US 2492384 A
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ARTHUR L. KASLOW ATTORNEY Dec. 27, 1949 A. l.. KAsLow STOMACH IRRIGATION TUBE Filed March 29, 1947 Patented Dec. 27,l 1949 UNITED STATES PATENT 4OFFICE STOMACH IRRIGATION TUBE Arthur L. Kaslow, Hollywood, Calif.
Application March 29, 1947, Serial No. 738,019
7 Claims. (Cl. 12S- 227) The present invention relates generally to devices professionally referred to as gastro-intestinal tubes which are arranged for insertion through the mouth or nasal passages and esophagus into the stomach or other portion of the intestinal tract for diagnostic purposes or passing of liquids for laving or feeding a patient.
It has heretofore been common practice to utilize a single lumen tube and a syringe connected thereto, for example, in laving the stomach of a patient. The syringe is lled with clean liquid which is forced into the stomach and thereafter sucked out by reverse operation of the syringe. The syringe must be then disconnected, emptied, and refilled with clean liquid before the process can again be repeated. The operation is therefore one which is inconvenient to accomplish with a single lumen tube and also is inherently undesirable due to the fact that the syringe tends to squirt the liquid with such force that the membranes lining the stomach may become irritated.
In its broad concept, my present invention contemplates a double-lumen tube which is so arranged that the fluids may be gradually admitted into the stomach and continuously circulated without causing irritation and discomfort to the patient. Moreover, when utilizing the device of my invention for the feeding of fluids directly into the stomach, this feeding may be accomplished at a gradual admission rate so that the foods are absorbed without being caused to accumulate and cause distension and possible vomiting. My improved construction further enables my improved device to be utilized for a multiplicity of purposes, for which the single lumen tube is ill adapted. p
Having the foregoing in mind, it is a primary object of the present invention to provide an improved device of the herein described type utilizing a double-lumen construction in which the lumina have separate connections at their proximal ends and separate communication openings at their distalends, so as to enable employment of the device for a plurality of purposes; for example, the continuous circulation of a laving iiuid; simultaneous feeding and medieating; fractional gastric analysis while administering a stimulant to increase gastric flow activity; as well as other purposes which will be apparent to those familiar with the use of such devices.
It is a further object to provide an improved device of this character in which the communieating openings at its distal end are so arranged that the possibility of their becoming blocked or occluded by mucosa or otherwise is reduced to a minimum, if not entirely eliminated.
Another object is to provide an improved'construction at the distal vend of the device, wherein a tip is formed by a projecting looped portion of the innermost tube, this tip being non-metallic and non-traumatic, and from which there will be no danger of irritation to mucous membranes, either during intubation or during use of the device.
Itis also an object of the invention to provide a device of this character which is constructed of a material of such nature as to permit the use of ointments for facilitating intubation and which will not deleteriosly be affected thereby, as in the case of previously used rubber tubes, and which may be made transparent so as to enable continuous visualization of the gastro-intestinal drainage and permit frequent changes in therapy.
Further objects of the invention Will be brought out in the following part of the specification, wherein detailed description is for the purpose of fully disclosing preferred embodiments of the invention without placing limitations on the scope of the invention defined in the appended claims.
Referrng to the drawings which are for illustrative purposes only, the single iigure is a fragmentaryvview of the device of my invention, portions being cut away and parts shown in section to more clearly disclose certain features of its construction.
As specifically disclosed, the gastro-intestinal tube of my invention comprises an elongate tube I0 of smooth transparent plastic material of approximately 16 French diameter Within which there is disposed an inner transparent plastic tube of approximately 3 to 4 French diameter, the inner tube being indicated by the numeral II. In general, the tubes I 0 and II are assembled in concentric relation with the tube I I running substantially throughout the length of the tube I0.
The entire device, for purposes of consideration, may be considered as made up of three portions, a proximal end portion, as generally indicated by the numeral I2, a distal endportion, as
. generally indicated by the numeral I3, and an intermediate portion connecting these end portions, as generally indicated by the numeral Il.
The distal end of the tube I!) is inwardly folded upon itself as shown at I5 to provide a rounded end edge I6. The associated distal end of the small or inner tube I I is formed into a reentrant loop I1, theV extreme vend I8 of this tube being sealed and projecting back into the interior of the distal end of the outer tube IIl. vThis end of the tubeV l'is then sealedA around the small tube by utilization of a suitable plastic solvent or other means.
The loop I1 is provided on its inside with a series of openings or fenestrations I9 so that this loop forms a tip or nozzle for the passage of fluid for purposes which will be subsequently explained more fully.
The distal end of the tube I is likewise provided withy a plurality of openings or fenestrations as indicated bythe numerali 20.. In practice, these fenestrations are located in the six or seven inch end portion of the tube I0, and are positioned along a spiralled line around this end of the tube.
The construction just described. is. particularly advantageous in that the tip or nozzle formed by the reentrant loop l1 gives a pliable soft construction which is non-traumatic, and will not irritate the mucous membrane linings. Moreover, by placing the openings I9Y on the inside of the loop portion, these openings are not easily blocked or occluded by intestinallmucosa'or otherwise. During intubati'on or when engaging an object, this loop will Vact with a spreading action and tend to push the object or mucosa away, providing better drainage and keeping the path clear. Likewise, in the case ofthe openings in the tube 'I-U, these openings by being arranged spirallfy around the wall ofthe tube are not all! apt` tobecome blocked at the same time, and! in practice it has been found that a passage through a portion of the openings will' be main-tained at all times.
