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Publication numberUS3828782 A
Publication typeGrant
Publication dateAug 13, 1974
Filing dateApr 10, 1972
Priority dateApr 10, 1972
Publication numberUS 3828782 A, US 3828782A, US-A-3828782, US3828782 A, US3828782A
InventorsS Polin
Original AssigneeS Polin
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Temporary colostomy tube
US 3828782 A
Abstract
A temporary colostomy tube for inserting through an incision in the colon and including an open ended excrement tube having an inflatible balloon at one end thereof. A retainer means secures the opposite end of the tube on the outside of the body, which prevents the tube from moving further inward in the colon. A band is positioned around the colon adjacent the balloon. The balloon is inflated to occupy the entire lumen and is slightly larger in circumference than the band. The cooperation of the band with the balloon blocks the tube from moving toward the incisions. The cooperation of the retainer means and the band with the balloon prevents the fecal stream from seeping around the balloon and tube. A disposal bag is secured to the tube on the outside of the body for receiving the fecal matter.
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nited States Patent [191 Polin [11] 3,828,782 Aug. 13, 1974 TEMPORARY COLOSTOMY TUBE 22 Filed: Apr. 10,1972 21 App1.No.:242,624

[52] US. Cl 128/283, 128/303 R, 128/344, 128/349 B [51] Int. Cl. A61f 5/44 [58] Field of Search l28/D1G. 25, 283, 295, 128/303, 344, 349 B [56] References Cited UNITED STATES PATENTS I 565,386 8/1896 Meengs 128/349 B 1,066,934 7/1913 Manney 128/283 1,217,567 2/1917 Clare ..128/283 1,389,531 8/1921 Riche 128/283 1,863,234 6/1932 Bacon 128/303 R 2,564,399 8/1951 Franken l28/D1G. 25 2,667,167 l/l954 Raiche 128/283 2,677,375 5/1954 Raiche 128/349 B 2,759,477 8/1956 Mains 128/283 3,459,175 8/l969 Miller 128/344 OTHER PUBLICATIONS Surgery, June 1970, Vol. 67, No. 6, pp. 9l8-921.

Primary ExaminerCharles F. Rosenbaum Attorney, Agent, or Firm-Jerome Goldberg [5 7] ABSTRACT A temporary colostomy tube for inserting through an incision in the colon and including an open'ended excrement tube having an inflatible balloon at one end thereof. A retainer means secures the opposite end of the tube on the outside of the body, which prevents the tube from moving further inward in the colon. A band is positioned around the colon adjacent the balloon. The balloon is inflated to occupy the entire lumen and is slightly larger in circumference than the band. The cooperation of the band with the balloon blocks the tube from moving toward the incisions. The cooperation of the retainer means and the band with the balloon prevents the fecal stream from seeping around the balloon and tube. A disposal bag is secured to the tube on the outside of the body for receiving the fecal matter.

22 Claims, 7 Drawing Figures PATENTED mm 3814 sum 1 or 2 PATENIEDMIBI 1 14 3.828 782 saw a or 2 IIIIIIIIIJ TEMPORARY COLOSTOMY TUBE BACKGROUND OF THE INVENTION This invention relates to a colostomy apparatus for evacuating fecal matter, and more particularly relates to a colostomy tube apparatus for totally diverting the fecal stream.

A colostomy is a vent in the colon for the purpose of evacuating stool and gas. Depending upon the patients specific condition, the colostomy may be permanent or temporary. A temporary colostomy can be constructed to partially or totally divert the fecal stream.

Prior to the subject invention, a colostomy generally required that the bowel be extended out from the abdominal incision. A colostomy pouch supported by a belt or girdle, was kept constantly in position to receive the feces discharged during the colostomy. This arrangement, however, was extremely objectionable due to the frequent escapage of odors and leakage of the fecal matter onto the body and wearing apparel.

