US 2508690 A
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Description (OCR text may contain errors)
May 23, 1950 E. F. SCHMERL 2,508,690
GASTROINTESTINAL TUBE Filed July 13, 1948 F1Ei l P113421- I 1 5 I I 5 5 7 I 4 a z 5 I 4 I I INVENTOR. f6 o/v Fe/ 7-: fr /nae;
Patented May 23, 1950 UNITED STATES PATENT OFFICE GASTROINTESTINAL TUBE Egon Fritz Schmerl, Piedmont, Calif.
Application July 13, 1948, Serial No. 38,503
Claims. (Cl. 128-276) The invention relates to various types of stomachal, duodenal or intestinal tubes which are adapted for insertion into the gastro-intestinal tract of a patient for feeding fluids into the tract or in removing fluids or other matter therefrom.
Gastro-intestinal tubes of the character described are of several well-known types such as the Levin, Rehfus, Wangensteen, and Miller-Abbott tubes, and are generally designed for insertion, by pushing action, through the oral or nasal passages of the body into the oesophagus and thence into the stomach, duodenum, etc. As will be appreciated, the insertion of such a tube is sometimes difficult, requires considerable slclll on the part of the doctor or nurse, and such insertion is not only most discomforting to the patient but is best accomplished with his active cooperation. Sometimes, through lack of skill or error on the part of the doctor or nurse, the inserted end of the tube will enter the larynx or air passage instead of the oesophagus, and where inserted through the nasal passage will sometimes curl back through the mouth instead of passing into the oesophagus. To assist in the insertion of the tube, the patient, if conscious, is called upon to swallow the inserted tube end, which causes the epiglottis to swing over and seal off the air passage and thereby guide the inserted tube end into the oesophagus, and to thereafter continue to swallow until the inserted tube end has reached and passed through the cardia or stomach entrance. Where the patient is unconscious at the time of the insertion of the tube and his cooperation in swallowing cannot be elicited, the insertion of the tube may be more difiicult, sometimes practically impossible. Another disadvantage of the tubes described above and their method of insertion is the fact that the exit opening or openings in the inserted end of the tube may become clogged during the course of the insertion with mucus or other matter in the stomach, thereby blocking the tube and requiring its removal for cleaning before it may be again inserted. Also, tubes heretofore available have been inherently comparatively expensive and designed for repeated use, thus involving the problems of washing, cleansing, sterilizing and storing in a sterile condition each time the tube is used involving a, series of time consuming operations by trained personnel. Frequently it is desirable that the patient in home treatment insert such a tube himself at regular intervals over a period of perhaps several weeks for the purpose of carrying out what is sometimes referred to as a continuous drip treatment, as for in- 2 stance advocated in cases of duodenal ulcer. Manifestly, the self-administration of tubes of the character above is most diflicult and distressing to the patient and cannot be accomplished at all by some patients.
An object of the present invention is to provide a new and improved form of gastro-intestinal tube which may be quickly and easily inserted within the stomach or other part of the gastrointestinal tract of the patient without requiring any special skill and without any appreciable discomfort to the patient, and which may be simply and readily inserted by the patient himself without assistance.
Another object of the present invention is to provide a gastro-intestinal tube and insertion method of the character described which will deliver the inserted end of the tube into the stomach or other part desired of the gastro-intestinal tract while positively insuring that the exit opening or openings of the tube will remain free, open and unobstructed during insertion.
A further object of the invention is to provide a gastro-intestinal tube of the character described which will be simple and inexpensive in its manufacture, readily sterilized at time of manufacture and maintained in sterile condition until used, and which is designed for single use and disposal after such use.
Still another object of the invention is to provide a method of insertion of a gastro-intestinal tube of the character described which permits of the use of a soft, flexible, pliable, thin walled tube, as contrasted to the stifi'er, thick walled tubes heretofore required, thus adding materially to the comparative comfort of the patient while the tube is inserted.
The invention possesses other objects and features of advantage, some of which, with th foregoing, will be set forth in the following descniption of the preferred form of the invention which-- is illustrated in the drawings accompanying and forming part of the specification. It is to be understood, however, that variations in the showing made by the said drawings and description may be adopted within the scope of the invention as set forth in the claims.
Referring to said drawings:
Figure 1 is a cross-sectional view on an enlarged scale of a gastro-intestinal tube constructed in accordance with the present invention.
Figure 2 is an end elevation of the tube illustrated in Figure 1, on a similarly enlarged scale.
Figure 3 is a cross-sectional view similar to,
Figure 1 but showing a modified form of construction.
