US 3169528 A
Description (OCR text may contain errors)
Feb. 16, 1965 F. s. KNOX m, ETAL 3,169,528
CORONARY SINUS sucxma Filed May 24, 1955 INVENTOR FRANCIS S. KNOX II 9 HARLESTON J. HAL LAR ATTORNEY such as a suitable transparent plastic material.
United States Patent 3,169,528 CORONARY SlNUS SUCKER Francis S. Knox El, 814 Woodsdale Road, Wilmington, Del, and Harleston J. Hall, Jr., 261 Upper Mountain Ave, Upper Montclair, NJ.
Filed May 24, 1963, Ser. No. 282,895 2 Claims. (Cl. 128-359) This invention relates to a surgical drainage collection device.
The primary object of this invention is to provide a surgical drainage collection device or coronary sinus sucker which is adapted to be used for reclaiming reusable blood from the operative field during open heart surgery and the like.
A further object is to provide an aspirator or coronary sinus sucker which consists of one or more tubes that are adapted to be made of a suitable material such as transparent plastic material which may be polvinyl chloride, and wherein the reinforcing member such as a length of wire is suitably embedded in the tube or tubes, and wherein the ends of the wire terminate inwardly at the ends of the device.
Still another object is to provide an improved coronary sinus sucker for cardiac surgery and the like wherein there is provided a reinforcement which causes the sucker to retain any configuration into which it is bent, and wherein the present invention can be made at low cost, and wherein in one form of the invention the wire may be embedded in the wall of a single tube, or else in another form of the invention the length of wire may be interposed between inner and outer concentrically arranged tubes.
Another object is to provide a surgical drainage collection device of the character described that is economical to manufacture and efficient in use, and further objects and advantages are to provide improved elements and arrangements thereof in a device of the character described that is durable in form and conducive to the most economical use of materials and uniformity of members formed therefrom.
Still further objects and advantages will become apparent in the subsequent description in the specification.
In the drawings:
FIG. 1 is a perspective view illustrating one form of the surgical drainage collection device of the present invention.
FIG. 2 is an enlarged sectional view taken on the line 2-2 of FIG. 1.
FIG. 3 is a sectional View taken on the line 3-3 of FIG. 1.
FIG. 4 is a sectional View taken on the line 4-4 of FIG. 1.
FIG. 5 is an enlarged fragmentary sectional view taken on the line 55 of FIG. 4 illustrating certain constructional details of the present invention.
FIG. 6 is a view similar to FIG. 1 illustrating a modification.
FIG. 7 is a sectional view taken on the line 77 of FIG. 6.
FIG. 8 is a sectional view taken on the line 88 of FIG. 7.
FIG. 9 is a fragmentary sectional view illustrating a further modification.
Referring in detail to the drawings, and more particularly to FIGS. 1 through 5 of the drawings, the numeral 23 indicates the surgical drainage collection device of the present invention which is shown to comprise a pair of concentrically arranged inner and outer tubes 21 and 22 which are adapted to be made of a suitable material The numeral 23 indicates a length of wire or ductile material or metal which is interposed between the tubes 21 and 22, and as shown in the drawings the inner tube 21 is longer than the outer tube 22 so that there is defined a projecting end portion 24 for connecting to the intake hose of a suction system of conventional construction, and the opposite end portion 25 of the tube 21 defines a pickup end. As shown in FIG. 1 for example, the end portion 25 has a plurality of spaced apart perforations or apertures or openings 26 therein, and other apertures or openings 27 are also arranged in the end portion 25 in spaced relation from the apertures 26. As shown in FIG. 5, with the wire 23 interposed or embedded between the tubes 21 and 22, the adjacent portion of the tube. 22 has a tendency to bulge outwardly as at 28, and the adjacent or contiguous portion of the tube 21 has a tendency to bulge inwardly as at 29. The ends of the tube 21 are open as at 30 and 31, and the numeral 32 indicates the hollow interior of the inner tube 21.
The tubes 21 and 22 are adapted to be bonded together at their meeting surfaces and at the ends of the larger or outer tube 22.
