Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1991-12-02
1993-09-21
Isabella, David
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604151, 128DIG12, A61M 100
Patent
active
052464229
DESCRIPTION:
BRIEF SUMMARY
The present invention concerns a device for continuous irrigation and drainage of tissues of cavities in the human or animal body with a physiological irrigating liquid during an endoscopic type procedure, said device comprising at least one peristaltic type pump and means for controlling said irrigation.
Endoscopy is a rapidly developing technique in the medical field. It permits a cavity in the human body to be examined using fiberoptic observation techniques. Certain of these cavities must be dilated to permit endoscopic exploration. Presently there are two techniques for such dilation: a technique using gas, such as carbon dioxide, and one using a physiological liquid such as saline or glycine solution. The use of gas is limited to surgery and is gradually disappearing. The first technique is now used only in procedures using transfusions. The second technique, however, which uses injection of a liquid, is becoming more widespread. It is used not only for observation but also for rinsing and evacuating debris. This technique is used in general surgery, in orthopedics, in urology, in gynecology, in otorhinolaryngology, in gastro-intestinal endoscopy, in ophthalmology, etc.
In these different areas, the physiological liquid may circulate in an open or closed circuit. In the case where fluid circulation takes place in a closed circuit, it is necessary to maintain constant pressure in the cavity being explored. In the case where fluid circulation takes place in an open circuit, it is not necessary to maintain constant pressure in the cavity, but rather a generally constant pressure at the outlet of the rinsing nozzle. Open circuit fluid circulation is used in general surgery and otorhinolaryngology, for rinsing gastrointestinal areas and for rinsing open incisions.
At present there are three known ways of obtaining fluid circulation in a closed circuit:
The first technique, based on the principle of gravity induced flow, uses a pouch containing physiological serum, consisting for example of a 0.9% saline solution suspended at a height determined by the surgeon and which is usually of the order of 1 meter above the patient. This pouch is connected to the operating zone by a sterile duct which is itself connected to an instrument such as, for example, an arthroscope introduced into the joint when the procedure is arthroscopy. A drainage duct with a valve is used to drain the liquid, either all at once or continuously, thereby evacuating debris generated during the procedure and continually renewing the supply of serum so the surgeon can follow his/her work visually inside the joint.
The second technique is essentially identical to the preceding one, but the pressure applied in the operating zone is not generated by a column of water, but rather by a peristaltic pump. Draining the liquid takes place by gravity, as before, using a duct with a valve or a control for adjusting flow.
The third technique uses two peristaltic pumps, one placed above the operating zone and one below it. The first one is for conducting liquid to the operating zone and the second is for draining the liquid and the solid or liquid materials it contains. The two pumps are preferably controlled and, at least in theory, ensure constant pressure in the operating zone. When diagnosis or surgery takes place in an open cavity, the methods presently in use derive directly from the gravity distention technique or from the technique of using a peristaltic irrigation pump. Draining the liquid may also be done using an aspiration nozzle connected directly to a vacuum pump provided in the operating area.
At present each type of procedure requires a specific apparatus. Thus, pumps made by the U.S. company 3M or pumps made by the Swiss company ORTHOCONCEPT are used in arthroscopic procedures, irrigation systems sold by the DAVOL company are used for irrigating open incisions, and a pump proposed by the ORTHOCONCEPT company is used for prostate resections.
The fact that such a panoply of specific systems for each procedure must be maintained in the op
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Ferton Holding
Isabella David
Jones MaryBeth O.
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