ZA200801909B - Trans-urethral prostate resection procedure irrigation equipment - Google Patents

Description

' ' a oo 2 = (1) TITLE OF THE INVENTION

TRANS-URETHRAL PROSTATE RESECTION PROCEDURE IRRIGATION EQUIPMENT (2) BACKGROUND TO THE INVENTION

The procedure for performing a trans-urethral resection of the prostate (TURP) involves the introduction of a scope to the bladder through the urethra and the scraping of the prostate by sections. As this procedure generates substantial bleeding an extensive washing or irrigation effect is required to ensure good visibility and the removal of the blood. Liquid irrigation agent is conventionally gravitationally introduced along the scope from two or more agent supply bags with agent reaching the scope via flexible tubing at the remote ends of which the bags and the scope are found. When a bag with agent runs empty during performance of : the procedure another bag must be opened and the first one exchanged with a full bag.

Such change over must be rapidly done to maintain continuous irrigation for preventing clot formation in the bladder. As the location of change over is conventionally remotely situated from the person involved in performing the surgical procedure, in fact being found in a non- sterile part of the operating environment, the change over is done by an operator that must remain available for performing this function. This increases the manpower requirement for performing the procedure. One object of this invention is to, amongst others, to deal with this situation.

A major problem experienced with the use of equipment known to the inventor in performing

SE *°200 - 3 8 / .

Ui1ggg - the TURP procedure is that air becomes entrained in the irrigation agent impairing the vision of the person performing the procedure. Another object of this invention is to also deal with such problem. (3) FIELD OF THE INVENTION 5s This invention relates to manually controllable liquid application equipment for use in gravitationally passing liquid from an upstream supply to a downstream location of application. It also relates to a gravitationally chargable drip chamber for use along liquid flow tubing in the appropriate case forming part of the equipment of the invention. While not so limited the invention find useful application when used during the performance of relevant surgical procedures such as the trans-urethral resection of the prostate. (4) SUMMARY OF THE INVENTION

According to one aspect of the invention there is provided a gravitationally chargable drip chamber for use along liquid flow tubing comprising a housing encompassing a liquid through-flow zone ending in a downstream location of drip chamber discharge, and an upstream location of drip chamber charging extending into the liquid through-flow zone in forming a liquid releasing sub-chamber that is formed with a liquid releasing orifice layout via which liquid is releasable from the releasing chamber into the through-flow zone, characterised in that the liquid releasing orifice layout is configured to release liquid at least substantially off the direction of liquid flow ascribable to the force of gravity into the through- flow zone, once the drip chamber is positioned for use, and of which orifice layout the total cross sectional area of release is adequately larger than that of the inlet to the chamber to cause liquid being released from the chamber to become released at a suitably low flow velocity to, in conjunction the direction of liquid release, limit the entrainment of air in liquid passing into the through-flow zone and consequently from the drip chamber, once in use, with the locations of charging and discharge being arranged to enable the inter-coupling of the chamber to such liquid flow tubing.

The liquid release orifice layout may preferably be arranged to cause the release of liquid from the liquid releasing sub-chamber at least substantially transverse to the direction of gravitational force exertion once the drip chamber is positioned for use.

The drip chamber may be configured to result in the location of charging and discharging being in vertical alignment with one another once the drip chamber is positioned for use.

- In an embodiment the liquid releasing sub-chamber may extend in the form of a regularly shaped stub of closed end wall into the liquid through flow zone.

In a preferred embodiment the stub may extend cylindrically.

The orifice layout may preferably be in the form of a plurality of orifices that are arranged by way of a regularly spaced array formed circumferentially though the sidewall of the liquid releasing chamber.

Further according to the invention there is provided manually controllable liquid application equipment for use in gravitationally passing liquid from an upstream supply to a downstream location of application comprising flexible liquid flow tubing that is applicable for delivering liquid from a single discharge at a location of liquid application, at least one gravitationally chargable drip chamber that comprises a housing encompassing a liquid through-flow zone ending in a downstream location of drip chamber discharge and an upstream location of drip chamber charging via which locations the drip chamber is exposable to the through flow of liquid as passing along the liquid flow tubing once the equipment is in use, and a liquid releasing sub-chamber formed at the end of the upstream location of charging that extends into the liquid through-flow zone and that is formed with a liquid releasing orifice layout via which liquid is releasable from the releasing chamber into the through flow zone, and at least one manually operable liquid flow control facility that is situated downstream of the drip chamber with the equipment providing for its liquid flow connection to such upstream supply, characterised in that the releasing orifice layout is configured to release liquid at least substantially off the direction of liquid flow ascribable to the force of gravity into the through- flow zone, once the equipment is ready for use, and of which orifice layout the total cross sectional area of release is adequately larger than that of the inlet to the chamber to cause liquid being released from the sub-chamber to become released at a suitably low flow velocity to, in conjunction the direction of liquid release, limit the entrainment of air in liquid passing into the through-flow zone and consequently from the drip chamber and the tubing, once the equipment is in use.

