US 2210744 A
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Description (OCR text may contain errors)
Aug- 6, 1940- cs.v L.. wxNDER A2,210,744
(MTHETER4 Filed Jan. 17, '1959 Patented Aug. 6, 1940 l l UNITED STATES PATENT OFFICE CATHETER George L. Winder, Cuyahoga Falls, Ohio, assignor to AmericanAnode Inc., Akron, 0hio, 'a corporation of Delaware Application January 17, 1939, Serial No. 251,328
Claims. (Cl. 12S-349) This inventionrelatesto surgical accessories plane including the two inating' ducts of the and particularly to catheters designed lespecially catheter;
for usein broncho-spirometry. Fig. 3 is a vertical section taken on line 3-3 f Broncho-spirometry is a procedure recently deof Fig. 1; 5 veloped for determining the functional capacity Fig. 4 is a vertical section taken on line 4-4 5 of the lungs and is particularly useful as an aid of Fig. 1 ;v l in judging the character and degree of treatment Fig- 5 is an elevation showing another catheter which may safely be attempted in an effort to for use in broncho-spirometry, considerable porcure pulmonary tuberculosis. In the procedure, tionsof the catheter structure being broken away the respiratoryv passages of the patient are closed for clarity of illustration; 10 and he is caused to breath through tubes leading Fig. 6 is a vertical section taken on line 6-6 from the lungs to a spirometer..an instrument of Fig. 5;
Which measures and records characteristic factors Fig. 7 is a vertical lsection taken on `line 'I-l concerning the gases inhaled and exhaled by-the of Fig. 5;
patient and thereby affords a basis for calculat- Fig. 8 is a horizontal section taken on line 8*-8 15 ing the functional capacity of Lthe lungs. of Fig. 5;
The devices heretofore utilized in broncho- Fig, 9 is a fragmentary elevation showing the spirometry for conducting the gases from the Adistal end oa modified catheter generally simlungs to the spirometer have been only partially ilar to, the catheters of the other figures.
satisfactory, however, andrit is accordingly the The catheters illustrated in the .drawing are 20 chief object of this invention to provide a wholly adapted to be inserted in the respiratory passages satisfactory catheter for use in broncho-spirom-V of a patient and include appropriate separate fluid etry. More specifically, it is an object of the inchannels having separate outlets or openings for vention'to providev a compact, flexible, unitary communicating-with the lngs individually and catheter adapted to be inserted in the respiraalsoinclude spaced-apartinatable sealing means 25 tory passages of a patient with the least possible with the necessary inflating ducts for sealing the trouble and pain to the patient and to insure respiratory passages at the required points. against collapse of the structure as it is passed Referring rst to Figs. 1 to 4 inclusive, a typical through the tortuous passages as well as while catheter embodying the present invention comit is in use. It is a further object of the invenprises a main tubular structure I0 having an elon- 30 tion to provide such a catheter having separate gated configuration of suicient length to extend fluid channels to` communicate with the lungs inthrough the respiratory passagesy of a patient at dividually, and to provide convenient and effecleast from the mouth to a point within the main tive means for sealing th'e lungs from each other bronchus of one lung. The walls of the tubular as well as from the outside atmosphere in order structure Il) are provided with one opening II 35 that the functioning of the individual lungs may at a position adjacent-the distal end of the cathbe tested separately, and, if desired, simultaneeter which -is adapted'to be positioned withiny ously. It is a furtherobject of the invention to the said bronchus. The opening II conveniently provide the necessarily complicated structure. of may be provided simply by leaving the distal end 40 such a catheter in essentially unitary, one-piece, of the catheter open as shown. A second open- 40 integral form affording maximum simplicity and ing I2 is provided in the walls of the tubular safety, and contributing toward ease of thorough structure I0 at a point proximal to the rst opensterilization by eliminating all joints. ing I I and which will be generally aligned with The manner in which these and other objects the main bronchus of, for. example, the right of the invention are attained will be apparent .lung when the first opening II is positioned 45 from the following detailed description of cath within the main bronchus of the left lung. The eters embodying the invention in preferred forms. lumen of the tubular structure is divided into In the course of the description, reference will be two separate uid channels I3 and I4 by means had to the accompanying drawing, of which of a central partitioning web I5 extending from Fig. 1 is an elevation showing a catheter for the proximal end of the tubular structure I0 to 50 use in broncho-spirometry, portions of the catha lpoint I6 between the two openings II and I2 eter structure being broken away for clarity vof at which pointthe web I5 curves towardand illustration; is attached to the walls of the tubular structure Fig. 2 is a sectional-View of the catheter of to terminate the channel Il. It is thus seen Fig. 1, the section being taken through a central that the separate channels I3 and I4 communi-- cate respectively with the openings II. and I2 at the distal end of the tubular structure I0.
