Surgery – Instruments – Cutting – puncturing or piercing
Reexamination Certificate
1998-07-23
2001-07-24
Dawson, Glenn K. (Department: 3761)
Surgery
Instruments
Cutting, puncturing or piercing
C606S159000, C606S180000, C606S192000, C604S022000, C604S096010
Reexamination Certificate
active
06264667
ABSTRACT:
BACKGROUND OF THE INVENTION AND DESCRIPTION OF THE PRIOR ART
One of the side effects of many urological procedures is formation of blood clots in the urine within the bladder. Typically after urological procedures the patient will be fitted with a catheter to facilitate bladder drainage. Clots forming in the urine within the bladder tend to clog the inlet orifice for a catheter thereby preventing effective voiding of the bladder. This is a particular problem subsequent to urological procedures such as transectional prostatectomies, radial prostatectomies and nephrolithotomies.
Magnetic coupling in surgical devices is known, being disclosed in U.S. Pat. No. 5,609,602. However, '602 is concerned with a magnetic couple which limits rotation of one element when driven by a second element, incorporating a mechanical stop for the first element allegedly to produce high frequency oscillations in one of the magnetically coupled pair of elements.
SUMMARY OF THE INVENTION
In one of its aspects, this invention provides an irrigating bladder dethrombulator including a housing insertable into the human bladder via the urethra with an outflow conduit therewithin for transporting bodily fluid from the human bladder and a bladder pressurization conduit for transporting fluid into the bladder to increase bladder internal pressure. The dethrombulator preferably includes means connected to the housing located within the outflow conduit and rotatable with respect thereto for mechanically reducing size of clots in the bodily fluid passing through the outflow conduit. The mechanical clot size reducing means is preferably driven by means connected to the exterior of the housing which drives the clot size reducing means via a magnetic coupling upon manual or powered rotation of the drive means. The housing preferably includes at least one aperture proximate the clot size reducing means for influx of bodily fluid from within the bladder into the outflow conduit for dethrombosis of the same as the fluid passes through the outflow conduit to exit the bladder and the housing.
In another embodiment of the invention, the means for mechanically reducing size of clots in bodily fluid traversing the outflow conduit is powered by fluid passage through the pressurization conduit.
In another of its aspects, this invention provides a rotating mechanical thrombectomy device, preferably incorporating a turbine, driven by a hydrostatic, pneumatic or other power source, with rotating or torquing blades to break down and shred clots into smaller clots enabling easier passage of the shredded clots out of the patient, thereby preventing occlusion of the outflow port or ports of a drainage catheter.
In yet another of its aspects this invention provides an irrigating bladder dethrombulator having a housing including an outflow conduit adapted for transporting urine and other bodily fluids out of the human bladder with the outflow conduit having a closed distal end. The dethrombulator thus provided preferably further includes a bladder pressurization fluid conduit for transporting fluid into a human bladder and releasing the fluid thereinto to raise internal pressure within the bladder. The dethrombulator preferably further comprises a balloon control conduit adapted for passage therethrough of air or other gaseous fluid for pressurizing a balloon within the human bladder. The pressurization conduit, the outflow conduit and the balloon control conduit are preferably parallel, with walls of the pressurization and balloon conduits preferably being connected to or even formed in an exterior wall of the outflow conduit.
The dethrombulator preferably further includes at least one clot cutting device such as a blade, vane or wire, rotatably mounted within the outflow conduit proximate the distal end thereof, for reducing size of clots in urine by cutting any clots encountered in the course of rotatably passing in close proximity along the interior wall of the outflow conduit.
The dethrombulator may further preferably include a turbine or vane rotatably mounted on a common shaft with said clot cutting device where the turbine or vane is located within the outflow conduit remote from the distal end of the outflow conduit relative to said cutting blade. The turbine or vane, even though largely positioned within the outflow conduit, preferably has at least tip extremities in fluid communication with the pressurization conduit interior, to rotate responsively to fluid passage through said pressurization conduit and driving said clot cutting device.
The dethrombulator yet further preferably includes a balloon adapted to be in fluid communication with the balloon control conduit and connected to the exterior of the outflow conduit for retaining a distal end of the irrigating bladder dethrombulator within the human bladder to be irrigated and dethrombulated.
The outflow conduit preferably includes at least one aperture in the wall thereof at the location of the clot cutting device for influx of urine and other bodily fluid from within the bladder into the outflow conduit for dethrombosis of the same as the fluid passes the cutting blade in the course of passage through the outflow conduit to exit said bladder.
In another of its aspects, this invention provides a method for irritatingly dethrombulating bladder fluid by inserting an outflow conduit into a human bladder through the urethra, internally pressurizing the bladder and turning mechanical clot size reducing means within the outflow conduit to reduce size of clots in bodily fluid passing out of the bladder via the conduit by rotating magnetically coupled drive means located externally of the outflow conduit. Preferably the rotating is performed manually. The method may further include inflating a balloon within the bladder to increase pressure therewithin and retain the conduit within the bladder and may further yet include internally pressurizing the bladder by introducing fluid thereinto.
In yet another of its aspects, this invention provides a method for irritatingly dethrombulating bladder fluid by inserting an outflow conduit into a human bladder through the urethra, internally pressurizing the bladder, turning a clot cutter mounted within the outflow conduit to reduce size of clots and bodily fluid passing out of the bladder via the conduit, responsive to influx of pressurizing fluid into said bladder.
REFERENCES:
patent: 4167944 (1979-09-01), Banko
patent: 4850957 (1989-07-01), Summers
patent: 5002549 (1991-03-01), Nash
patent: 5609602 (1997-03-01), Machemer et al.
patent: 5779722 (1998-07-01), Shturman et al.
patent: 5823990 (1998-10-01), Henley
patent: 5860994 (1999-01-01), Yaacobi
Dawson Glenn K.
Rex Medical
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