The liquid release orifice layout may preferably be arranged to cause the release of liquid from the liquid discharge chamber at least substantially transverse to the direction of gravitational force exertion once the drip chamber is positioned for use.

: 5 Te *'2008/ 0199 - The liquid application equipment may be arranged to result in the locations of charging and discharging of the drip chamber being in vertical alignment with one another once the drip chamber is positioned for use.

In a preferred embodiment the liquid releasing sub-chamber may extend in the form of a regularly shaped stub of closed end wall into the liquid through-flow zone.

In a specific embodiment the stub may extend cylindrically.

The orifice layout may preferably be in the form of a plurality of orifices that are arranged by way of regularly spaced array formed circumferentially though the sidewall of the liquid releasing sub-chamber.

The drip chamber may be located at the upstream end of the tubing as regards the direction of liquid flow there along with the tubing extending from its downstream location of drip chamber discharge. !

The liquid application equipment may, at least when employable in an environment of switch over batch feeding that supplies a single liquid discharge from at least two batch supplies that are remotely located from an equipment user and along the tubing of which equipment the uninterrupted flow of liquid is controllable by way of a single person manual batch supply switch over action while an equipment user is also involved in the performance of a physical action involving function relating to the discharge of liquid from the equipment, once the equipment is in operative use, preferably include at least two drip chambers from the location of discharge of each a discharging liquid flow tube extends which discharging liquid flow tubes merge into a single equipment discharge tube, and a manually operable liquid flow control facility located along each of the drip chamber discharging liquid flow tubes that are situated in adequate close proximity of the location of liquid discharge from the equipment, at least once the equipment is so in use, to enable simultaneous user control over both the manipulation of the equipment discharge and the liquid flow control facilities.

In a preferred embodiment the tubing may be sized to enable the performance of a single person physical action involving function in the form of an irrigation action in flushing an internal bodily location amongst others exposed to examination by scope, as thus also passing along the tubing.

- (5) BRIEF DESCRIPTION OF THE DRAWING

The invention is now described, by way of example, with reference to the accompanying drawings. In the drawings :

Figure 1 diagrammatically shows manually controllable liquid application equipment in the form of irrigation equipment amongst others employable in a trans-urethral prostate resection procedure,

Figure 2 shows a drip chamber forming part of the equipment of figure 1 while also independently forming a further aspect of the invention, in side elevation, and

Figure 3 diagrammatically shows the use of the liquid application equipment of figure 1. (6) DETAILED DESCRIPTION OF THE DRAWINGS

Referring to figures 1 and 3 of the drawings manually controllable liquid application equipment in the form of irrigation equipment amongst other employable for performing trans-urethral prostate resection procedures is generally indicated by reference number al 10.

The equipment 10 comprises flexible liquid flow tubing in the form two drip chamber discharging liquid flow tubes as provided by liquid flow tube sections 12 merging into a single equipment discharge tube in the form of a downstream tube section 14, two drip chambers 16 each of which, as also forming another aspect of the invention, is situated upstream of the tube sections 12, a manually operable liquid flow control facility in the form of a clamp 18 situated along each of the tube sections 12 and thus downstream of the drip chambers 16 and upstream of the location of tube section merging 20, and a manually operable liquid flow rate controller 22 situated along the downstream tube section 14.

In referring more particularly to figure 2, in which figures 2(a) and 2(b) show a drip chamber 16 rotated through 90 degrees relative to one another, each chamber 16 is formed with an upstream location of drip chamber charging in the form of a charging spigot 24 via which its drip chamber 16 is conventionally connectable to a batch supply bag 26. The spigot 24 extends by way of a liquid releasing sub-chamber in the form of an end wall closed off cylindrical liquid releasing stub 28 into a liquid through-flow zone 30 as encompassed by a housing 32. The stub 28 is formed with a liquid releasing orifice layout in the form of a plurality of orifices 34 that are arranged by way of a regularly spaced array formed circumferentially though the sidewall 36 of the stub 28. The combined cross sectional area of the orifices 34 is larger than the cross sectional area of the inlet to the stub 28 which is in effect the cross sectional area of the spigot 24. This has the effect of causing liquid that is

- released via the stub 28 into the through-flow zone 30 to be unexposed to upstream ! pressure causing it to simply flow from the stub 28 once the equipment 10 is in use.

