator has penetrated the tracheal wall and is put in place, the outer branch may be disconnected. The dilatation of the wall may then be done by means of the dilatator including an introduction of a tracheal port, also called trachport.
- An alternative procedure is to introduce the outer branch into the patient down along the side of the endotracheal tube.
- the branch rests in this case against the front side of the endotracheal tube and will be centered due to the fact that the larynx is triangular with its one apex directed forward.
- a further alternative procedure is to arrange the needle in such a way that it penetrates the trachea outwardly from the inside.
- an embodiment of a tracheotomy facilitating device comprises a device 1 similar to a pair of forceps 1, having a first branch 14 that is designed to be introduced down into the trachea, and a second branch 12 that is located on the outside of the neck, opposite to the first branch 14.
- the two branches are pivoted around a common axis 13.
- the first branch 14 terminates distally in a protecting plate 17, and the other branch is distally provided with a guiding tube 16 for a tracheal puncturing device, such as an obturator or a needle.
- the first branch is introduced down into the trachea through an endotracheal tube. This procedure is made easy by two handles 18, 19 on the proximal ends of forceps 1, respectively.
- this alternative device comprises two separate branches that cannot move pivotally in relation to each other, but which are pushed into one another at each proximal end 28, 29, respectively, until the opposite ends meet, i.e. the two branches may not be turned laterally.
- this tracheotomy facilitating device 2 comprises a first branch 24 that is designed to be introduced down into the trachea, and a second branch 22 that is located on the outside of the neck, opposite to the first branch 24.
- the first branch 24 terminates in a protecting plate 27, and the other branch is provided with a guiding tube 26 for a tracheal puncturing device, such as an obturator or a needle.
- the two branches 22, 24 are connectable to each other at ends 28, 29, as indicated by the double headed arrow in Figure 2.
- FIG. 3 Yet another embodiment of the device is illustrated in Figure 3.
- This embodiment of a tracheotomy facilitating device 3 is similar to the embodiment shown in Figure 1, having a first branch 14 and a second branch 12 pivotably connected to each other.
- device 3 further comprises a measurement device 30 in order to provide a determination of the distance from the exterior side of the patients' neck to the inside of the trachea.
- the measurement device may be a scale fastened between the branches 12, 14, as shown in Figure 3. By means of the scale a reading is provided how far the distal ends of device 3 are located from each other.
- Alternative measurement devices comprise magnetic distance indicator units, optical distance measurement units, etc.
- the distance measurement may directly be performed at the tip of the device (not shown in the figures), e.g.
- a detectable means in the distal end of inner branch 14 such as a magnetic element or another marker detectable from outside the patient's neck, as for instance by magnetic detection (Hall sensor) , ultrasonic detector (reflected sound wave) , light detector (of suitable tissue penetrating wavelength), etc.
- Figure 8 is a schematic illustration of a further embodiment of a device for facilitating tracheotomy. More precisely, the illustrated device 8 has two branches 82, 84 that are fixed to each other at connection area 81. The inner branch is releasably inserteable into an opening at the proximal end of the outer branch 84, as indicated by the dotted lines in Figure 8. Thus branch 84 may be fastened to each other, either by sliding the inner branch 82 into the outer branch 84, or by sliding the outer branch 84 over the inner branch 82.
- a suitable locking unit may be provided for locking the two branches to each other in order to avoid unintended release or misalignments.
- the branches 82, 84 are provided in a curved design further facilitating application of the device 8.
- Inner branch 82 has an even radius, facilitating introduction down into the trachea or endotracheal tube, as explained below with reference to the exemplary tracheotomy method.
- inner branch 82 of this embodiment is of circular diameter.
- Inner branch 82 is hollow in order to allow gas flow there through.
- the distal tip of inner branch 82 comprises both a receiving device 87 in form of a cutout, as well as a rounded tip 80.
- Tip 80 may be made of a plastic material having low friction, such as PTFE. This tip region is shown more detailed in Figures 12A and 12B.
- a gas connector 83 is in fluid communication with the hollow inner of branch 82, leading to receiving device 87.
- Figure 9A and 9B are schematic illustrations of a further embodiment of the device for facilitating tracheotomy, wherein two states are illustrated, respectively.
- Figure 9A shows the surgical position
- Figure 9B shows the introduction position of device 9.
- the illustrated device 9 has two branches 92, 94 that are pivotable to each other around a joint element 93.