Referring now to FIGS. 6, 7 and 8 of the drawings, there is illustrated a modified or alternative surgical drainage collection device which is indicated generally by the numeral 33, and the device 33 is in the form of a single tube sucker wherein the single tube is indicated by the numeral 37, and the ends of the tube 37 are open as at 34 and 35. The numeral 36 indicates a length of wire which is embedded in the wall 45 of the single tube 37, and the tube 37 is longer than the wire 36 so that there is defined a projecting end portion 44 which serves the same purpose as the previously described projecting end portion 24 of the device 20. Also there is defined at the other end of the tube 37 a pickup end 38 which has spaced apart openings 32 and 49 therein. As shown in FIG. 7, with the wire 36 embedded in the wall 45 of the tube 37, portions of the wall contiguous to the wire bulge outwardly and inwardly as at 41 and 42. The numeral 43 indicates the hollow interior or bore of the tube 37.
From the foregoing, it will be seen that there has been provided an improved surgical drainage collection device or coronary sinus sucker, and in use with the parts arranged as shown in FIGS. 1 through 5 for example, it will be seen that the device 20 consists of the inner and outer tubes 21 and 22 with the wire 23 interposed between the tubes 21 and 22. The tube 21 is longer than the tube 22 so that there is defined a projecting end portion 24 as well as the pickup end portion 25, and the end 25 has the openings 26 and 27 therein. The tube 22 is longer than the wire 23. The tubes are adapted to be made of a suitable material such as suitable transparent plastic material.
In the form of the invention shown in FIGS. 6, 7 and 8, the device is indicated generally by the numeral 33 and consists of a single tube 37 which has the wire like member 36 embedded in the wall 45 thereof, as for example as shown in FIG. 8. The tube 37 is adapted to be made of transparent plastic material, and the tube 37 is longer than the wire 36 so that there is defined a projecting end portion 44 and the oppositely arranged pickup end portion 38, and the pickup end portion 38 has the openings 39 and 40 therein which serve the same purpose as the previously described openings 26 and 27.
It will be seen that in FIGS. 1 through 5 that there has been provided a surgical drainage collection device which consists of two concentric tubes made of transparent thermoplastic material and polyvinyl chloride is especially suitable as a material for making the tubes. These tubes enclose between their walls the length of ductile metal such as the copper wire 23, and as shown in FIG. 1, the larger tube extends beyond both ends of the wire 23,
and the smaller tube 21 extends beyond the end of the larger tube 22. The smaller tube 21 has the apertures or perforations 25 and 27 in one end thereof for facilitating the collection and aspiration of fluids. These two tubes 21 and 22 are bonded together by any suitable means where their surfaces meet or join at each side of the wire and around the ends of the larger tube, and the present invention provides certain important advantages or improvements over existing devices and the present invention is especially suitable for use during surgery, especially where drainage is to be returned to the circulatory system of the patient.
As shown in FIGS, 6, 7 and 8 the surgical drainage collection device 33 may consist of a single tube 37 which has the length of ductile metal such as copper wire 36 embedded in its wall 45, and the tube 37 extends beyond the ends of the wire.
In both forms of the invention the device is bendable along its axis throughout the greater portion of its length at the will of the user, and the device will retain its bends or curves until again adjusted or altered by the user, and the device will contribute greatly or help maintain a clear view of the operating field and also will maintain clear working space for the surgeons hands as well as for the surgical instruments.
Due to the bendable nature of the device, it is suitable also for use as a surgical retractor while also performing its primary function. The device is adapted to utilize materials, because of its construction, which do not require surface treatment or coating for inhibiting damage to the blood of the patient. In addition, because of the material which can be used in its construction, and because of the bendable characteristic of the device, and due to its uniform diameter, it can be used as a postoperative drain inserted through a small orifice or opening in the body. The device can be made at low cost as compared to existing such devices. In addition because of its construction, the present invention will permit and insure a significant reduction in cost of its preparation for reuse since no special surface treatment is required and due to the consequent reduction in time required for preparing the device for reuse. The openings such as the openings 26 and 27 or the openings 39 and 49 are arranged in one end of the device so as to insure that that one end is made more flexible and this flexibility helps reduce the danger of trauma to the blood vessels or other living tissue to which the tube may be applied.
