Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1995-12-04
1998-05-19
Rimell, Sam
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604 29, 604280, A61M 532
Patent
active
057529396
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
The present invention relates to catheters. More particularly, the present invention relates to catheters for the injection and drainage of dialysis solution during the process of continuous ambulatory peritoneal dialysis which is an effective method of hemocatharsis in chronic renal failure patients.
Use of catheters for continuous ambulatory peritoneal dialysis is known in the art. For example, continuous ambulatory peritoneal dialysis, which is a hemocatharsis for chronic renal failure patients, has been recognized by Japanese Health Insurance organizations as an effective form of hemodialysis treatment since March, 1985. Additionally, since Apr. 1, 1986, continuous ambulatory peritoneal dialysis has been approved for general practice with the only requirement being notification of the local self-govering body in the district where medical institutions are established. For these reasons, continuous ambulatory peritoneal dialysis has been put into practice at many hospitals and clinics.
The concept of continuous ambulatory peritoneal dialysis was first disclosed in the U.S. by Popovich and Moncrief in 1976. The disclosure reveals a method for continuous ambulatory peritoneal dialysis, whereby the patient carries a bag made of a soft material, such as polyvinyl chloride, in which dialysis solution is contained. The dialysis solution is connected through a tube from the soft bag into the peritoneal cavity of the patient.
This system has a distinct advantage over traditional dialysis because it allows the patient to receive dialysis while performing normal daily activities without the sense of being incapacitated.
Hemodialysis, in general, is based on the principle of allowing blood to contact a semipermeable membrane, the other side of which is in contact with an isotonic dialysis solution. Toxins, and other relatively small molecules, diffuse across the membrane until their concentration in both the dialysis solution and the blood equilabrates.
The isotonic dialysis solution is then changed to a fresh solution to permit continued purification of the blood. Solution replacement may be continuous or discontinuous. The efficiency of dialysis is directly related to many factors including, volume of dialysis fluid, number of changes of dialysis solution (or flow rate in a continuous system), length of time between changes, surface area of membrane, pore size of the membrane, rates of diffusion of the toxins, patient variables, etc.
Peritoneal hemodialysis is principled in the substitution of the natural semipermeable capillary bed membranes that are abundant within the peritoneal cavity, for the artificially provided semipermeable membranes of the hemodialysis machine. By continuously flooding the interperitoneal extravascular space with isotonic dialysis solution exchange of toxins from the blood occurs and dialysis is accomplished.
A closed system utilizing continuous ambulatory peritoneal dialysis as the fundamental principle is comprised, as shown in FIG. 1, of catheter A, catheter adapter B, made of titanium, connecting tube C, and bag D, made of polyvinyl chloride, which contains peritoneal dialysis solution. However, longstanding problems still remain with catheters used in this field.
Refering to FIG. 2, the catheter shown, for continuous ambulatory peritoneal dialysis, initially disclosed in the prior art is called a Tenckhoff type catheter. Such devices in the prior art were constructed with hypodermic tunnel portions (for example, as shown at F) provided at intermediate portions of elongated straight tubes made of silicon rubber.
One leg portion G serves as external extension, and the other leg portion H serves as peritoneal cavity insertion portion having suction/drainage holes. A first cuff I is provided at the boundary between the hypodermic tunnel portion F and the peritoneal cavity insertion portion H, and second cuff J is provided with a suitable spacing from first cuff I at the hypodermic tunnel portion F.
A disadvantage with this system is that in order to preven
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Kabushiki Kaisha Hayashidera Medinooru
Rimell Sam
Yeh Luke J.
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