Surgery – Means for introducing or removing material from body for... – Material introduced into and removed from body through...
Patent
1987-12-30
1989-01-03
Coven, Edward M.
Surgery
Means for introducing or removing material from body for...
Material introduced into and removed from body through...
128 4, A61M 103
Patent
active
047954248
DESCRIPTION:
BRIEF SUMMARY
The present invention relates to an apparatus for controlled irrigation of the natural cavities and tubes of the human body, namely for endoscope, in particular for urological endoscope which include at least one duct to inject, either intermittently or continuously, an irrigation fluid in a corporeal cavity and conduit intervention area, so as to permit interventions as well with intermittent as with continuous irrigation, this apparatus comprising: duct with irrigation fluid; the joining conduit, for measuring the instant pressure being in this conduit at the level of these means sensitive to the pressure and for emitting a measuring signal representing this pressure; area.
It is known that in endoscopy certain procedures, be they only examinational or even surgical, require the presence of a generally aqueous fluid in the intervention area. The same applies, in particular, to urological endoscopy, namely for the bladder, ureters, urethra, prostate or kidneys. However, more generally, this requirement is also present in the case of natural or pathological cavities, which must be examined or treated by resection for example, or a simple lavage . or irrigation.
When performing endoscopy in an artificial fluid environment, either a continuous or an intermittent irrigation, with or without a liquid flow, is applied.
In the first case, the fluid is injected through a duct of the endoscope and withdrawn either through another duct of this endoscope, or by other means, such as a catheter. In the second case, one and the same duct of the endoscope serves to inject and withdraw the fluid.
Both in the continuous and intermittent irrigation, the injection is nowadays accomplished by gravity with the use of a tank with fluid, which is at a higher level than the endoscope in its working position. With this arrangement, the pressure of the fluid injected into the intervention area is, in principle, determined by the height of the fluid column between the endoscope and the fluid level in the tank.
In the case of intermittent irrigation, the withdrawal of the fluid is nowadays performed through the manual activation of the physician who, either opens an outlet stopcock or similar valve which is mounted on the sheath of the endoscope, or extracts the set of working elements with telescope from the sheath of the endoscope. This method presents no major drawbacks because the area of examination or operation has simply to be emptied.
In the case of continuous irrigation, the withdrawal of the fluid is nowadays performed either through the outlet duct when a two-way endoscope is used, or through a catheter when a one-way endoscope is used. In both cases the withdrawal is obtained either by means of the gravity of the fluid which must be withdrawn, or by a pump with selected but constant flow rate.
A first problem arises when, due to the fluid consumption, the level of the fluid to be injected from the tank changes with time. This calls either for an adaptation to the developing change in pressure, or for placing the tank at an accordingly higher level.
A second problem arises, in the case of continuous irrigation, inasmuch as it is not always easy to satisfactorily regulate the withdrawal of the fluid. A too great withdrawal lowers the pressure in the intervention area, whereas a too small withdrawal bears the risk that a dangerous overpressure develops in this area.
The pressure value in the intervention area is in a direct relationship with the fullness of this area, i.e., with the volume of the fluid it contains. An incomplete filling may adversely affect the quality of the examination and Jeopardize the surgical phase, whereas an excessive fullness i.e., a too high pressure may endanger the patient, in particular, in the case of surgery. Otherwise, if the flow rate of the withdrawal is or becomes superior to the flow rate of the injection the fullness of the intervention area is incomplete, which engenders the first above mentioned drawback. On the contrary, if the flow rate of the withdrawal is becomes inferior to the f
REFERENCES:
patent: 3900022 (1975-08-01), Widran
patent: 4529397 (1985-07-01), Hennemuth et al.
patent: 4551131 (1985-11-01), Miles
patent: 4589280 (1986-05-01), Carlin
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