- the inner branch is inserted into an opening at one proximal end of joint element 93, as shown in Figure 9A.
- the branches 92, 94 are provided in a curved design further facilitating application of the device 9, similar as device 8.
- the use of device 9 made even easier.
- Inner branch 92 is hollow in order to allow gas flow there through.
- the distal tip of inner branch 92 comprises both a receiving device 97 in form of a cutout, as well as a rounded tip 90.
- Tip 90 may be made of a plastic material having low friction, such as PTFE. This tip region is shown more detailed in Figures 12A and 12B.
- a gas connector 93 is in fluid communication with the hollow inner of branch 92, leading to receiving device 97.
- a Y-piece of a respirator may be connected to gas connector 93 by sliding it onto the latter. Also, gas communication may be provided towards the endotracheal tube from opening 93 by a channel 100, when the tube is surrounding the inner branch 92.
- Figure 1OA and 1OB are schematic illustrations illustrating the release of a locking mechanism comprised in joint element 93 of the device 9 shown in Figure 9A and 9B.
- the locking mechanism is based on two notches 98, 99, releasably locking the outer arm 94 to the inner arm 92 in predefined positions.
- a locking member 95 is engaging one of notches 98, 99 in the surgical and the introduction position of device 9, respectively.
- Fig. 1OA illustrates manual manipulation of locking member 95 by a finger of a user, schematically illustrated on the left of this Figure. The finger presses on member 95, pushing it perpendicular to the outer branch 94. The depressed, unlocked position is shown in Fig. 1OB.
- FIG 11 is a schematic illustration illustrating the two states shown in Figure 9A and 9B, respectively, with an alternative locking mechanism.
- the device 11 is shown in the surgical position by continuous lines, whereas the introduction position of device 11 is shown in dashed lines. More precisely, the illustrated device 11 has two branches 92, 114 that are pivotable to each other around a joint element 93. The inner branch is inserted into an opening at one proximal end of joint element 113.
- a locking mechanism comprised in joint element 113 of the device 11 comprises two notches 118, 119 arranged on the periphery of joint element 113, as shown in Figure 11. Similar to the embodiment of Figures 9A and 9B, a locking element 117 is releasably locking the outer arm 114 to the inner arm 92 in predefined positions by engaging one of notches 118, 119 in the surgical and the introduction position of device 11, respectively. Locking element 117 is released by drawing it out of a notch.
- the tracheostomy facilitating device such as the above illustrated forceps may be made of a particularly rigid plastic material and be disposable, or of metal for multiple use.
- the sharp object such as a needle, scalpel, etc. may be integrated with the distal end region of one of the branches, e.g. be formed as an integral part with said guiding means .
- the sharp object is oriented towards the receiving means and travels on a substantially straight trajectory towards said receiving means .
- the inner branch which is introduced down into the endotracheal tube may have a ventilation channel.
- the receiving means located at the distal end of this inner branch may be provided in the form of a bowl formed end, eventually integrated into the branch.
- the other branch which is outside of the patient, has at its end a guiding means, such as a holder or guide, e.g. of tubular hollow form, for guiding a puncturing means, such as needle, an obturator or another sharp object suitable for penetrating skin and into the trachea for cutting open the desired opening for the tracheostomy in the patient's neck.
- the guiding means and the receiving means are oriented towards each other, such that for instance when the puncturing means is guided in the guiding means, it is directed towards the receiving means.
- the puncturing means may for instance be integrated into the guiding means and thus be directed towards the receiving means together with the guiding means, e.g. on a substantially straight trajectory in a single plane.
- the puncturing means is thus facing the receiving means. The point or line where the branches virtually meet is the place for the tracheotomy.
- the patient 40 is intubated and ventilated through a traditional endotracheal tube 41 having e.g. a respirator or hand bellows connected at its proximal end for ensuring proper ventilation of the patient during the procedure.
- the endotracheal tube 40 has a cuff 42, i.e. an inflatable balloon, approximately lcm from its distal end.
- the cuff is positioned below the vocal cords 43, in the trachea 44, see Figure 4.
- the inner branch 14 may be is hollow, such that ventilation may be provided through the branch.
- the inner branch may be of a diameter that is smaller than the inner diameter of the endotracheal tube 41, such that it has also a longitudinal measurement rod or measurement scale for providing a control of how far down the branch is in relation to the endotracheal tube.