The aspirator or coronary sinus sucker of the present invention is intended primarily for reclamation of reusable blood from the operative field during open heart surgery, and it is also useful for removing discardable fluids during other types of surgery, and it can also be used as a drainage catheter. That is, it can be left in the incision for a part of the post-operative period to permit drainage of waste products and the like. The device is adapted to be made of a suitable material such as a suitable plastic tubing such as polyvinyl chloride, and the wire member may be annealed copper or brass Wire, and and vinyl cement is adapted to be used for bonding or joining the parts together. The parts can be made in different shapes or sizes and of various materials as desired or required. The suckers may have an inner bore for example that ranges from /8 inch to A inch, and the tubing may be made in different lengths, and for example the tubing 21 may be 30 centimeters long. The larger diameter tubing 22 may be about 18 to 20 centimeters long, and the piece of wire 23 is inserted or interposed between the inner and outer tubes, and this wire may be several centimeters shorter than the outer tube and may have a diameter of about .085 to .09 inch. Vinyl cement is adapted to be introduced or used between the tubes for bonding the tubes together along either side of the length of Wire and for bonding the ends of the outer tube to the surface of the inner tube, and this cement serves to fix the Wire in an alignment roughly parallel to dthe longitudinal axis of the tubes, and also serves to seal off the wire so that no blood or other liquids can come into contact with the same.
The projecting end 24 of the inner tube 21 is adapted to be fitted to the intake hose of a conventional suction system, and the other end is trimmed so that approximately 1.5 to 3.5 centimeters project beyond the end of the outer tube 22. As shown in FIG. 1 three or four openings or perforations 26 which may be .1 to .2 centimeter in diameter at the inner surface are made in the wall of the inner tube close to its open end 31, and two or three similar holes 27 are formed in the tube wall near the end of the outer tube 22. Due to this construction, with the device being used, when the open end 31 is placed against tissue or the like, fluid will be drawn through the openings 26 near the tip, and if these openings should become occluded by solid matter, the openings 27 further from the tip will admit air to reduce the suction and to permit the tip to be moved without pulling or causing damage to the tissue.
An important feature or aspect of the present invention is that it is pliable or malleable and it can be bent easily so that it can pass around obstructions and can be kept out of the surgeons way. The inelastic wire 23 or 36 prevents the plastic from springing out of the desired shape or configuration, and there is enough inherent stiffness to permit the sucker to double as a retractor in certain applications. In cardiac surgery the drainage is put back into the patients blood supply through the heart-lung machine, and the suckers that are now generally in use are made of stainless steel which promotes excessive foaming when in contact with a mixture of blood and air and they must therefore undergo inconvenient processing before each use thereof. Vinyl plastics do not promote foaming and no prior treatment of the surface is required, and relative low cost permits them to be discarded after being used if it is desired to avoid cleaning, rinsing, wrapping, sterilizing and the like. Another important feature of the present invention is the transparency of the tubing and the fact that the device collapses due to suction if all of the intake openings become occluded. Thus the surgeons can readily take notice of any change in conditions without being required to turn their heads or to request information or the like.
In the modification of FIGS. 6, '7 and 8 the device consists of a single tube sucker with the st ffening wire 36 embedded in the wall 45 of the tube.
Coronary sinus suckers heretofore available have had a number of disadvantages or drawbacks such as being expensive, somewhat difficult to clean, and usually they have been made of stainless steel and must be coated internally with silicone grease before each use for inhibiting foaming of blood, and in addition they are rigid and thus cannot be shaped to conform to cavities, apertures and the like. In order to overcome these disadvantages, the sucker of the present invention has been made pliable and is made of a material other than steel, and vinyl tubing is especially suitable for making the parts, and when making the device of two pieces of tubing of different diameters, the diameters are such that there is a fairly close fit one within the other. The device 20 in FIGS. 1 through 5 is assembled or formed with the straight piece of annealed copper or brass wire that is 1 or 2 centimeters shorter than the outer tube inserted between the walls of the two tubes, and vinyl cement is arranged along both sides of the wire and around both ends of the outer tube, and this serves to insure that the wire is maintained isolated and is also held loosely but adequately in alignment along the axis of the tubing.
enerally when the sucker is used, the conditions are such that small quantities of blood from shallow pockets are intermittently collected. It is not feasible to use a single intake orifice because any tissue encountered will be drawn against the orifice and close it and defeat its purpose and thus make withdrawal difficult and may result in a traumatic condition. Thus metal sucker tips are of necessity usually rather complicated in order to pernut ventilation thereof. Unfortunately this means that turbulent mixing of air and blood occurs inside the tip except at the rare moments when the entire tip is submerged and this condition is known to pfomote foammg and is believed to be an important factor contributing to hemolysis. Since there seems at the present time no Way of overcoming these conditions, the present invention has been provided in such a manner as to maintain the instrument as simple as possible and to provide ventilation merely by perforating the wall at the pickup end 25 or 38 of the protruding tube portion, and this is entirely satisfactory insofar as blood pickup and ventilation are concerned even when the total area of the openings or apertures is much greater than the cross-sectional area of the tube lumen.