Figure 4 is a side elevation of the tube in position for unwinding within the stomach of the patient.
Figure 5 is a cross-sectional view of the tube showing its use as a sheath for guiding a conventional type tube into the gastro-intestinal tract.
In accordance with the present invention and as a principal feature thereof, I provide a soft, flexible gastro-intestinal tube 6 which is compacted into a small volumetric form as illustrated in Figures 1, 2 and 3, capable of being swallowed and encapsulated in a material I dissolvable in the gastro-intestinal tract, whereby the tube may be released for unfolding in the stomach after swallowing, as illustrated in Figure 4, for drawing up one end I I of the tube into the oral cavity of the patient by means of a draw thread 8 hav-- ing one end 9 thereof connected to the tube end H and having a length sufficient to leave its opposite end 12 within or outside of the oral cavity upon swallowing of the encapsulated tube. The tube 6 is preferably formed of a thin wall of flexible plastic material such as nylon, vinylite, cellophane, or the like, and should have a length, depending upon its use, of from approximately 12 to 30 inches. The minimum indicated length of 12 inches will extend from the front of the oral cavity into the oesophagus. A tube of approximately 18 inches is required to extend into the stomach and approximately 30 inches is required for extension into the duodenum, the latter measurements being also taken from the front of the oral cavity. The tube may be compacted in any suitable manner, as by folding or rollin into a helical, coiled or other compacted construction having an overall size capable of being swallowed. A compacted form of approximately /4" diameter by A" in length is suitable for this purpose.
In order to maintain the compacted tube in a soft, flexible condition for ready unfolding or unwinding when released within the gastro-intestinal tract, the tube may, at the time of compacting, be appropriately coated or otherwise lubricated with a suitable lubricant for this purpose. Finely powdered hydrogenated vegetable oil, sold under the trade name of Stearotex, finely powdered stearic acid, purified talc, or a mixture of starch and talc, boric acid, liquid petrolatum, or glycerin may be used. Preferably, the lubricant should be of a material either soluble in the gastro-intestinal juices or readily carried oil by such juices.
The compacted tube may be held in compacted form by either enclosing the tube in a gelatin capsule as illustrated in Figure l or by coating the compacted form with a gelatinous material for maintaining its shape, as illustrated in Figure 3. A hard type of capsule is shown in Figure l in which the tube 6 is inserted within the body or base [3 of the capsule and sealed therein by the capsule cap 14, the latter being perforated for passing therethrough of the thread 8. This type of capsule is widely used in the practice of pharmacy and is made laregly from gelatin and sugar, the pharmacopoeia permitting gelatin for this purpose to contain 0.15 per cent sulphur dioxide to prevent decomposition during manufacture. Glycerin may also be used for imparting flexibility. The gelatinous material used as a coat in the form of the invention illustrated in Figure 3 may be essentially the same as that used in the capsule illustrated in Figure 1. The essential characteristic required of the capsule or gelatithe gastro-intest'inal tract.
nous coating material in the two forms of the invention is that such material be dissolvable in the gastro-intestinal tract so as to release the tube for unfolding after the unit has been swallowed. Where it is desired to pass the unit through the acid juices in the stomach and into the intestinal tract for dissolving in the alkaline intestinal fluids, the capsule or envelope may be provided with an enteric coating such as salol, as is well understood in the art.
The drawthread 8 may be of any suitable material such as cotton, silk, rayon or appropriate plastic or the like and of a length sufficient to extend from. outside of the oral cavity to caudal part of the gastro-intestinal tract to which the compacted tube is to be inserted. A thread length of from 30 to 40 inches will be sufiicient for most purposes. Preferably the diameter of the thread should be small to facilitate swallowing and easy withdrawing, without being so fine as to irritate the mucous membranes overwhich it is drawn under the light tension which is required to draw up the tube end. The word thread as used herein is intended to define any elongated element of the character described including a cord or string.
It will now be clear that the compacted encapsulatet. tube of the present invention may be easily and conveniently swallowed by the patient for deposit into the stomach or other part of the gastro-intestinal tract, while the outer end l5 of the thread is maintained outside of the body.
