Surgery – Respiratory method or device – Respiratory gas supply means enters mouth or tracheotomy...
Patent
1997-10-01
2000-04-25
Weiss, John G.
Surgery
Respiratory method or device
Respiratory gas supply means enters mouth or tracheotomy...
12820717, 12820026, 128912, 623 9, A61M 1600
Patent
active
060531673
DESCRIPTION:
BRIEF SUMMARY
The invention relates to a tracheostomy cannula for insertion in a tracheostoma, in accordance with the preamble of claim 1. It is provided with a hose-like outer cannula, inside which an inner cannula, which is also hose-like, can be guided and locked to the proximal part of the outer cannula, whereby in the proximal area of the outer cannula, a cannula plate for placing on the neck of the patient is fitted. The outer cannula and inner cannula together form the cannula tube.
Tracheostomy cannulas of this type with a cannula plate pivotable about one axis only have been long known. Reference is made in this connection to U.S. Pat. No. 5,067,496, EP-0 107 779 B1, EP-0 037 719 B1, U.S. Pat. No. 4,852,565 and U.S. Pat. No. 4,009,720 in the patent literature.
Tracheostomy cannulas of this type are inserted in a tracheostoma resulting from an operation, in order to keep it open until it heals. There are circumstances, however, in which a tracheostomy cannula must remain permanently in the tracheostoma. In other cases, the tracheostomy cannula assists artificial respiration.
The outer cannula can be inserted in the trachea, widening the tracheostoma with the aid of a so-called guide rod (stylet or obturator). The outer cannula keeps the tracheostoma open and needs only to be removed from time to time for cleaning. On the proximal side of the outer cannula there is fitted a so-called cannula plate, which lies against the patient's neck when the tracheostomy cannula is in the tracheostoma. The cannula plate prevents, inter alia, the tracheostomy cannula from being inserted too far into the trachea or from sliding down into it.
The correspondingly configured hose-like inner cannula fits exactly inside the outer cannula, and can be easily removed from it for frequent cleaning. This has the advantage that the outer cannula does not also have to be removed from the trachea and the tracheostoma, which could otherwise result in pain and injuries.
The tracheostomy cannulas known from the documents listed above have a cannula plate with respect to which the cannula tube is mounted pivotally about one axis, that is to say about the horizontal axis. For this purpose, the cannula plate is provided with an aperture through which the outer cannula reaches. Two pegs project into the aperture, which engage with corresponding holding means in the external area of the outer cannula such that the cannula tube is pivotable in a certain range of approximately .+-.45.degree. with respect to the cannula plate. A degree of wearer comfort is produced by means of this pivoting, to the extent that when the patient bends or lifts his or her head, the tracheostomy cannula can adjust its position to a certain degree so that the pain which a patient feels when, for example, the cannula is pressed against the front or rear wall of the trachea, is reduced.
Nevertheless, the resulting wearer comfort of the known tracheostomy cannulas is not yet satisfactory.
A tracheostomy cannula of the type described in the preamble is known from U.S. Pat. No. 4,686,977. In this a tracheostomy cannula is described wherein the cannula plate is mounted by means of a ball joint in the proximal part of the cannula. This type of mounting allows the pivoting of the cannula tube with respect to the cannula about the three spatial axes X, Y and Z. This proposal provided a theoretical approach as to how the wearer comfort of such a tracheostomy cannula could be improved. However, the production of this tracheostomy cannula ran into difficulties. There is, on the one hand, insufficient pivoting of the cannula tube with respect to the cannula plate, as the outer half-shell jaw has to enclose the ball in the joint to a comparatively large degree in the interests of safety, as otherwise there is the danger of the cannula becoming detached from the mounting and falling into the trachea. On the other hand, the fixing of the inner cannula is difficult to effect, in particular having regard to the replacement of the inner cannula which has to be done very frequently. The docume
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Srivastava V.
Tracoe Gesellschaft fu medizinische
Weiss John G.
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