In addition the plastic suckers are much less noisy than the metal devices and they can be autoclaved but because of the heating having a tendency to cause some softening, preferably gas sterilization is used. Since the parts are made of plastic, the plastic will not cause foaming or clotting and no silicone grease coating is required. Also, hemolysis caused by contact with the tube wall will be minimized or reduced as compared with metal tubes. Furthermore since there is no abrupt change of section within the tube, there is little tendency to turbulence and consequential ill effects. The primary advantage of the present invention is that the wire reinforcement causes the sucker to retain any configuration to which it is bent. This means that the surgeon can manipulate the device with one hand if necessary, into any combination of curves and bends to suit the particular requirements, and the sucker can serve the additional function of a retractor if desired or required. Also the sucker can be used as a coronary perfusion instrument during lengthy open heart surgery with the advantage over existing devices that it can be shaped in situ in order to conform to the individual peculiarities of the cardiac region of a particular patient.
The materials are inexpensive and the devices can thus be made at a low cost. While the suckers may not need to be reused in view of the low cost thereof, if necessary they may be reused in subsequent operations at least until the wire begins to work harden or difiicult to manage kinks form.
In the device of FIGS. 6, 7 and 8 the wire 36 is embedded in the wall of the single tube and both forms of the invention are inexpensive to make and eflicient in use.
As shown in FIG. 5 the two tubes are brought together just past the end of the wire 23 so there is practically no void remaining. Similarly in FIG. 8 there is substantially no void remaining at the end of the wire 36 and the device can be made in any suitable manner as for example by vacuum forming during extrusion so that there will be a fairly tight closure. As shown in FIGS. 6, 7 and 8 for example, the wire 36 is arranged relative to the center line of the tube 37 so that the tube wall bulges outwardly as well as inwardly as at 41 and 42 and this helps prevent occlusion at sharp bends. The outwardly and inwardly bulging portions 28 and 29 serve generally the same purpose as the bulging portions 41 and 42.
Attention is directed to FIG, 9 of the drawings wherein the numeral 47 indicates a further modified portion of a coronary sinus sucker that includes a tube 48 of suitable material such as transparent pliable material, and a length of wire 49 is arranged in the tube 48, and the tube 48 is longer than the wire 49 so that there is defined a pickup end portion 53 that has its tip or end closed as at 59. The portion 53 is adapted to be provided with apertures 51 therein as well as larger openings or holes 52 therein.
Thus, instead of having the end open as at 31 or 35 in connection with the previously described arrangements, the end or tip is closed as at 50, and the openings such as the openings 51 and 52 suffice for the intended or desired purpose so that it is not necessary to have the end open as at 31 or 35.
Also, the sucker of the present invention may be used in a smaller diameter and with a longer perforated tip as a specialized abdominal drain, and one of the medical procedures would be to use such a drain as a catheter for peritoneal dialysis. It may be used also for the introduction of fluids for flushing out body cavities or surgical fields such as a feminine douche.
Minor changes in shape, size and rearrangement of details coming within the field of invention claimed may be resorted to in actual practice, if desired.
What is claimed is:
1. An appliance for thoracic, cardiac surgery, said appliance adapted to have body fluids pass therethrough, said appliance embodying a tube having a bore, a proximal end and a distal end, said tube having at least one of its ends open, said tube having a cylindrical shaped wall, said tube being made of pliable transparent plastic material, and a reinforcing member consisting of a wire that is arranged externally of the bore of said tube, said reinforcing member being made of ductile material and being affixed to said tube, and said reinforcing member being shorter than said tube wherein the reinforcing member has its ends terminating inwardly of the ends of the tube, so that the proximal and distal ends of the tube are not reinforced thereby alleviating damage to the body tissue, said reinforcing member adapted to initially support said tube in a first configuration whereupon upon bending said tube into a second configuration, said member will retain the tube in the configuration into which it is shaped and bent, said distal end always retaining a straight shape, said wire being circular in cross section and permitting all portions of the appliance to bend in any direction.
2. The structure as defined in claim 1 and further including apertures in one of the end portions of the tube, and the other end portion of the tube being free of apertures, said wire terminating at a point spaced inwardly from said apertures.
References Cited by the Examiner UNITED STATES PATENTS RICHARD A, GAUDET, Primary Examiner,