Within a reasonably short period of time, the gelatinous envelope of the tube will be dissolved or liquefied by the gastro-intestinal juices to thereby release the compacted tube for unfolding or uncoiling. The thread 8 may then be drawn outwardly from the oral cavity so as to draw up the tube end H out of the stomach and through the oesophagus into the oral cavity. In this latter operation, the normal constricting action of the cardia ofthe stomach about the portion of the tube passing therethrough will assist in insuring the proper unwinding of the tube Within the stomach and prevent the coiled tube from being withdrawn from the stomach as a coiled unit. This latter operation of drawing out of the tube is a very simple one and is accomplished without any material discomfort to the patient. Also, since this withdrawing action requires no cooperation of the patient such as his swallowing, the tube end may be easily Withdrawn from the stomach and into and from the mouth as above described when the patient is unconscious. This fact makes the tube of the present invention ideally used in instances where such tubes .are
required for post-operative treatment. In such cases the patient may swallow the encapsulated tube prior to the. operation and thereafter. and
soft, pliable, thin-walled tube is indicated. Such.
a tube is. best used for feeding of fluids into the gastro-intestinal tract. Where it is desired to remove body fluids or substances from the gastrointestinal tract, a conventional thick-walled tube suitable for suction may be desired. In such cases, the tube of the present invention may be used as a sheath, as indicated in Figure 5 of the drawing, through which the conventional'thickwalled tube 1.6 may be inserted and guided into In such use. th sheath 6', illustrated in Figure 5, is compacted,
encapsulated, swallowed, and withdrawn as hereinabove described, so as to provide a positive guide for the heavy-walled tube I6 into the oesophagus and the gastro-intestinal tract of the patient.
The tube and encapsulating envelope of the present invention may be conveniently sterilized at the time of manufacture and assembly, and due to its hermetically-sealed condition the tube will remain sterile until used. Also, as will be understood, since the tube is inserted as a compacted unit into the gastro-intestinal tract as above described, while enclosed in its envelope, the opening or openings provided in the inserted end of the tube will at all times be and remain free, open and unobstructed, and the problem of the clogging of such openings by mucus or other material in the tract during insertion is completely obviated. Where used as a feeding tube and not as a sheath, the lower end [2 of the tube may be formed closed and the exit opening or openings formed in the side of the tube adjacent such end as is common in the art and illustrated at the lower end ll of the conventional tube 16 shown in Figure 5. It will also be clear that method of insertion of the present tube by swallowing the compacted tube as a whole and the drawing up of one end of the tube as described, enables the use of a very soft, flexible, pliable, thin-walled tube as contrasted to the tubes heretofore used, and which, by reason of their method of insertion by being pushed into the gastrointestinal tract, had to be much stiffer and thicker walled. Accordingly, the present tube may be much smaller and thereby occupy less room in the tract, and because of this and its softness and flexibility, be much more comfortable to the patient when inserted.
1. A gastro-intestinal tube comprising, a length of flexible tubing compacted into a small volumetric form capable of being swallowed, means enclosing said compacted tubin to retain said form and dissolvable in the gastro-intestinal tract, and a thread connected to one end of said tubing and extending therefrom for retaining of one end of said thread for manual engagement upon swallowing of said compacted tubing and means.
2. In a device of the character described, a flexible tube having a length extendable from the oral cavity to the oesophagus of the user, an envelope enclosing said tube in compacted form cap- 6 able of being swallowed and dissolvable in the gastro-intestinal tract, and a thread connected to one end of said tube and extending from said envelope and having a length sufiicient to permit retaining of one end of said thread for manual engagement upon swallowing of said envelope and tube.
3. In a device of the character described, a capsule of a size capable of being swallowed, a flexible tube having a length eXtendable from the oral cavity to the stomach of a user and compasted into said capsule, and a thread connected to one end of said tube and extending from said capsule by a distance sufficient to permit manual engagement of one end of said thread upon swallowing of said capsule, said capsule being soluble in the stomach to release said tube therein and permit the withdrawing of said tube end to the oral cavity by means of said thread.
4. In a device of the character described, a flexible tube compacted into a small volumetric form capable of being swallowed and being coated with a material retaining said tube in compacted form and being dissolvable in the gastro-intestinal tract, and a thread connected to one end of said tube and having a length sufiicient to extend from the stomach to the oral cavity of the user whereby upon dissolving of said material and release of said tube from compacted form said tube end may be drawn from the stomach into the oral cavity by means of said thread.
5. In a device of the character described, a flexible tube having a length sufiicient to extend from the gastro-intestinal tract to the oral cavity of a user and compacted into a volumetric form capable of being swallowed, lubricating means assisting the unfolding of said tube from compasted form, means enclosing said compacted tube to retain said form and being dissolvable in the gastro-intestinal tract so as to release said tube for unfolding therein, and a thread connected to one end of said tube and extending therefrom by a distance suflicient to retain one end of the thread in the oral cavity upon swallowing of said compacted tube whereby upon release of said tube in said tract said tube end may be drawn into the oral cavity by said thread.
EGON FRITZ SCHMERL.
No references cited.