The catheter for providing connection to the small intestine to move liquids

 

(57) Abstract:

The invention relates to medicine, namely to surgery, and is designed to provide connection to the small intestine to move liquids, preferably for conveying fluids, such as supply of nutrients specified in the intestine, as well as for diagnostics (introduction of a contrast agent for an x-ray studies of the intestine or for sampling the contents of the intestine or mucous membranes). The catheter includes a tube introduced into the small intestine through the stomach, having proximal and distal open ends and with a constitutional tendency to curl into a spiral on a segment of the distal end of a given length, and the guide posted with the possibility of displacement in the tube from the proximal end to the straightening of the specified segment so that he was in a flattened condition in the process of introducing into the stomach. The tube has at least the specified specified part of the fibrous, non-glossy, rough, ribbed outer surface (16) or a surface with ledges. The invention provides inadvertent advancement of the catheter without prescription of stimulant drugs (metoclopramide or erythromyc the terms. 7 C. p. F.-ly, 4 Il.

The invention relates to a catheter for providing connection to the small intestine to move liquids, preferably for conveying fluids, such as supply of nutrients specified in the intestine, as well as for diagnostics (introduction of a contrast agent for an x-ray studies of the intestine or for sampling the contents of the intestine or mucous membranes), which includes a tube introduced into the small intestine through the stomach, having open proximal and distal ends and having a tendency to curl into a spiral on a given segment, located at the distal end, and a removable guide placed in the tube at its proximal end and is used to straightening the specified range to the specified segment was in a flattened condition during introduction of the catheter into the stomach.

The catheter of this type is used to supply nutrients through the intestines after surgery to replace intravenous nutrition, which is more difficult to type, and it costs 5-10 times more expensive and associated with significant complications. The distal end of the catheter is placed in the small intestine, predpochteniem able twisted into a spiral, straighten by means of the guide is pushed into the specified segment, and then enter the distal end into the stomach through the nose or mouth, through the esophagus or through the skin. After a certain period of time, as in the normal diet, the catheter is pushed from the stomach into the small intestine under the action of the contractions of the stomach and intestines, as twisted in a spiral segment of the catheter is subjected to the same treatment in the stomach and the small intestine as the surrounding food. Thus, the catheter moves spontaneously. Usually twisted in a spiral segment of the catheter should be placed in the upper part of the jejunum and when it reaches this position, the catheter is fixed so that it did not progress further into the small intestine. After placing the distal end of the catheter is held in the jejunum due to the fact that twisted in a spiral segment inside the intestine is in engagement with the corrugated surface of the intestine. Thus, the task is to maximize the friction between the catheter and the wall of the intestine.

In the patent JP A 08098889 disclosed catheter, which is injected into the internal organs of the body and which relates to catheters known type having a load on distal is blikali in its distal part forms a guide and has a number of several bodies in the form of polyhedra with a specific gravity of 1 or higher, prisoners in the elastic film so that the catheter outside has irregularities that allows you to promote it during peristaltic contractions. The advantage of this catheter, as stated in the publication, is that simplified the catheter, and at the same time reduces the pain experienced by the patient.

The catheter described in the patent EP WITH 0278937, has worked well in practice. The catheter is essentially not different from the usual silicone tubes introduced into the nose or into the abdominal cavity, and therefore the cost of production of such catheters are not much above the cost of production of silicone tubing. It was found that the catheter is pushed into the small intestine within 4-6 hours after administration. After the introduction of the catheter is well held in place in the upper part of the jejunum until then, until removed, usually after seven days or so. The risk of premature return of the catheter in the stomach is very small, because the specified segment of the catheter has a tendency to curl into a spiral that prevents the displacement of the catheter, as he grips the inner surface of the small intestine. Approximately 95% of cases, when applied to the catheter, it has reached the desired position in the small intestine is Yes or erythromycin, but not all patients tolerate these drugs because they have side effects.

The present invention is to improve the catheter on an EP WITH 0278937 against inadvertent advancement of the catheter without prescription of these drugs and thus to remain at a safe level or even improve the retention of the catheter in a predetermined position, and for this purpose the catheter of the present invention, the characteristics of which are disclosed in paragraph 1 of the claims.