At the proximal end of the tubular structure, the uid channels I3 and I4 diverge and termi-v nate in separate tubular extensions I1 and I8 respectively, each adapted to be connected with appropriate fluid conductors such as conductors leading to separate spirometers.
For sealing the respiratory passages about the catheter,'two iniiatable collars I3 and 20 are provided encircling the tubular structure I0 at longitudinally spaced-apart positions, one iniiatable collar I9 being positioned between the openings II and I2 at a position adapted to seal the main bronchus of one lung into which the distal end of the catheter is extended, and the second inflatable collar 20 being positioned proximal to both openings I I and I2 in a position adapted to seal the trachea of a patient when the catheter is properly positioned for use.
For inflating collars I9 and 20, separate inflating ducts 2I, 22are provided extending longitudinally through the tubular structure Ill at circumferentially spaced-apart positions and cornmunicating respectively with the linflatable collars I9 and 20. Adjacent the proximal end ofthe tubular structure I0, the ducts ZI and22 diverge and terminate in separate tubular extensions 23., 24, respectively, each adapted to be connected to any appropriate conductor for supplying 1nflating fluid to the collars. By providing a vseparate inflating duct for each of the collars, the
collars may be iniiated individually and different pressures may be applied in the various collars.
A somewhat modified catheter embodying additional features of the invention is illustrated in Figs. 5 to 8 inclusive.- In its general aspects, the.
catheter of Figs. 5 to 8 is similar to the previously described catheter of Figs. 1 to 4 and comprises a tubular structure 30 having an opening 3| at the distal end, a second opening 32 proximal thereto, a central partitioning web 33-extending longitudinally from the proximal end of the tubular structure I0 to a point 34 between the two openings 3l and 32 where the web joins the walls of the tubular structure I0, thereby dividing the lumen of the tubular structure I0 into separate fluid channels 35 and 36 communicating respectively with the openings 3I and 32 and which diverge at the proximalV end and terminate in separate tubular extensions 31 and 38, respectively. -The relative arrangement, purposes, and functions of the several elements thus far mentioned all are substantially* identical with the relative arrangement,- purposes and functions of corresponding elements of the catheter of Figs. 1 to 4 and will not'be repeated here.
'For `sealing the respiratory passages about the tubular structure 30, two inflatable collars 39 and similar to the collars I9 and 20 of Figs. 1 to 4' are provided at corresponding positions on the tubular structure 30, the collar 38 circling the structure 30 betweenv the openings 3I and 32 and the collar 40 encircling the structure at a positipn proximal to both openings. Instead of providing a separate inflating duct for each ofthe' collars as in Figs. l to 4, however, the catheter of Figs. 5
to 8 has a single inflating lduct extending longitudinally. through the tubular structure 30 and communicating with both inat'able collars 3.9 and 40 for conducting iniiatingnuid thereto. The duct 4I diverges from the tubular structure 30 at the proximal end thereof and terminates in a tubular extension 42 adapted to be connected with any suitable means for supplying inatng ,uid under controlled pressure.
As more fully described hereinafter, the catheters of the present invention preferably are formed essentially of soft-vulcanized rubber or similar flexible material in order that the catheter may readily conformto the tortuous passages through which it must be passed. It is also desirable to make the walls of the catheter relatively thin in order to provide maximum lumen size for free passage of inhaled land exhaled gases. When this is done, however, the realatively large main tubular structure is subject to collapse and sometimes does collapse while being passed through the respiratory passages or later while being used in broncho-spirometry. Further, when the sealing collars are inflated, the catheter is subjected to localized severe collapsing pressures by the two collars and this pressure has sometimes caused the catheter to collapse at the collars.