Discharging of liquid from the drip chamber 16 is achieved via a downstream location of drip chamber discharge in the form of discharging stub 38 found at the end of the liquid through- s flow zone 30. The drip chamber 16 extends symmetrically about a central axis 40 while the charging spigot 24 and the discharging stub 38 are in alignment with one another. Being so arranged any flow of liquid from the liquid releasing stub 28 takes place substantially laterally to the flow of liquid along the through-flow zone 30 along arrow 42 and thus laterally to the direction of the force of gravity. This has the effect of limiting the flow velocity of liquid on becoming released into the through-flow zone 30 once the equipment 10 is in use.

Owing to entrainment of air in liquid leaving a drip chamber 16 being promoted by a rapid flow of liquid through the zone 30 the combined effect of the cross sectional area differences between the orifices 34 and the spigot 24 and the lateral direction of liquid release from the stub 28 cause liquid to be released into the zone 30 via the stub 28 at a low velocity. Liquid so released consequently does not effectively become entrained with air on passing along the through-flow zone 30 resulting in liquid being discharged from the equipment 10, once in use, also being substantially air free.

In addition to limiting the inclusion of entrained air, a further object of the equipment 10 is to facilitate its single person manipulation. Such circumstance is, for example, found in the case of performance of a medical procedure during which maintenance of the continuous flow of liquid as well as involvement in the discharge end of the downstream tube section 14 is required. This is typically found in performing a prostate trans-urethral resection procedure during which a continuous flow of liquid agent in performing an irrigation function is required.

As such procedure is naturally performed under sterile conditions while the batch supply bags 26 are situated outside the sterile area to enable their replacement, the length of the tube section 14 and the proximity of the clamps 18 are selected to enable the equipment user to attend to a liquid supply switch over between the bags 26 via the clamps 18 from within the sterile area without impairing such user's involvement in the surgical procedure.

In use and in more particular referring to figure 3 the equipment 10 is set up to supply liquid agent for performing a specific task such as an irrigating function in washing out blood during the performance of a trans-urethral prostate resection procedure.

To this effect the bags 28 are conventionally suspended and the upstream ends of the chambers 16 connected thereto via the spigots 24 while the controller 22 is maintained in the

- | 8 - closed condition. Once the discharge end 44 of the tube section is properly situated for performing an irrigation function such as within the bladder with a scope fitted along the tubing, the attendant surgeon simply opens one of the of the clamps 18 causing the agent to perform is irrigation function without impairing such person's other functions.

When is becomes clear to such surgeon that the relevant bag 28 is emptying a switch over between the bags 28 is achieved by simply closing the one clamp 18 and opening the other one promoting a continuous irrigation action. The empty bag being situated outside the sterile area is simply replaced by an assistant for a subsequent switch over. During the procedure the flow of agent is adjusted by way of the controller 22 that is also used for closing off the flow of agent once completed. In addition to promoting a continuous irrigation action the configuration of the drip chambers 16 promote a washing agent supply at least substantially free of entrained air that otherwise would have had the effect of impairing the vision of the equipment user via a scope in turn obstructing such person's ability for properly performing the surgical procedure.

Claims (1)

1. cL - (7) CLAIMS ToT (1) A gravitationally chargable drip chamber for use along liquid flow tubing comprising a housing encompassing a liquid through-flow zone ending in a downstream location of drip chamber discharge, and an upstream location of drip chamber charging extending into the liquid through-flow zone in forming a liquid releasing sub-chamber that is formed with a liquid releasing orifice layout via which liquid is releasable from the releasing chamber into the through-flow zone, characterised in that the liquid releasing orifice layout is configured to release liquid at least substantially off the direction of liquid flow ascribable to the force of gravity into the through-

   flow zone, once the drip chamber is positioned for use, and of which orifice layout the total cross sectional area of release is adequately larger than that of the inlet to the chamber to cause liquid being released from the chamber to become released at a suitably low flow velocity to, in conjunction the direction of liquid release, limit the entrainment of air in liquid passing into the through-flow zone and consequently from the drip chamber, once in use,