For a more detailed explanation of the invention hereinafter described some embodiments of the invention with reference to the drawings, in which

Fig. 1 is a side view of a catheter with a flattened tube according to one of the embodiments of the invention;

Fig. 2 is a side view of the tube according to Fig. 1, when the specified period of tubes, having a tendency to curl into a spiral, is in a twisted state;

Fig. 3 is a side view of the distal end of the catheter in another embodiment of the invention;

Fig. 4 is a view corresponding to the view of Fig. 3, catheter, representing a third option done by the other flexible tube 10, preferably of plastic or rubber, suitable for medical purposes, such as polyurethane or silicone rubber, having a proximal end 10A and a distal end 10B. Preferably, the catheter has an outer diameter of 3.6 mm and an inner diameter of 1.5 mm, but it can have other dimensions. At the proximal end 10A of the tube has a guide pipe 11 which communicates with the lumen of the tube, while the tube at its distal end 10B has a tip 12 which communicates with the lumen of the tube at one end and closed at the other end and which has at its ends a radial side openings 13. The pipe 11 serves to retain the catheter fingers, so it was easier to use a catheter, and can also be used to secure the proximal end of the holder.

Flexible, but not elastic and relatively rigid shift of the guide 14, which represents a wire from steel wire whose length essentially equal to the length of the tube 10, is introduced into the tube with the possibility of bias; at the proximal end of the guide device 15 to hold it with your fingers, by which the guide can be held at offset it in the tube.

Near the distal kV spiral to education (as a function of memories) of spiral turns, as shown in Fig. 2. This property can be given to the segment of the tube by appropriate selection of the material, and heating and curing of the segment of tubing wound on a core. Twisted in a spiral part of the tube may contain from 1 to 5 turns and have an outer diameter of about 40 mm When the guide push in a piece of a tube of a given length, this piece is essentially straightens, as shown in Fig. 1, which implies that the guide has sufficient rigidity to exert a force that exceeds the force of the torsion tube in a spiral.

In accordance with the present invention by at least a predetermined section of the tube at its distal end, having a tendency to twist in a spiral on the outer surface of this segment made such a fringe of short hairs, as shown at number 16 in Fig. 1 and 2, which are designed to stimulate the advancement of the catheter and to prevent its displacement when it is in a predetermined position in the intestine, due to increased friction of the outer surface of the tube. However, this can be achieved by other means, for example, making a tube with non-glossy rough or ribbed surface. Well peopke, containing hairs, radially protruding on the surface. Such surface do temporarily adhesive, applying glue on it, then the short hairs of the same length is applied to the surface in an electrostatic field, and the hairs under the influence of the electrostatic field are held in place so that they are directed radially outward from the tube. This provision hairs remains after curing of the adhesive.

During use of the catheter it is introduced into the stomach through the nose or mouth and then through the esophagus, or through the skin, and the catheter is introduced into a flattened form, i.e., when the guide 14 is introduced into the segment of a given length, having a tendency to curl into a spiral, i.e., in the state shown in Fig. 1. Given that twisted in a spiral part has the above dimensions, the tube according to Fig. 1 has an effective length of 30 mm greater than the length of the catheter in the state shown in Fig. 2. After insertion of the catheter into the stomach of the guide pulled out a length corresponding to this difference in effective length, i.e., about 30 mm, so that the tube is free to twist in a spiral in the stomach, then the tube is promoted by an appropriate distance in the stomach, i.e. pribliziteljny completely from the tube. Now the catheter passes, as when swallowing the usual way through the esophagus, which, of course, implies that the tube shall be of such dimensions that there remains a space for the passage of food. The food in the stomach will be surrounded by twisted in a spiral cut tube in it, and this segment of the tube will move in the same way as food, and the catheter is pushed into the small intestine under the action of the contractions of the stomach, and then under the action of peristalsis of the small intestine. Thus, the catheter is moving independently, as described in patent EP WITH 0278937. When the distal end of the catheter enters the upper part of the jejunum, the catheter is fixed and its further advancement is prevented, for example by gluing catheter with tape to the patient's body. The position of the distal end of the intestine can be checked using x-rays, and for this purpose, the distal end (e.g., tip) can be made suitable contrast agent. Twisted in a spiral segment of the catheter holds the catheter in a predetermined position in the gut and, thus, acts as a lock, preventing the offset. Due to the fact that the specified period has hairs, uneven, rough or ribbed surface the catheter increases, and it does not create obstacles for sliding the catheter during introduction. Therefore, we can assume that will be provided 100% prevent inadvertent advancement of the catheter, and the catheter will be held accurately in a predetermined position.

The flow of the nutrient solution or medication or, on the contrary, the sampling is carried out through the tube after the catheter is inserted into the assigned position.