- the cuffed endotracheal tube 41 is then pulled out as far as possible, such that the cuff rests against the lower edge of the vocal cords . Then the inner branch 14 of device 3 is introduced down the endotracheal tube 41, as is illustrated in Figure 5.
- the connections of the respirator are switched, such that ventilation is provided through the inner branch 14.
- the outer branch 12 is moved, i.e. in this case pivoted around axis 13, towards the neck of the patient 40 and the desired position for the tracheotomy - 2cm above the upper edge of the breastbone / or as far below the vocal cords as desired - may be adjusted by moving device accordingly within the endotracheal tube 41 and consequently outside of the neck, respectively, until the desired position is determined.
- the guide 16 which is provided in the tip of the outer branch 12, provides guidance of the above mentioned puncturing device, such as a needle 60. Needle 60 is moved towards receiving means 17 through guide 16 for puncturing the trachea.
- the plate of the inner branch may receive the tip of the needle, such that no risk of injuries of the rear wall of the trachea is run, see Figure 6.
- the puncturing device is stopped facing the receiving device, before actually engaging with the receiving device, e.g. by a suitable scale on the puncturing device, or a stop device.
- a measurement device may be fastened between the branches as shown in Figure 3.
- the outer branch 12 is then fold away/removed in order to facilitate the continued dilatation of the tracheal wall for introduction of a trachport.
- the trachport will serve as a holder for a conventional tracheal cannula 70, see Figure 7.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Pulmonology (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Surgery (AREA)
- Emergency Medicine (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Pathology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP06769658.3A EP1919544B1 (en) | 2005-08-09 | 2006-08-09 | Device method for tracheotomy |
CA2617152A CA2617152C (en) | 2005-08-09 | 2006-08-09 | Device and method for tracheotomy |
CN2006800285457A CN101247846B (en) | 2005-08-09 | 2006-08-09 | Device and method for tracheotomy |
US11/997,822 US8573220B2 (en) | 2005-08-09 | 2006-08-09 | Device and method for tracheotomy |
JP2008525966A JP5059763B2 (en) | 2005-08-09 | 2006-08-09 | Apparatus and method for tracheostomy |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
SE0501786A SE0501786L (en) | 2005-08-09 | 2005-08-09 | Device and procedure for tracheotomy |
SE0501786-8 | 2005-08-09 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2007018472A1 true WO2007018472A1 (en) | 2007-02-15 |
Family
ID=37727581
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/SE2006/050279 WO2007018472A1 (en) | 2005-08-09 | 2006-08-09 | Device and method for tracheotomy |
Country Status (8)
Country | Link |
---|---|
US (1) | US8573220B2 (en) |
EP (1) | EP1919544B1 (en) |
JP (1) | JP5059763B2 (en) |
CN (1) | CN101247846B (en) |
CA (1) | CA2617152C (en) |
RU (1) | RU2419462C2 (en) |
SE (1) | SE0501786L (en) |
WO (1) | WO2007018472A1 (en) |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2009078097A1 (en) * | 2007-12-18 | 2009-06-25 | Sumitomo Bakelite Co., Ltd. | Guide tube having balloons for puncture |
WO2010050875A1 (en) * | 2008-10-31 | 2010-05-06 | Safetrach Ab | Device and method for tracheotomy |
WO2011012554A1 (en) | 2009-07-31 | 2011-02-03 | Safetrach Ab | A dilator assembly, a device for facilitating tracheostomy and methods of making a percutaneous tracheostoma |
WO2011032965A1 (en) * | 2009-09-18 | 2011-03-24 | Atos Medical Ab | Pharynx protector |
IT201700035827A1 (en) * | 2017-03-31 | 2018-10-01 | Alessandro Terrani | Device for optimally positioning a tracheostomy needle with respect to an endotracheal tube, and apparatus comprising said device connected to an endotracheal tube |
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CA2923628C (en) | 2013-09-23 | 2019-12-03 | Event Horizon Limited | Emergency tracheotomy device |