Furthermore, temporary colostomy as'conventionally known heretofore, implies that at a future time the abnormal colon opening will be closed by an operation, which would entail surgery and an anesthetic, both of which carry some risk. It would additionally involve time for recuperation, post-operative pain, expense and time away from family and job. The apparatus described herein replaces the conventional temporary, completely diverting, colostomy previously used. The subject apparatus is easy to install and can be withdrawn without the need for subsequent surgery and anesthesia.

Previous to the subject invention, a colostomy tube device was experimentally used with dogs. The experimental colostomy tube device included a flexible rubber excrement tube which was shaped to a right angle by suturing together several corrugations on one end part of the tube with a horizontal mattress suture. A balloon was fitted on the non-corrugated other end part of the tube. An incision was made in the abdominal wall and colon. The tube was then inserted in the colon and the balloon inflated. A Silastic sheeting (Dow- Corning) was banded around the exterior of the colon between the inflated balloon and the incision. The fecal stream was diverted and flowed out from the tube.

The subject invention improves upon the aforedescribed experimental device to provide a colostomy tube apparatus for clinical use. It includes among other features, securing means for maintaining the colostomy tube apparatus in place to prevent outward and inward movement of the apparatus during peristalsis, or when the patient is engaging in normal body movement, such as walking or bending. The securing means also functions to prevent the colon from pulling away from the abdominal wall.

The inflatible balloon and the circular band of the herein improvement, are positioned so that a circular area of the colon is sandwiched between the band and balloon. This prevents seepage of the fecal stream around the balloon and excrement tube and, consequently, the fecal stream is fully diverted into the apparatus.

Accordingly, the primary object of the subject invention is to provide a temporary colostomy tube apparatus suitable for clinical use.

Another object is to provide a temporary colostomy, which for its termination, does not require a subses quent operation and anesthesia and the risks involved therewith.

Another object is to provide a temporary colostomy tube apparatus which is safeguarded against leakage and escapage of odors.

Another object is to provide a colostomy tube apparatus which includes a fecal matter disposal bag which can be easily removed and replaced by the patient. A related object is to include means to release gas from the disposal bag prior to the need for the replacement of the bag.

Another object is to provide a colostomy tube apparatus which is easily positioned in the colon, and easily removed therefrom.

Still another object is to provide a colostomy tube apparatus which does not move inward or outward after being installed.

Still another object is to provide a colostomy tube apparatus which totally diverts the fecal stream into. the apparatus, and includes means to prevent seepage of the fecal stream around the tube.

BRIEF DESCRIPTION OF THE DRAWINGS Referring to the drawings in which the same characters of reference are employed to indicate corresponding or similar parts throughout the several figures of the drawings:

FIG. 1 is a sectional view of the colostomy tube apparatus positioned in the body, and embodying the principals of the invention;

FIG. 2 shows the outside portion of the colostomy tube bent downward at substantially a right angle from the incision in the body, and further illustrating the disposal bag having a gas outlet opening;

FIG. 3 is an expanded sectional view of the gas outlet opening of the disposal bag;

FIG. 4 is a sectional view taken on the plane of the line 44 in FIG. 1, illustrating the lining on the inside of the tube and the air valve for controlling air flow into the balloon;

FIG. 5 is a fragmentary view of the threaded disposal end of the tube spaced from the complementary threaded collar of the disposal bag;

FIG. 6 is a perspective view of another embodiment of the colostomy tube apparatus with the various parts thereof spaced apart, and also embodying the principals of the invention; and

FIG. 7 is a sectional view of the colostomy tube apparatus of FIG. 6 positioned inside the body, and various areas of the apparatus are shown in cross-section or cut away.

DESCRIPTION OF PREFERRED EMBODIMENT Referring now to FIG. 1 of the drawings, the reference numeral 10 indicates generally a temporary colostomy tube apparatus for inserting into the colon 11 of the large intestine of the body. Generally, the colostomy tube 10 would be positioned in the transverse coion.