In the intermediate portion M, the tube t0 and tube H are continuous. In the case of the outer or larger tube IU, a mark, asfindicated at Zl, is placed on the outer surface of thetube and marked or iden-tainedA with the numeral 3H to indicate that this mark is thirty inches from the distal end of the device. If desired, of course, addi-tional marks may bepositioned and properly identified' along the outer surface of the tube'for use as a measure to indicate the amount of' insertion or ntubati'on.
The proximal end l2 may consist of a tubular extension V22 which may be of plastic, butlmay be of rubber. This-extension is connected with one end of the tubet0- by means of' a tubular connector 23 which may be of clear plastic material.
The inner tube I I passes through the connector 23 and 'thereafter is carried through a slit or opening Z4 in the Wall of the extension 22. YAt the point of passage through the opening 24,the tube II is sealed with reference to the `wall of they extension 22, so that there will be no leakage at this point. vVlith the construction just described, it will be apparent that separate connections will be provided into the tubes llt and v|"l at the proximal end of the device.
The utilization of plastic materials in the tubes and il is of particular advantage that it is possible to make these tubes transparent so that acontinuous visualization oi' the gastricintestinal drainage is permitted and the desirability for changes in therapy determined. Moreover, the use of plastic materials not deleteriously aiected by ointments which would ordinarily be injurious to rubber tubes, permits the use of these ointments for facilitating intubation with greater ease and less discomfort. to the patient.
As examples of a Vnumber of uses for my improved device, it is particularly adapted for cleansing or lavingoff thesto'maoh or intestinal tract and when so used, provides' a continuous circulation. For such purpose, a container 25,
which may be part of a drip feed device, is connected through a hollow needle with the proximal end of the tube ll. In this case, the proximal end of the tube I0 may be connected to a suitable source of suction. With the tubes thus connected and inserted, for example, into the stomach, fluid may be gradually fed through the openings 19 of the loop Il and extracted by the suction through the openings 20 in the distal end of the: tube Ie.
The device is also admirably adapted for use where it may be desired to simultaneously feed and medicate the stomach. In such case, the feeding may be accomplished through the tube l0 and medication administered through the small tube H.
Another example of using the present device is for fractionalgastric analysis, in which oase, contents of the gastro-intestinal tract may be sucked through the large tube, and, if desired, a. stimulant may be simultaneously administered through the smal-l inner4 tube toA increase the gastric; flow activity.
In the case of feeding, my improved device has been found very advantageous, since it permits supplying o the liquid food at a rate sufoiently slow to permit absorption, of the: food without causing a distension due to accumulation. Vomiting may thus be obviated and the food administered without discomfort to the patient,
Other advantages and uses of. my improved device will readily become apparent to those Afamiliar with the use of such devices.
I claim as my invention:
l. AA gastro-intestinal device. comprising an outer transparent. tube of plastic material, a smaller tube of transparent plasticmaterial withinthe first. tube, said tubesr at their proximal ends havin-g the smaller tube. carried through the wall of the outer tube to effect separate4 connections to saidI tubes, andv atv their distal ends having, the smaller tubey formed into. a looped portion projecting fromv the associated endl of the outer tube and provided on'thel inside of the loop with a plurality of openings, the. distal end portion of the outer tube being. provided with a series of wall openings.
2. A gastro-intestinal device comprising an outer tube having an opening adjacent its distal end, and another tube disposed vwithin the iirst tube with an end projecting from the distal end of said rst tube and formed into a loop having au opening therein, said distal end being sealed with respect to the inner tube passing therethrough.
3. A gastro-intestinal device comprisingan outer tube having a spiraled line of openings at its distal end, anotherl tube disposed within the first tube with a looped end projecting from the distal end of the rst' tube, said looped end having an opening therein, and meansI sealing said distal end with respect to the innermost tube.
4. A Vgastro-intestinal device comprising an outer tube having aY series of openings adjacent its distal end, another tube disposedl within the first tube with a looped end projecting from the distal end of the first tube, said looped end having a series'of openings on its inner side, and' means sealing said distal 'end with respect to the innermost tube.
5. .A gastro-intestinal device comprising an outer tube havingl a turned-back distal end portion, and another tube disposed 'within the first tube with an end Iprojecting from said distal. end, the. projecting portion of the inner tube and the;
adjacent portion of the distal end having wall openings therein; .i
6. A gastro-intestinal device comprising a pair of elongate iiexible tube members in concentric relation, the innermost of said tubes projecting 5 from an end ofthe outermost tube and being formed into a reentrant loop portion having a plurality of openings therein, the adjacent portion of said end of the outermost tube having openings therein, and means sealing said end with i0 Number of the outermost tube, said tubes having 'iow zo openings adjacent the distal end of the outermost tube.
ARTHUR L. KASLOW.
REFERENCES CITED The following references are of record in the le of this patent:
UNITED STATES PA'rizzN'r` Name Date 1,188,180 Kelis June 20. 1916 2,168,270 Paisley et al. Aug. 1, 1939 2,257,369 Davis Sept. 30, 1941 OTHER REFERENCES Livingston, E. M. et al.: Surgical aids to the intercavitary treatment and study oflcancer o! the stomach, a review in Surgery of the Abdomen, pages 559, 560.