WO2016139224A1

WO2016139224A1 - Surgical instrument

Info

Publication number: WO2016139224A1
Application number: PCT/EP2016/054378
Authority: WO
Inventors: Robert Mlynski; Christoph Punke
Original assignee: Universität Rostock
Priority date: 2015-03-04
Filing date: 2016-03-02
Publication date: 2016-09-09
Also published as: DE102015103166A1

Abstract

A surgical instrument is proposed for inserting a balloon catheter into the eustachian tube, said surgical instrument being made of a tube which consists of plastic and comprises a continuous channel (3) for the balloon catheter. The tube begins with a straight portion (1), to which a front portion (2) that is angled and/or curved relative to the straight portion is attached and which is used to handle the instrument. The tube has a bend which allows the application of the surgical instrument via the oral cavity. This allows the user to achieve a greater overview of the surgical region. Additionally, this alternative access path offers the prospect of treating patients even when the insertion of an instrument via the nose is not possible. The tube consists of a transparent plastic in order to allow the position of the inserted balloon catheter to be detected.

Description

Surgical instrument

The invention relates to a surgical instrument for introducing a

Tubal catheter.

In medicine, tube catheters are commonly used surgical instruments. For example, a balloon catheter for treating malfunctioning of the

Eustachian tube used. The balloon catheter is inserted through a rigid tube and then the balloon is inflated using sterile water (Danish Medical Journal April 2014).

For this balloon catheter exists an introducer having a rectilinear tubular rigid body and a displaceable in the tubular body shank for moving the balloon catheter. The

Insertion device is made of stainless steel or plastic. The material should enable a good sterilization (DE 20 2010 005 388 U

1 )-

Also known is a surgical instrument, which consists of an insertion tube and a displaceable in the insertion tube in the axial direction catheter. However, this is not a balloon catheter. This surgical instrument can be produced as a disposable instrument (DE 41 15 007 A1).

The known devices require because of the need to sterilize them before use, considerable effort in the treatment before and after sterilization. In addition, they are uncomfortable for the patient during use. Furthermore, there is a higher in previous instruments

Risk of injury (risk of bleeding and infection) due to the placement of several surgical instruments through the nose with limited freedom of movement of the instruments. A direct optical control of the position of the catheter ie immediate view of the catheter balloon is not possible. The invention is based on the object to provide an easy to implement and cost-effective way to insert a balloon catheter in particular in the Eustachian tube. To solve this problem, the invention proposes a surgical instrument with the features of claim 1. Further developments of the invention are

Subject of dependent claims. The invention also proposes the

Use of such a surgical instrument. The serving for insertion tube thus contains a substantially rectilinear portion on which the surgeon attacks to align the tube and

insert. The front section, which is angled and / or bent, allows the instrument to be introduced with less annoyance to the patient, thus facilitating the insertion of the tube catheter. By forming the tube from a transparent or translucent plastic, the position of the catheter can be checked continuously. The degree of transparency is chosen so that the catheter is visually recognizable at first glance. In a further development of the invention, the tube may have a suction port, which is arranged in the rectilinear portion of the tube.

The insertion opening for the catheter can be formed in training, for example, at the distal end of the tube itself. However, it is also possible to arrange the insertion opening laterally on the tube with a certain distance from the end of the tube. The insertion opening may be inclined in the wall of the tube to prevent the insertion of the catheter and the

Pushing through the channel to facilitate. In a further embodiment of the invention can be provided that the

Suction port is formed laterally on the pipe.

In a further development of the invention can be provided that the front portion at least in the transition region to the rectilinear portion under a obtuse angle, for example, is about 120 to 150 degrees. The front portion therefore deviates at least in its initial region by an angle of about 30 to 60 ° from the longitudinal axis of the rectilinear portion,

in particular by about 45 °.

The front portion can from the rectilinear portion a

Pipe bend to make the transition between the rectilinear portion and the front portion of the tube continuously. It may be provided according to a further feature that the front portion is in turn angled or bent, for example, has at least two mutually angled or bent subsections. It can be provided that the angling or bending out of the plane in which the rectilinear portion lies, leads out.

In yet another embodiment of the invention can be provided that the surgical instrument is intended for single use, so it is disposed of after use. The strength and stability of the plastic pipe therefore need not be interpreted for the possibility of multiple sterilization or multiple use. The instrument is supplied sterile in sterile packaging and used as a disposable instrument.

In a further development can be provided that the plastic tube is rigid, which facilitates its handling. Because the insertion of the plastic tube must be done by pushing, as the surgeon attacks on the rectilinear section.

However, it can also be provided that the plastic tube is semi-rigid, that has a certain flexibility.

The degree of flexibility can be realized both by the choice of material and by the geometric design. It is also conceivable, the front portion of the plastic tube using a smaller wall thickness something more flexible than the rectilinear section on which the attending physician attacks.