The colostomy tube apparatus includes a hollow open ended excrement tube 12 preformed into a substantially L-shape. Preferably, tube 12 is sufficiently rigid in construction to maintain its shape upon inserting into the colon and during use. Silastic plastic (Dow- Corning) is recommended for the tube material, al-

The tube 12 is operatively passed through an abdominal incision and a slit opening 13 which is cut into the colon 11. The inner section 14 of the tube is positioned horizontally in colon 11 as viewed in FIG. 1, and is of longer length than the outer section 15, which extends from the inside to the outside of the body. The elbow section 16 of the tube is also positioned in the colon. The receiving end 17 of the tube 12 receives the fecal stream, which is then transferred through the tube 12 and finally to the tube disposal end 18, for flowing into a disposal or colostomy bag 19.

An inflatible balloon 20 formed of a rubber or an elastic plastic type material, is fused to the outside surface of the excrement tube 12, adjacent to the receiving end 17. The balloon is inflated so that there is a slight circular bulge 21 around the colon 1 1. As may be seen in FIG. 1, the balloon 20 extends outward from end 17, so that the balloons outermost surfaces 22 function as guides for directing the fecal matter into the tube 12.

An elongated tubular member 24 is integrally formed to the inside surface of tube 12 (FIGS. 1 and 4) and communicates with the inside of the balloon 20 via opening 25. The balloon is inflated and deflated through an air valve means 26 positioned at the outer end of the tubular member 24.

A pliable resilient retainer ring or washer 28 is formed with a central opening 30, to receive the outer section of the tube 12 in a tight-fitting and locking relationship. The tube may be bent downward at substantially a right angle from the ring 28 as shown in FIG. 2. Alternatively, the tube 12 may also be bent to the side (FIG. 1), and the disposal bag 19 would then hang downward from that position.

The tube 12 may include a liner 32 (FIGS. 1 and 4) for supporting the tube in a new configuration after bending, such as in the downward position of the outer section 15 shown in FIG. 2. The liner 32 may be formed from a malleable type material, such as a copper sheeting or other suitable material which would provide the desired support. Alternatively, the tube 12 may itself be constructed of a malleable type plastic which, upon the application of sufficient force, would be bent into a new position.

The disposal end 18 of tube 12 may have external threads 34 to connect with complementary internal threads 36 of the collar 37 of the disposal bag 19 (FIGS. 1 and 5).

A band 38 is encircled around the outside of the colon 11 inside the body. Band 38 is formed by wrapping a sheet material around the colon and suturing or otherwise securing the free ends together. The circumference of the band should correspond to the circumference of the arrested colon at the selected site and the circumference of the inflated balloon should be slightly greater than the arrested colon. Th band slightly depresses the colon at the site. The band prevents the inflated balloon 20 and the tube 12 from being pushed forward toward the slit 13 during peristalsis.

The band 38 is positioned spaced from the slit 13 at a distance less than the horizontal length of the tube 12 when the tube is positioned in colon II, as viewed in FIG. I. The band 38 lies between the balloon 20 and the slit 13; but should be adjacent to the inflated balloon, in substantially an abutting relationship, with a section of the colon 11 sandwiched therebetween. After the band 38 is in place, the ring 28 should be forced inward, flush with the body skin, so that the abutting relationship of the band and balloon is maintained during the colostomy period. This prevents the fecal matter from seeping around the balloon 20 and the outside of tube 12, and therefore, the fecal stream is completely diverted into the tube 12. Band 38 should be elastic without causing any undue or restrictive stress on the colon. Silastic (Dow-Corning) has been found to be suitable material.

The disposal bag 19 includes means for releasing gas accumulations from the intestines which may inflate the bag prior to the need for its replacement. As shown in FIGS. 2 and 3, such gas release means may be a protruding finger 40 including an opening 41 formed in the upper part of bag 19. A metal or plastic wire 42, a resilient band or clamp (not shown), may be used to fully close the opening 41. Alternatively, a valve arrangement 42, either press-fitted or threadedly associated with the channel opening 41 (FIG. 6), may also be used.

Referring now more particularly to FIGS. 6 and 7, another embodiment indicated generally by the reference numeral 10a will be described, and similar parts therein will be referred to by the same numerals with an a suffix.