US10695089B2 (en) * | 2015-07-10 | 2020-06-30 | Medtronic, Inc. | Medical tools and methods for gaining access to extravascular spaces |
CN105381528A (en) * | 2015-10-14 | 2016-03-09 | 周天敏 | Auxiliary percutaneous tracheostomy tube |
US10080584B2 (en) | 2015-12-03 | 2018-09-25 | Timothy L. Miller | System and method for receiving tube forceps for use in body piercings |
US20200030561A1 (en) * | 2017-04-07 | 2020-01-30 | Hamad Medical Corporation | Kits and methods for retrograde percutaneous dilational tracheostomy |
CN108742756A (en) * | 2018-03-28 | 2018-11-06 | 芜湖聚潮信息科技有限公司 | A kind of gastroscope soft tissue folder |
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DE102004026316B3 (en) * | 2004-05-26 | 2005-06-23 | Dollner, Ralph, Dr. | Endotracheal tube for percutaneous dilatation tracheotomy has protection plate projecting from its distal end and expandible ballon adjacent distal end |
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- 2006-08-09 RU RU2008108839/14A patent/RU2419462C2/en active
- 2006-08-09 JP JP2008525966A patent/JP5059763B2/en not_active Expired - Fee Related
- 2006-08-09 CN CN2006800285457A patent/CN101247846B/en not_active Expired - Fee Related
- 2006-08-09 WO PCT/SE2006/050279 patent/WO2007018472A1/en active Application Filing
- 2006-08-09 CA CA2617152A patent/CA2617152C/en not_active Expired - Fee Related
- 2006-08-09 US US11/997,822 patent/US8573220B2/en active Active
- 2006-08-09 EP EP06769658.3A patent/EP1919544B1/en active Active
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US20040103900A1 (en) | 2002-12-03 | 2004-06-03 | Melker Jeremy S. | Tracheotomy surgical device |
DE102004026316B3 (en) * | 2004-05-26 | 2005-06-23 | Dollner, Ralph, Dr. | Endotracheal tube for percutaneous dilatation tracheotomy has protection plate projecting from its distal end and expandible ballon adjacent distal end |
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Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2009078097A1 (en) * | 2007-12-18 | 2009-06-25 | Sumitomo Bakelite Co., Ltd. | Guide tube having balloons for puncture |
JP5059875B2 (en) * | 2007-12-18 | 2012-10-31 | 住友ベークライト株式会社 | Guide tube with puncture balloon |
US8486100B2 (en) | 2007-12-18 | 2013-07-16 | Sumitomo Bakelite Co., Ltd. | Guide tube having balloons for puncture |
WO2010050875A1 (en) * | 2008-10-31 | 2010-05-06 | Safetrach Ab | Device and method for tracheotomy |
US20120090623A1 (en) * | 2008-10-31 | 2012-04-19 | Safetrach Ab | Device and method for tracheotomy |
EP2341971A4 (en) * | 2008-10-31 | 2016-04-27 | Safetrach Ab | Device and method for tracheotomy |
WO2011012554A1 (en) | 2009-07-31 | 2011-02-03 | Safetrach Ab | A dilator assembly, a device for facilitating tracheostomy and methods of making a percutaneous tracheostoma |
EP2281594A1 (en) | 2009-07-31 | 2011-02-09 | SafeTrach AB | A dilator assembly, a device for facilitating tracheostomy and methods of making a percutaneous tracheostoma |
US8997748B2 (en) | 2009-07-31 | 2015-04-07 | Safetrach Ab | Dilator assembly, a device for facilitating tracheostomy and methods of making a percutaneous tracheostoma |
WO2011032965A1 (en) * | 2009-09-18 | 2011-03-24 | Atos Medical Ab | Pharynx protector |
IT201700035827A1 (en) * | 2017-03-31 | 2018-10-01 | Alessandro Terrani | Device for optimally positioning a tracheostomy needle with respect to an endotracheal tube, and apparatus comprising said device connected to an endotracheal tube |
Also Published As
Publication number | Publication date |
---|---|
EP1919544A4 (en) | 2017-03-01 |
RU2419462C2 (en) | 2011-05-27 |
JP5059763B2 (en) | 2012-10-31 |
RU2008108839A (en) | 2009-09-20 |
EP1919544A1 (en) | 2008-05-14 |
CA2617152C (en) | 2014-04-08 |
CN101247846A (en) | 2008-08-20 |
US8573220B2 (en) | 2013-11-05 |
CA2617152A1 (en) | 2007-02-15 |
EP1919544B1 (en) | 2018-12-26 |
CN101247846B (en) | 2011-07-27 |
JP2009504236A (en) | 2009-02-05 |
SE0501786L (en) | 2007-02-10 |
US20080295848A1 (en) | 2008-12-04 |
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