For resisting such collapsing tendencies and for imparting a high degree of transverse rigidity to the normally collapsible tubular structure of the catheter without, however, materially detracting from lits longitudinal flexibility reenforcing elements are embodied in the structure, preferably by completely embedding the reenforcing elements in the Walls of the structure. A most effective combination of reenforcing elements illustrated in Figs. 5 to 8 includes a helical wire element 43 extending from the proximal end of the tubular structure 30 to a point-just proximal to the opening 32. A second, similar, helical wire element 44 is provided extending from apoint just distal to the opening 32 to a point at least past the dista1 end of the inflatable collar 39 and preferably to a point adjacent Athe heely of the angular distal end 4,5 of the catheter. The helical wire elements 43 and 4 4 conveniently may be formed of 0.007 inch gauge stainless steel wire and desirably should -have a low but denite pitch of, for example, 20 convolutions to the inch so that successive convolutions will be denitely spaced-apart and completely surrounded by rubber or other wall material. For reenforcing the tubular structure in the zones about the opening 3| and 32, it has been found desirable to embed circumferentially' extending fabric reenforcing elements 46 and 41, respectively, in the rubber. Such reenforcing elements-'formed of ordinary square-woven cotton fabric' such as cheesecloth have been -found to provide adequate transverse rigidity adjacent the openings and are convenient for manufacturing purposes as the fabric may either be pre-trimmed to proper size and shapebefore. being embedded in vthe rubber or may be cut with the rubberl in forming the openings after the tubular structure has been fabricated. .Y
Such reenforcements providing transverse rigidity have been found to be highly desirable, lf not absolutely essential, forsafe and reliable use ofthe present type of catheter in bronchospirometry where an undetected collapse of the tube in ruse obvlouslymight seriously alter the 'data recorded by the spirometer and might even prove fatal to the patient, if thel collapse were not detected promptly.
Any of the catheters embodying the present invention may be provided with-a pre-formed and permanently-set arcuate .conguration at the distal end, substantially as indicated at 50 in Fig. 9, for facilitating passage of the catheter into thebronchus of one of the lungs. Such arcuate configuration should conform generally to'the path of the respiratory passage from the trachea into the main bronchus of one lung.
The catheters of the present invention desirably are formed essentially of lsoft-vulcanized rubber or similar iiexible material and preferably have a unitary structure in which the rubber parts present a one-piece integral structure, as such a catheter is more easily sterilized and, especially, is not subject to separation at joints while in use. The complicated structure of the present catheters including'the embedded reenforcing elements may be provided by building up the various rubber portions by dipping suitable forms in liquid rubber latex and assembling the coated forms with the reenforcing elements and re-dipping. The inflatable collars may be provided by treating the desired local area or zone to prevent adhesion of subsequent dips and then applying further dips of latex. A catheter so made presents the desired one-piece unitary integral structure and exhibits the continuous grainless structure characteristic of rubber de posited in final form from latex. Although somewhat less desirable, the inflatable collars may be provided by cementing separately formed rubber membranes about the tubularstructure at the proper points. Although the catheters hereinabove described were designed particularly for use in bronchospirometry, the principles of the invention as herein set forth obviously may be employed advantageously in catheters for other purposes and in surgical accessories in general. Likewise, numerous modifications and Variations in the details herein described may be effected without departing from the spirit and scope of the invention as defined by the appendedclaims.
1. A surgical accessory comprising a tubular structure of elongated configuration having at least three longitudinal passageways each separate from the others, a plurality of inflatable collars lencirclingthe tubular structure at longitudinally spaced-apart positions, each of said inflatable collars communicating with at least one of said longitudinal passageways for receiving infiating uid therefrom, the walls of said tubular structure having a plurality of openings therein at longitudinally spaced-apart positions separated by at least one of said inflatable collars, each of said openings communicating with one of said longitudinal passageways and at least two of said passageways communicating with different openings, the proximal ends of said passageways being adapted to be connected with appropriate fluid conductors, said tubular structure being formed essentially of exible rubber normally subject to collapse and having embedded therein a collapseresisting reenforcement.