The tube 12a includes an inner section 14a and outer section 15a with the elbow section 160 therebetween. The receiving end 17a of the tube receives the fecal stream for transfer to the disposal end 180. The balloon 20a is fused to the receiving end 17a of the tube and the outermost surfaces 22a guide the fecal stream into the tube 12a.

An elongated tubular member 46 is integrally ormed to the balloon 20a and communicates with the inside thereof via an opening 47. The tubular member 46 loosely extends along the outer periphery of tube 12a; but, alternatively, may be fused to the outside of tube 12a (not shown). Air is inserted in the outer end 48 of the tubular member 46 to inflate the balloon 20a. A closure cap 50 may be press-fitted into the end 48. Alternatively, the end 48 and cap 50 may be threadedly associated together, or the end 48 may be closed by a resilient type clamp means (not shown).

A retainer ring 52 is formed with a central opening 54 and a side opening 56. Openings 54 and 56 respectively receive the outer section 150 of tube 12a and the outer end 48 of the tubular member 46, in a tight-fitting relationship.

A right angled connector 58 press fits onto the disposal end 18a of tube 120. A clamp 60 secures the connector 58 to end 18a upon tightening the screw 62 in any suitable manner. The outer end 64 of the connector may extend to a side direction (FIGS. 6 and 7), or rotated to point in a downward direction, and the disposal bag 19a would then hang as shown in FIG. 2.

A circular notch 66 may be formed in the outside surface of outer end 64 of the connector 58. A narrow elastic band 68 fits over the outer end 64. The neck 70 of the disposal bag 19a is passed over the end 64 and secured in place when the narrow band 68 is resiliently locked in notch 66.

Mode of Operation With reference more specifically to FIG. 1, the use of the temporary colostomy tube will be briefly described. A site on the colon proximal to the midtransverse colon is selected. An incision is made through the entire thickness of the abdominal wall, at a point corresponding to where the selected segment of colon 11 will lay. This point should not be at the waist line if possible.

The mesentery is dissected away from the colon for a distance of approximately 1 /2 inches. The sheet 38 is banded around the colon where the mesentery was dissected away, and it is cut to correspond in circumference to the colon at the selected site. The ends of the sheet 38 are sutured together with a non-absorbable suture.

Stool in the colon is milked proximally, to empty the selected segment, and non-crushing bowel clamps (not shown) are placed to isolate about a 4 inch length of colon.

A purse string suture is placed on the anterior surface of the colon just distal to the sheet band 38. The purse string suture formed of a non-absorbable material is seromuscular in depth.

A stab is made in the center of the purse string to form the slit opening 13. The receiving end 14 of the tube 12 with the balloon deflated is inserted into slit 13 until the elbow 16 of the tube is also positioned in the lumen of the colon. The purse string is tied snugly in place. The bowel clamps are removed. The balloon 20 is inflated with air forced into tubular member 24, so that the balloon 20 occupies the entire lumen and is slightly larger in circumference than the band 38.

The washer 28 is fitted over the disposal end 18 of the tube. End 18 of the tube is pulled until the inflated balloon 20 rests at the proximal edge of band 38 (but would be the distal edge with respect to slit 13), and the colon is in contact with the parietal peritoneum. The washer 28 is now manipulated downward until it is flush with the skin.

The end 18 of the excrement tube 12 is bent at a right angle in a downward direction. Antibiotics effective against colon organisms are started promptly. The disposal bag is now secured in place. The bag 19 is preferably smaller than prior conventional colostomy bags to prevent excessive accumulations of stool. The bag, therefore, must be replaced frequently. Upon any accumulation of gas inflating the bag 19, the patient in his privacy, may release the gas by unwinding the wire 42 (or opening valve 42 in FIG. 6).

All parts of the colostomy tube apparatus 10 may be formed from plastic material. All indwelling parts are preferably formed from Silastic or other material that does not harmfully react in the body. The indwelling parts may also be radiopaque so that their position can be checked as often as necessary.

When peristalsis resumes, the feces, which are semiliquid or soft to at least the mid transverse colon, are diverted out the tube. Fecal softeners or enemas instilled through the tube help evacuation of stool.