   with the locations of charging and discharge being arranged to enable the inter-coupling of the chamber to such liquid flow tubing. (2) A gravitationally chargable drip chamber as claimed in claim 1 in which the liquid release orifice layout is arranged to cause the release of liquid from the liquid releasing sub-chamber at least substantially transverse to the direction of gravitational force exertion once the drip chamber is positioned for use. (3) A gravitationally chargable drip chamber as claimed in claim 2 that is configured to result in the location of charging and discharging being in vertical alignment with one another once the drip chamber is positioned for use. (4) A gravitationally chargable drip chamber as claimed in claim 3 in which the liquid releasing sub-chamber extends in the form of a regularly shaped stub of closed end wall into the liquid through flow zone. (5) A gravitationally chargable drip chamber as claimed in claim 4 in which the stub extends cylindrically. (6) A gravitationally chargable drip chamber as claimed in claim 4 or claim 5 in which the orifice layout is in the form of a plurality of orifices that are arranged by way of a regularly spaced array formed circumferentially though the sidewall of the liquid releasing chamber.

   ; | 10

   - (7) Manually controllable liquid application equipment for use in gravitationally passing liquid from an upstream supply to a downstream location of application comprising flexible liquid flow tubing that is applicable for delivering liquid from a single discharge at a location of liquid application,

   at least one gravitationally chargable drip chamber that comprises a housing encompassing a liquid through-flow zone ending in a downstream location of drip chamber discharge and an upstream location of drip chamber charging via which locations the drip chamber is exposable to the through flow of liquid as passing along the liquid flow tubing once the equipment is in use, and a liquid releasing sub-chamber formed at the end of the upstream location of charging that extends into the liquid through-flow zone and that is formed with a liquid releasing orifice layout via which liquid is releasable from the releasing chamber into the through flow zone, and at least one manually operable liquid flow control facility that is situated downstream of the drip chamber with the equipment providing for its liquid flow connection to such upstream supply, characterised in that the releasing orifice layout is configured to release liquid at least substantially off the direction of liquid flow ascribable to the force of gravity into the through- flow zone, once the equipment is ready for use, and of which orifice layout the total cross sectional area of release is adequately larger than that of the inlet to the chamber to cause liquid being released from the sub-chamber to become released at a suitably low flow velocity to, in conjunction the direction of liquid release, limit the entrainment of air in liquid passing into the through-flow zone and consequently from the drip chamber and the tubing, once the equipment is in use.

   (8) Manually controllable liquid application equipment as claimed in claim 7 in which the liquid release orifice layout is arranged to cause the release of liquid from the liquid discharge chamber at least substantially transverse to the direction of gravitational force exertion once the drip chamber is positioned for use.

   (9) Manually controllable liquid application equipment as claimed in claim 7 or claim 8 that is arranged to result in the locations of charging and discharging of the drip chamber being in vertical alignment with one another once the drip chamber is positioned for use.

   (10) Manually controllable liquid application equipment as claimed in claim 9 in which the liquid releasing sub-chamber extends in the form of a regularly shaped stub of closed end wall into the liquid through-flow zone.

   ~ ) | 11 - (11) Manually controllable liquid application equipment as claimed in claim 10 in which the stub extends cylindrically. (12) Manually controllable liquid application equipment as claimed in claim 9 or claim 10 in which the orifice layout is in the form of a plurality of orifices that are arranged by way of 5s regularly spaced array formed circumferentially though the sidewall of the liquid releasing sub-chamber. (13) Manually controllable liquid application equipment as claimed in any one of claims 7 to 12 in which the drip chamber is located at the upstream end of the tubing as regards the direction of liquid flow there along with the tubing extending from its downstream location of drip chamber discharge. (14) Manually controllable liquid application equipment as claimed in any one of claims 7 to 13 that, at least when employable in an environment of switch over batch feeding that supplies a single liquid discharge from at least two batch supplies that are remotely located from an equipment user and along the tubing of which equipment the uninterrupted flow of liquid is controllable by way of a single person manual batch supply switch over action while an equipment user is also involved in the performance of a physical action involving function relating to the discharge of liquid from the equipment, once the equipment is in operative use, includes at least two drip chambers from the location of discharge of each a discharging liquid flow tube extends which discharging liquid flow tubes merge into a single equipment discharge tube, and a manually operable liquid flow control facility located along each of the drip chamber discharging liquid flow tubes that are situated in adequate close proximity of the location of liquid discharge from the equipment, at least once the equipment is so in use, to enable simultaneous user control over both the manipulation of the equipment discharge and the liquid flow control facilities. (15) Manually controllable liquid application equipment as claimed in claim 14 in which the tubing is sized to enable the performance of a single person physical action involving function in the form of an irrigation action in flushing an internal bodily location amongst others exposed to examination by scope, as thus also passing along the tubing.

   A PS van der Merwe Patent Agent for Applicant