Surgery – Instruments – Means for inserting or removing conduit within body
Reexamination Certificate
1998-07-17
2002-03-26
O'Connor, Cary E. (Department: 3732)
Surgery
Instruments
Means for inserting or removing conduit within body
Reexamination Certificate
active
06361541
ABSTRACT:
BACKGROUND OF THE INVENTION
1. Field of the Invention
The present invention relates to the field of surgical instrumentation. More particularly, the present invention relates to surgical instruments which are used to remove an implanted catheter from a patient.
2. Background
Catheters are surgically implanted in a patient when it is necessary to provide medications, blood products, liquid food, etc. to the patient for a significant amount of time. It is essential is such cases that the implanted catheter is anchored within the patient. One approach to anchoring the implanted catheter is the placement of a permeable member of the implanted catheter inside the patient to promote tissue ingrowth within the permeable member. Typically, the permeable member is either a catheter tube or a cuff affixed around the catheter tube as described in U.S. Pat. Nos. 4,266,999, and 4,405,313, hereby incorporated by reference. A commercial example of a cuff is a Dacron® cuff
12
of a Cook TPN™ (Total Parenteral Nutrition) single lumen catheter
10
as shown in FIG.
1
. Referring to
FIGS. 1 and 2
, an illustrative implantation of catheter
10
involves surgically creating a subcutaneous tunnel
23
through a skin
20
and a tissue
21
of the patient to a blood vessel
22
of the patient, inserting a distal end
11
a
of a catheter tube
11
of catheter
10
through subcutaneous tunnel
23
into blood vessel
22
, and positioning cuff
12
midway between a skin entry point
20
a
and a blood vessel entry point
22
a
. Subsequently, tissue adhesion occurs along an interface A of cuff
12
and tissue
21
to promote ingrowth of a portion
21
a
of tissue
21
within cuff
12
as shown in FIG.
2
. As a result, portion
21
a
of tissue
21
anchors catheter tube
11
within the patient. Upon completion of the treatment, catheter tube
11
must be removed from the patient. Presently, a cutting instrument, e.g. a scalpel, is utilized to dissect cuff
12
away from tissue
21
. Referring to
FIG. 3
, the drawbacks associated with the utilization of a cutting instrument are the concurrent dissection of portion
21
a
and a portion
21
b
of tissue
21
away from tissue
21
, the difficulty in minimizing the amount of portion
21
b
of tissue
21
that is dissected with cuff
12
, and the promotion of a substantial amount of bleeding at
24
throughout subcutaneous tunnel
23
.
SUMMARY OF THE INVENTION
The present invention provides a new and unique surgical instrument for removing an implanted catheter which operates to extract tissue ingrowth from a permeable member of an implanted catheter. The surgical instrument is easy and convenient to use, and overcomes the aforementioned drawbacks associated with the utilization of a scalpel to dissect tissue adhering to the permeable member of the implanted catheter.
As shown in the following description of the preferred embodiments, a surgical instrument is operable to extract a tissue ingrowth out of a permeable member of a catheter implanted in a patient by forcibly pulling the tissue ingrowth out the permeable member. The surgical instrument comprises a first extracting component including a first wedge having a blunted leading edge, and a second extracting component including a second wedge having a blunted leading edge. The extracting components are pivotally coupled to move the wedges to a closed position or to an open position. The blunted leading edges of the wedges are sized and shaped to be lodged adjacent an adhesion interface of the permeable member and the tissue of the patient when the wedges are in the closed position. As a result, the wedges can be pivotally moved to the open position to forcibly pull the tissue ingrowth out of the permeable member.
It is an object of the present invention to provide a surgical instrument for removing a catheter implanted within a patient which is operable to forcibly pull tissue ingrowth out of a permeable member of the catheter without any deliberate dissection of the permeable member away from the tissue of the patient.
It is another object of the present invention to provide a surgical instrument for removing a catheter implanted within a subcutaneous tunnel of a patient which minimizes the amount of blood induced throughout the subcutaneous tunnel as the catheter is being removed.
These and other objects and advantages of the present invention will become more apparent from a review of the following description of the preferred embodiments.
REFERENCES:
patent: 673598 (1901-05-01), Dolge
patent: 3653388 (1972-04-01), Tenckhoff
patent: 4266999 (1981-05-01), Baier
patent: 4405313 (1983-09-01), Sisley et al.
patent: 4484911 (1984-11-01), Berlin et al.
patent: 4574800 (1986-03-01), Peers-Trevarton
patent: 4585437 (1986-04-01), Simms
patent: 4608982 (1986-09-01), Pollard
patent: 4655218 (1987-04-01), Kulik et al.
patent: 4676782 (1987-06-01), Yamamoto et al.
patent: 4889112 (1989-12-01), Schachner et al.
patent: 5292324 (1994-03-01), McDonald
patent: 5580344 (1996-12-01), Hasson
patent: 5651767 (1997-07-01), Schulman et al.
patent: 5693069 (1997-12-01), Shallman
patent: 5697936 (1997-12-01), Shipko et al.
patent: 5725532 (1998-03-01), Shoemaker
patent: 5772670 (1998-06-01), Brosa
patent: 5910155 (1999-06-01), Ratcliff et al.
patent: 0815893 (1996-10-01), None
O'Connor Cary E.
The University of Iowa Research Foundation
Woodard Emhardt Naughton Moriarty & McNett
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