When the clinical situation is appropriate, at the time a conventional colostomy would be closed, a barrium enema per rectum can be performed to ascertain healing of the pathologic area. The balloon 20 can then be deflated and the tube 12 plugged to allow a clinical trial of fecal passage across the healed pathologic area. If the patient resumes successful bowel movements per rectum, then the tube is withdrawn. A fecal fistula will be present along the path occupied by the tube. Be-

cause the colon was held up against the abdominal wall, the fistula will be very short and should heal. Until the fistula closes, the patient wears a conventional colostomy bag to catch the drainage. The band 38 is permanently retained in position around the colon after healing, but does not obstruct nor restrict the colon.

The disposal bag 19 is securely fastened to the excrement tube 12 without a belt, as was heretofore re quired. The screw on attachment shown in FIGS. 1 and 5 or the band-groove arrangement in FIGS. 6 and 7 for connecting the bag to the tube, obviates the possibility of leaks and odors.

The ability of the tube to be bent so that it lays parallel to the abdominal wall, or as otherwise desired, enables the portions of the temporary colostomy tube apparatus 10 which are outside the body, to be worn under clothes without producing any substantial bulging effect.

It is further contemplated that the disposal bag 19 should be smaller than prior conventional size colostomy bags, to prevent excessive accumulation of stool; and hence, such smaller bag would not get excessively heavy even if it were completely filled. This would also reduce unsightly bulging, and permit the use of a less expensive disposal bag.

It will be understood that various modifications and variations may be effected without departing from the spirit or scope of the novel concepts of my invention.

I claim as my invention:

1. A method for diverting the fecal stream in the colon of the patient, a colostomy tube apparatus including an excrement tube with a balloon at the one end thereof, a sheet material and a retainer ring, said method including the steps of:

cutting the abdomen to gain entry into the colon;

wrapping and securing the sheet material around the colon into a band at a predetermined distance from an area on the colon selected to be slit open;

slitting said area;

inserting said excrement tube into the lumen of the colon through said slit, so that the balloon end thereof extends past the band;

inserting the opposite end of the tube with respect to the balloon through the retainer ring;

inflating the balloon; and

pulling the tube through the retainer ring until the balloon is adjacent the circular edge of the band, so that the balloon and-said edge of the band sandwich a common area of the colon.

2. The method of claim 1 wherein said retainer ring is forced inward until the inner surface thereof is substantially flush with the body.

3. The method of claim 1 wherein a disposal bag is secured to the outer end of the tube, and said outer end of the tube is bent at substantially a right angle to point in the downward direction with respect to the patients lower extremities.

4. The method of claim 1, wherein the diameter of said band is substantially the same as the arrested colon.

5. A method for diverting the fecal stream in the colon of a patient using a colostomy apparatus including an excrement tube with an inflatable balloon disposed at one end thereof and a sheet material, said method including the steps of:

cutting the abdomen to gain entry into the colon;

wrapping and securing the sheet material around the colon into a band at a predetermined distance from an area on the colon selected to be slit open;

slitting said area;

inserting said excrement tube into the lumen of the colon through said slit, so that the balloon end thereof extends past the band and the band is thereby between the balloon and the slit;

inflating the balloon;

pulling the tube until the balloon is adjacent said band; and

securing said tube on the outside of said body to prevent said tube from moving further inward inside said colon, after initially being positioned therein.

6. A temporary colostomy apparatus for inserting through a slit made in the colon of the body, said apparatus comprising:

a hollow excrement tube for positioning in the colon, said tube having-a receiving end and a disposal end and the fecal stream in said colon passing from said receiving end to said disposal end;

a balloon attached to the receiving end of the tube;

a band for encircling the outside of the colon between the balloon and said slit in the colon and having a distal annular edge spaced further inward from the slit than the opposite annular edge, said inflated balloon having a larger circumference than said band and being operatively positioned adjacent to said distal edge of the band, and thereby preventing said tube from moving toward said slit; and

securing means for preventing the excrement tube from moving further inward inside said colon after initially being positioned therein.

