Laryngoscope

Details Laryngoscope Laryngoscope

2000-04-07

2002-10-29

Peffley, Michael (Department: 3739)

Surgery

Specula

Laryngoscope

C600S190000, C600S194000

Reexamination Certificate

active

06471643

ABSTRACT:

BACKGROUND OF THE INVENTION
The present invention relates to a laryngoscope, especially for introducing a tube into the trachea, having a laryngoscope spatula of substantially straight shape and a handle.
A laryngoscope of this kind is generally known.
A laryngoscope is a medical instrument that serves to visually observe the larynx. In anesthesia, such a laryngoscope is simultaneously used for introducing a tube, for example an anesthetic tube, with the aid of the laryngoscope into the patient's trachea under visual control in order to be able to supply the patient with air during anesthesia. The process of introducing a tube into the trachea can be considerably simplified by a laryngoscope.
A laryngoscope was described for the first time in 1895, and was used for the first time for intubation of a patient under visual control in 1912. Since then, the use of laryngoscopes for tracheal intubation under visual control has become an essential practical part of anesthesia and in intensive medical treatment.
Up to 1943, laryngoscopes with straight laryngoscope spatulas were in use. It was the first time in 1943 that Mackintosh described a laryngoscope with a curved laryngoscope spatula, which was used in laryngoscopy in combination with a novel application technique. Since then, the use of the curved laryngoscope has established itself as standard process, because the method after Mackintosh is easier to apply with an average patient than a method using a laryngoscope with straight laryngoscope spatula. Another reason is seen in the fact that many anesthetists did not arrive at the optimum method with a straight laryngoscope since they introduced the laryngoscope through the mouth centrally, over the back of the tongue. This method formerly used is little successful with most of the more difficult patients.
In contrast, the method after Mackintosh has proved to be very successful. Unfortunately, however, it does not allow visual observation of the larynx with 2% to 5% of all patients. With these patients, tracheal intubation can be achieved by a “blind” process without visual control. However, blind processes are connected with a plurality of risks, including the risk of a major trauma of tissue involved.
Problems encountered in connection with tracheal intubation are a main reason for fatalities under anesthesia. One has estimated that in the western world 600 fatalities annually occur as a result of problems encountered during tracheal intubation. In addition, other major complications, such as damage to the brain, the trachea, the esophagus and other tissue, may lead to fatalities.
Although there are a number of possibilities to overcome the difficulties connected with intubation, all blind methods are connected with significant fault rates. The ideal method should be relatively simple, make use of simple equipment and provide a high rate of success, and a low fault rate.
An optimally suited method (paraglossal straight laryngoscopy) of tracheal intubation for these patients has been described by the inventor of the present invention in 1997. The method described provides a high rate of success where the method after Mackintosh fails. Unfortunately, however, no laryngoscope is available at present that can be used for that method without any disadvantages.
Two problems are encountered in difficult tracheal intubation: The first problem consists in the necessity to observe the larynx, the second in the necessity to introduce the tube through the larynx and into the trachea.
The straight laryngoscope used most frequently is the laryngoscope after Miller. When this laryngoscope is used for the paraglossal method, it is usually successful where the method after Mackintosh fails. However, manipulation of the tube to be introduced requires that an additional space be opened along the tube. This in turn requires an increased lifting pressure. Such increased lifting force cannot always be achieved, and may in addition have a traumatic effect. In addition, the configuration of the laryngoscope as such also impairs the manipulation of the tube to be introduced.
There have been known further laryngoscopes (for example after Kleinsasser, Holinger, Benjamin) which permit good visual observation of the larynx with difficult patients. However, in these cases introduction of the tube is complicated and requires a plurality of steps and much time, which may be critical with difficult patients.
Another known laryngoscope, the PCV laryngoscope, permits easy introduction of the tube. Unfortunately, however, this laryngoscope does not present an optimum configuration. It comprises a curvature which on the one hand facilitates the introduction of the laryngoscope, while making visual inspection of the larynx unsatisfactory with most of the difficult patients. In addition, the configuration of the tip impairs the desired best possible control of the epiglottis. The light carrier projects into the lower side of the laryngoscope, where tissue pressure is exerted by the laryngoscope spatula, whereby the risk of a tissue trauma is increased. In addition, the PVC laryngoscope is cost-intensive.
As has been mentioned before, the laryngoscope after Mackintosh, used most frequently, is curved along its lengthwise axis. However, it is realized more and more that such configuration is connected with a higher fault rate in tracheal intubation than is the case with laryngoscopes with straight laryngoscope spatulas.
It is, therefore, the object of the present invention to improve a laryngoscope of the before-mentioned kind in such a way that the laryngoscope will permit improved visual control of the larynx and, at the same time, improved introduction of the tube through the larynx and into the trachea.
SUMMARY OF THE INVENTION
According to the present invention, this object is achieved by a laryngoscope, in particular for introducing a tube into a trachea of a patient, comprising:
a handle; and
a laryngoscope spatula connected to said handle, said laryngoscope spatula having a longitudinally substantially straight shape, and, further being configured, at least in part, as a tubular hollow body having a proximal end and a distal end,
wherein said tubular hollow body comprises a lateral longitudinal opening extending from said distal end to said proximal end, and,
wherein said laryngoscope spatula comprises at its distal end a substantially flat tip adjacent to said distal end which is in transverse direction substantially straight.
Compared with the known laryngoscopes, the tubular configuration of the laryngoscope spatula according to the invention provides the advantage that insertion of a tube into the trachea with the aid of a laryngoscope is considerably simplified. The tube can be introduced, according to a basic method, either directly through the lumen of the laryngoscope spatula or indirectly under visual control, using an introduction aid, likewise through the lumen of the laryngoscope spatula. Unlike the known laryngoscopes, it is not necessary with this way of introducing the tube, rendered possibly by the tubular configuration of the laryngoscope spatula, to open a free space on the side of the laryngoscope, whereby the lifting force required is reduced. Consequently, the tube can be introduced less traumatically and with success even with difficult patients. The laryngoscope spatula is, however, not configured as a fully closed tubular hollow body, but is provided with a longitudinal opening in its lengthwise direction. The laryngoscope spatula according to the present invention therefore can be described as a slotted tube. The lateral longitudinal opening leads to further considerable advantages of the invention. On the one hand, the lateral longitudinal opening permits improved visual observation of the area of the larynx during introduction of the tube. The longitudinal opening enlarges the field of vision so that binocular observation is rendered possible. On the other hand, the lateral longitudinal opening also facilitates removal of the laryngoscope after the tube has been inserted, as t

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