Surgery – Respiratory method or device – Respiratory gas supply means enters mouth or tracheotomy...
Patent
1987-01-05
1989-05-02
Apley, Richard J.
Surgery
Respiratory method or device
Respiratory gas supply means enters mouth or tracheotomy...
12820026, 623 9, A61M 2500
Patent
active
048258610
DESCRIPTION:
BRIEF SUMMARY
The invention relates to an endotube for positioning in particular in the esophagus, comprising a tubular central portion, at one end thereof a funnel-like enlargement portion and at the other end a thickened portion which is enlarged towards the central portion and which after passing through a constriction prevents the endotube from being pulled back or makes it difficult for the endotube to be pulled back.
It is known when dealing with stenoses of the esophagus, which are caused for example by carcinomas, for endotube or a by-pass tube to be inserted after the bougie operation, that tube making it possible for the patient to continue to swallow solid and liquid foods. The operation of using a bougie on the stenoses and subsequently setting the endotubes in position is effected in known manner either under X-ray control or by viewing through an endoscope; in that case, in known manner, the endoscope is passed through a tubular opening in the bougie. In the same manner the endoscope may also be passed through the opening in the endotube, thus facilitating the operation of setting it in place. So that the endotube remains secured at its appropriate position after the operation of setting it in place, the front side of the endotube is either fixed by operation from the stomach, after it has been set in place, or the endotube is provided in known manner at its front end with a collar-like thickened portion which makes it difficult for it to be pulled back through the stenoses. At thie rear end, which is towards the mouth, the known endotubes are provided with funnel-like enlargement portions to match them to the anatomical circumstances and to secure them in position. Regarding the state of the art discussed, attention is directed for example to EP-A-No. 138,089. Further examples of endotubes are discussed in the "British Journal of Surgery", volume 69 (1982), pages 61 to 68, and also in "Endoscopy" 8 (1976), pages 180 to 185.
The object of the present invention is to improve the known endotubes to provide for easier positioning thereof, including when viewing through an endoscope, both in regard to their function and their handling.
To achieve that object, the present invention takes as its starting point an endotube of the kind set forth in the opening part of this specification, and is characterized in that the thickened portion comprises two or more hollow thin-walled limbs which are open to the interior of the central portion and which project out from the central portion and whose height rises in a ramp-like configuration towards the central portion and which then terminate with a steep drop. Unlike the known collar-like enlargement portions, the abovementioned limbs can be completely pressed or folded in, even when an endoscope is passed through the tube, so that no difficulties occur when the tube is introduced through a stenosis and set in place. After having passed through the stenosis, the limbs then fold out and then, by virtue of their steep drop which provides an action in the manner of a barb, prevent the tube from being pulled back.
Further developments of the invention are set forth in the subsidiary claims. Thus, advantageously, adjoining the steep drop portion of the limbs the central portion has flat portions which reduce the wall thickness of the central portion. That further facilitates the inward folding movement of the limbs, without increasing the diameter of the endotube. The bore of the tubular central portion is advantageously provided with inwardly projecting longitudinal beads or raised portions which may preferably also adjoin each other in such a way as to give a groove internal cross-section. That arrangement ensures that, in the event of subsequent bending of a tube which has been set in position in the esophagus, the tube is not completely closed off. A cross-section always remains between the bent-over longitudinal beads or raised portions, which is at least sufficiently large to permit saliva to flow therethrough and to enable liquid food to be swallowed.
A stiffening coi
REFERENCES:
patent: 3807408 (1974-04-01), Summers
patent: 3896804 (1975-07-01), Ekbladh
patent: 4043338 (1977-08-01), Homm
patent: 4141364 (1979-02-01), Schultze
patent: 4614516 (1986-09-01), Blom
Apley Richard J.
Prizant James
Walter Koss of Industriestrasse
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