Surgery – Truss – Perineal
Patent
1985-02-26
1986-10-07
Grieb, William H.
Surgery
Truss
Perineal
604198, A61B 100
Patent
active
046153314
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The invention relates to an elongated, flexible medical instrument for the examination or treatment of body cavities, in particular endoscopes, with a device to assist introduction by the principle of the tubular structure which becomes everted.
PRIOR ART
The introduction of elongated, flexible medical examination instruments, such as, for example, endoscopes, into body cavities which have a convoluted course, such as, for example, the intestine or the esophagus, involves difficulties and is not without risk for the patient. For this reason, there are many suggestions as to how this introduction can be improved.
A device for the introduction of an endoscope for intestinal diagnosis is described in German Offenlegungsschrift No. 2,823,025, which device comprises a pipe-like housing to whose distal opening is attached a thin-walled tube. This tube is inverted inside the housing and its other end is connected to the distal end of an endoscope. By applying a pressure medium to the housing, the tube everts out of the housing into the body opening, the endoscope being pulled after. As eversion proceeds, the tube covers the surface of the body cavity so that the endoscope does not come into contact with its walls during penetration into the body cavity. This procedure, which inherently imposes very little stress on the walls of the body cavity, has the disadvantage that the investigator is unable to inspect the walls of the body cavity through the endoscope until the tube has completely everted.
A very similar device described in U.S. Pat. No. 4,321,915 avoids this disadvantage by the tube being fixed not to the distal end of the endoscope but to a sleeve which can move sealingly on the endoscope. Since, when pressure is applied to the housing, the endoscope advances into the body cavity at twice the rate of the covering of the surface of the wall of the body cavity by the inverting tube, pressure and reduced pressure are applied alternately and the endoscope is withdrawn a little relative to the tube during the reduced pressure phases.
SUMMARY OF THE INVENTION
The object of the present invention is to make available an elongated, flexible medical instrument having a device to assist introduction by the principle of the eversible tube, which instrument is simpler to construct and use than those of the prior art. This has entailed making use of the recognition that it is unnecessary to assist the introduction of the medical instrument throughout the entire advance by the everting tube; on the contrary, for straightforward passages through body cavities, it suffices to advance the medical instrument in a conventional manner and to make use of the principle of the everting tube only with difficult passages.
The object is achieved by the device to assist introduction comprising a pipe which is open at both ends and has pressure connectors on the sides, and comprising a flexible, eversible tubular structure which runs through the pipe and whose two ends are each connected to one end of the pipe, the medical instrument running through the pipe inside the tubular structure and the tubular structure being folded in several double-layers in the region of the distal end of the medical instrument.
The item according to the invention is now used in such a manner that the medical instrument is applied to the body opening of the body cavity into which the introduction is to take place, and is advanced in a conventional manner until a curve or other hindrance is made noticeable by an increase in the resistance. Pressure is now applied to the instrument to assist introduction, and the medical instrument is advanced further, during which the first layer of the multilayer folding of the tubular structure unfolds in the region of the distal end of the medical instrument, that is to say it everts into the body cavity. This means that the medical instrument can easily be introduced further, in fact at double the rate of advance of the eversion front of the layer of the tubular structure which is everting
REFERENCES:
patent: 3525329 (1970-08-01), Zeimer et al.
patent: 4321915 (1982-03-01), Leighton et al.
Grieb William H.
Sterimed Gesellschaft fur medizinischen Bedarf mbH
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