7. The apparatus of claim 6, wherein said securing means includes:

a washer having an opening for encircling said tube in a press fit relationship on the outside of the body for preventing said inward movement of the tube.

8. The apparatus of claim 6, wherein said inflated balloon extends further inward in the colon than the receiving end of said tube.

9. The apparatus of claim 6, wherein said securing means includes:

a tubular member secured to the balloon and in communication with the inside thereof to provide an air pathway for inflating the balloon; and

a washer having at least one opening to receive said tube and said tubular member in a tight fit relationship.

10. The colostomy apparatus of claim 6, wherein said securing means includes:

clamp means for securing said disposal end of the tube on the outside of the body for preventing said receiving end of the tube from moving inside said colon away from said slit.

11. The apparatus of claim 6 includes;

a disposal bag removably secured to the disposal end of said excrement tube to receive said fecal stream.

12. The apparatus of claim 11, wherein said disposal 65 a connector for connecting the disposal end of the tube with the disposal bag.

14. The apparatus of claim 11, wherein said disposal bag includes means for releasing gas accumulations 5 from the inside the bag to outside thereof.

15. The apparatus of claim 14 includes:

a finger formed in said bag and protruding outward therefrom, said finger having an opening for communicating the inside of the bag with the outside thereof, for releasing gases builtup in said bag; and

closure means for opening and closing said finger opening.

16. The apparatus of claim 14, wherein said gas release means is a valve means positioned at the upper end of the bag.

17. The apparatus of claim 14, wherein said closure means includes a ring for squeezing said finger to close said opening.

18. A temporary colostomy apparatus for inserting through a slit made in the colon of the body, said apparatus comprising:

a hollow excrement tube for positioning in the colon, said tube having a receiving end and a disposal end and the fecal stream in said colon passing from said receiving end to said disposal end;

means attached to said tube to guide said fecal stream into said receiving end;

a disposal bag removably secured to the disposal end of said excrement tube to receive said fecal stream; and

a connector for connecting the disposal end of the tube with the disposal bag, said connector being substantially right angularly shaped to enable said disposal bag to extend downward with respect to the lower extremities of the body.

19. A temporary colostomy apparatus for inserting through a slit made in the colon of the body, said apparatus comprising:

a hollow excrement tube for positioning in the colon, said tube having a receiving end and a disposal end and the fecal stream in said colon passing from said receiving end to said disposal end;

means attached to said tube to guide said fecal stream into said receiving end;

a disposal bag removably secured to the disposal end of said excrement tube to receive said fecal stream; and

a connector for connecting the disposal end of the tube with the disposal bag, said connector being bendable to vary the position of said disposal bag on the outside of the body.

20. A temporary colostomy apparatus for inserting through a slit made in the colon of the body, said apparatus comprising:

an excrement tube having a receiving end and a disposal end for positioning in the colon to provide a pathway for the fecal stream from the receiving end to the disposal end;

an inflatable balloon attached to said receiving end of the tube, said balloon when operatively inflated having a circumference slightly greater than the resting circumference of the colon;

securing means for preventing any substantial movement of said balloon after said inflated balloon is initially positioned in the colon;

a bag; and

a connector for connecting the disposal end of said excrement tube with said bag, said connector being bendable to enable the position of said bag to be varied.

21. The colostomy apparatus of claim 20 includes a liner positioned inside said connector to provide support after the connector is bent into a new configuratron.

22. A temporary colostomy apparatus for inserting through a slit made in the colon of the body, said apparatus comprising:

an excrement tube having a receiving end and a disposal end, for positioning in the colon to provide a pathway for the fecal stream from the receiving end to the disposal end;

an inflatable balloon attached to said receiving end of the tube, said balloon when operatively inflated having a circumference slightly greater than the configuration

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Classifications
U.S. Classification604/103.3, 604/328, 606/192, 604/339
International ClassificationA61F2/00, A61F5/445
Cooperative ClassificationA61F5/445, A61F2005/4455
European ClassificationA61F5/445