The invention also contemplates the use of a surgical element as described herein for introducing a tube catheter. Due to the bending of the tube, the application can be performed through the oral cavity. This allows the user to get a better overview of the surgical area. In addition, this alternative access route offers the prospect of providing patients with cases where insertion of an instrument through the nose is not possible.

Further features, details and advantages of the invention will become apparent from the claims and abstract, the wording of which is incorporated by reference into the description, the following description

preferred embodiments of the invention and with reference to the drawing.

Individual features of the different embodiments can be combined in any way, without departing from the scope of the invention.

In the drawing show:

Figure 1 is a side view of the proposed by the invention

surgical instruments;

Figure 2 is a view of the instrument shown in Figure 1 from above in

FIG. 1;

Figure 3 is a partial view of the front portion approximately in the direction of arrow III in

Figure 2; Figure 4 perspective view of the front end of the instrument.

FIG. 1 schematically shows the view of the surgical instrument proposed by the invention in a lateral view. The surgical instrument is formed by a tube having a rectilinear section 1 has, to which a front portion 2 connects. Through the pipe runs a continuous channel 3, which is only indicated in the drawing. At the lower in Figure 1, so the distal end of the instrument a insertion opening 4 is formed for the balloon catheter, to whose introduction the instrument is used. The distal end 5 of the instrument is slightly conical.

With a certain distance from the distal end 5 of the instrument, a suction port 6 is disposed in the wall of the tube, which communicates with the channel 3 in

Connection stands.

At the end of the straight section 1 of the tube, the front section 2 connects via a bend or a bend. In the side view of Figure 1, the front portion 2 deviates from the axis of the rectilinear portion by an angle of about 45 °. At the end 7 of the front portion then the outlet opening 8 is formed for the balloon catheter.

The front section 2 starts with a bow 2a. This sheet 2 a lies in the same plane as the straight section 1. This is then followed by the two sections 2 b and 2 c, which in turn lie in a common plane, but which extends angled relative to the plane of the straight section 1 and the sheet 2 a. The angle between the two levels is in the range of 30 to 60 °. This can be seen from Figure 2, which is a view of the

Instruments from above in Figure 1 shows. FIG. 3 shows the front section 2 of the instrument from a further one

Direction on an enlarged scale. The angled portions of the two sections 2b and 2c of the front section 2 are each made at an angle of approximately 45 ° with respect to the longitudinal axis of the respective preceding section 2a, 2b. The length of the two subsections 2b, 2c is in the range of about 2 cm.

FIG. 4 shows in a broken perspective view of FIG

Handling end from the front of the instrument. Finally, on the rectilinear section 1 of the surgical instrument, the arch 2a of the tube, which is still in the same plane as the latter. Angled towards the Arc 2a then follows the section 2b, and this section 2b is followed by the front section 2c. This is again in the same plane as the section 2b, but this is opposite angled again, but in the same plane.

Using the instrument:

The instrument is placed with its front section over the mouth in the

Nasenrachen the patient advanced and can be introduced here in the Eustachian tube. During this operation, the operator attacks the straight section 1 to align and push the tube forward. After inserting the instrument then the balloon catheter in the

Sliding opening 4 inserted and pushed through the channel 3. Due to the transparency of the plastic tube, the position of the catheter can be checked visually at any time.

Claims

claims

1 . Surgical instrument for inserting a tube catheter, with

- One from a translucent to transparent plastic

existing pipe that

- Starting from the area of its distal end (5), in the

essential rectilinear section (1) and

- Subsequently, an angled and / or bent

Having front section (2),

- Passing through the pipe at the front end of the

Front section (2) outgoing channel (3) for the catheter and with

- An insertion opening (4) for the catheter in the region of the distal end (5) of the tube.

2. Instrument according to claim 1, with a suction port (6) in the rectilinear section.

3. Instrument according to claim 1 or 2, wherein the insertion opening (4) for the catheter at the end of the rectilinear portion (1) opens out at the tube.

4. Instrument according to claim 2 or 3, wherein the suction port (6).

opens laterally at the tube.

5. Instrument according to one of the preceding claims, wherein the

Transition between the rectilinear portion (1) of the tube and the front portion (2) via a pipe bend (2a) takes place.

6. Instrument according to one of the preceding claims, wherein in a side view of the transition between the rectilinear portion (1) of the tube and the front portion (2) forms an obtuse angle.

7. Instrument according to one of the preceding claims, wherein the

Front portion (2) has at least two mutually angled or bent portions (2b, 2c).

8. Instrument according to one of the preceding claims, designed as a disposable instrument.

9. Instrument according to one of the preceding claims, wherein the

Plastic tube is at least partially rigid.

10. Instrument according to one of the preceding claims, wherein the

Plastic tube is formed at least partially semi-rigid.

1 1. Use of an instrument according to any one of the preceding claims for facilitating the insertion of a balloon catheter.

12. Use according to claim 1 1, wherein the balloon catheter only after the at least partial insertion of the front portion (2) in the

Body openings of the patient is inserted into the plastic tube.

13. Use according to claim 1 1 or 12, wherein the surgical instrument is used once and then disposed of.