2. A surgical accessory comprising a tubular structure of elongated conguration having at leastithree longitudinal passageways each separate from the others, a plurality of inflatable collars encircling the tubular structure ,as longitudinally spaced-apart positions, each of said in-4 flatable 'collars communicating with at least one of said longitudinal passageways for receiving inflating fluid therefrom, thevallsbf said tubular structure having a plurality of openings therein at longitudinally spaced-apart positions separated by at least one of said inflatable collars, each of said openings communicating with one of said -longitudinal passageways and at least two of said passageways communicating with different openings, the proximal endsof said passageways being essentially of exible rubber vnormally subject to collapse and having embedded therein a collapseresisting reenforcement comprising a wire helix of low but pronounced pitch so that successive convolutions of. the helix are spaced-apart and completely surrounded by rubber, said helix extendingat least the major portion of the length of said tubular structure.
3. A catheter for use in bronchc-spirometry comprising a tubular structure adapted to extend from the mouth of a patient, through the trachea, at least to a point within the main bronchus of one lung, an inflatable collar encircling the tubular structure at a point adjacent the distal end thereof and adapted to be positioned within the said bronchus,` a second inatable collar encircling the tubular structure at a point proximal to the rst collar and which will be positioned within the trachea when the first c ollar is within the bronchus, inflating duct means communicating with said inflatable collars for conducting inflating iiuid thereto, the walls of said tubular structure having one opening distal to both inflatable collars and a second opening between the two collars, a partitioning web dividing the lumen of said tubular structure into separate fluid channels communicating, individually, with said openings, the proximal ends of said channels and of said inflating duct means being adapted to be connected with appropriate fluid conductors, said tubular structure being formed essentially of ilexible rubber normally subject to collapse and `having collapse-resisting reenforcements embedded therein, said reenforcements comprising a wire helix extending the major portiony of the length of the tubular structure and a fabric reenforcement extending a vminor portion of said length adjacent at least one of the openings in the walls of said tubular structure.
4. Av catheter for use in broncho-spirometry comprising a tubular structure adapted to extend from the mouth of a patient, through the trachea, at least to a point within the main bronchus of one lung, an inflatable collar encircling the tubular structure at'a point adjacent 'the distal end thereof and adapted to be positioned within the said bronchus, a second inflatable collar encircling the tubular structure at-a point proximal to the iirst collar and which will be positioned within the trachea when the first collar is within the bronchus, inliating duct means communicating with said inflatable collars for conducting inflating iiuid thereto, the walls of said tubular structure having .one opening distal to both iniiatable collars and a second opening between the two collars, a partitioning web dividing the lumen of said tubular structure into separate uid channels communicating, individually, with said openings, the proximal ends of said channels and of said inflating duct means being adapted to be connected with appropriate uid conductors, said tubular structure being formed essentially of flexible rubber normally subject to collapse and having collapse-resistingi reenforcements embedded therein, said reenforcements comprising a wire helix extending substantially from the proximal end of the tubular structure to a point proximally adjacent to the opening in the wall thereof betweenv the two inatable collars, a second wire helix extending from a point distally adjacent to the said opening to a point adjacent the second opening `at the distal end of the 75 structure, and a fabric reenforcement in thev intervening region between the two helices.
5. A catheter comprising a tubular structure of elongated configuration adapted to be inserted in a body passage, the walls of said structure .having an opening adjacent the distal end thereof and a second opening proximal to the first opening, a partitioning web dividing the lumen of said structure into separate fluid channels communicating individually with said( openings, an inflatable-collar encircling the tubular structure at aposition between the said two openings, a second inflatable collar encircling the tubular structure at a position proximal to both said openings, anl inflating duct extending longitudinally through said structure and communicatlapse-resisting reenforcements embedded therein,
said reenforcements comprising a wire helix extending for a major portion of the length of the tubular structure and a fabric reenforecment extending for a minor portion of said length adjacent at least one of the said openings in the wall of the tubular structure.
GEORGE L. WINDER.