In the embodiment of the invention according to Fig. 3 on the outer surface of the tube has a running axis outstanding in the radial direction of the protrusion 17, which twisted in a spiral segment is located inside it, i.e. inside the coils. In the embodiment of the invention according to Fig. 4 also has a ledge 18, but in this case, the protrusion is located outside twisted in a spiral cut. The ledge should be thin and loose, he must be extremely soft and flexible and may be made of plastic or rubber. It can be made of a material of the tube, but not necessarily. The protrusion can be made in the process of extrusion of the tube, and it can go not only along the specified period, with a tendency to curl into a spiral, but also along the entire length of the tube. The tube may be the tube, and on the same tube can be manufactured in two diametrically opposite protrusions so that the segment of a given length, having a tendency to curl into a spiral, twisted in the state had one protrusion on the inside and the other outside. The ledge inside the coil may have a width of 10 mm, and the protrusion on the outside of a coil should be no more than 1-2 mm In yet another possible embodiment of the invention, the protrusion is in a spiral around the tube. The protrusion or protrusions provide even stronger "grip" between the catheter and the food in the stomach, and if the tab is on the outside, as in Fig. 4, the coupling between the catheter and the inner surface of the intestine contributes to spontaneous promote and strengthen the fixation of the catheter in a predetermined position.

1. The catheter for providing connection to the small intestine to move the liquid, it is preferable to supply power to the specified intestine, which includes the tube (10), injected into the small intestine through the stomach, having proximal and distal open ends (10A, 10B) and with a constitutional tendency to curl into a spiral on a segment of a given length of the distal end, and a shift of the guide (14), which is placed in the tube with the proximal ends of DL is to, characterized in that the tube (10) at least on a specified segment of a given length has a fibrous, non-glossy, rough, ribbed outer surface (16) or a surface with ledges.

2. The catheter under item 1, characterized in that the running axis radially outstanding ledge (17, 18) are made on the outer surface of the tube (10), at least along a segment of a given length, having a tendency to curl into a spiral.

3. The catheter under item 2, characterized in that the protrusion (17) twisted into a spiral portion formed by the specified segment of a given length, is inside this part.

4. The catheter under item 2, characterized in that the protrusion (18) twisted into a spiral portion formed by the specified segment of a given length, is on the outside of this part.

5. The catheter under item 1, characterized in that the protrusion (17, 18) is in a spiral around the tube (10).

6. The catheter on PP. 2-5, characterized in that the protrusion (17, 18) is thin and elastic, and soft and flexible.

7. The catheter on PP. 1-6, characterized in that twisted into a spiral portion formed with a specified segment of a given length, contains from 1 to 5 turns and has an outer diameter of 40 mm

8. The catheter according to any one of paragraphs.ness.

 

Same patents:

The invention relates to medicine, namely to devices and methods for laparoscopic puncture and drainage of hollow organs, as well as for the imposition of anastomoses between them

The invention relates to medicine and can be used for implantation of the peritoneal catheter

The invention relates to medicine, namely to endobiliary surgery

The invention relates to medicine, namely to surgery, and can be used in the treatment of gallstone disease

Device for dilation // 2062121
The invention relates to medical technology, and is intended to expand the lumen of hollow organs

The invention relates to the field of medicine, and more particularly to vascular surgery
The invention relates to medicine, surgery may be used to treat patients with various liver diseases

The invention relates to medicine, namely to surgical devices
The invention relates to medicine, surgery may be used in peritoneal dialysis

The invention relates to medical equipment, namely, devices intended for the injection of medicines or fluids in hollow organs and body cavities, in particular used in Pediatrics, child and adult surgery with long-term intravenous infusion in the human body blood, blood products and intravenous fluids introduced into the Central vein using a catheter
The invention relates to medicine, and had surgery, and can be used to puncture volume and cavitary mass in the abdominal cavity and retroperitoneal space
The invention relates to medicine, in particular for experimental surgery, and can be used to simulate the inflammatory process in the abdominal cavity in various laboratory animals

The invention relates to medicine and can be used in endovascular surgery

The invention relates to neurosurgery, in particular to selective catheterization of the spinal canal and intervertebral holes and local endolyumbalnye pharmacophobia in the treatment of diseases of the nervous system affecting etiology, and can also be used for intravascular manipulations for the dosed administration of medication directly into the lesion

The invention relates to medicine, in particular to abdominal surgery, namely the ways intubation of the small intestine
The invention relates to medicine, urology, may be used in the treatment of postoperative strictures of the ureter in patients with a transplanted kidney

The invention relates to medicine, namely to cardiovascular surgery

The invention relates to medical equipment and can be used in the manufacture of intravenous catheter

The invention relates to medicine, namely to pulmonology, to methods of treatment of pneumonia, complicated by shortness of breath with impaired cough reflex in the absence of chest pain
Up!