US 3830225 A
A bronchoscope is provided with means permitting the introduction or removal of fluids into or from a patient's lungs while at the same time performing a biopsy or obtaining specimens by means of a brush or otherwise. Moreover, the operations being performed may be continually observed by one or more persons who can manipulate the equipment readily and without interrupting the procedure to carry out the various different operative steps.
Description (OCR text may contain errors)
United States Patent, 1191 Shinnick, D.O.
MULTIPLE PURPOSE STOPCOCK ARRANGEMENT FOR SUCTIONING, INJECTION, OXYGEN CESSORY EQUIPMENT James P. Shinnick, D.O., Pickwick Village Apts., J-l5, Maple Shade, NJ. 08050 Filed: Jan. 31, 1973 Appl. No.: 328,350
US. Cl. 128/2 B, 128/4 Int. Cl .Q A61b 1/26 Field of Search 128/2 B, 2 R, 4, 6
References Cited UNlTED STATES PATENTS 10 1954 Wallace 128/6 10/1960 MacLean 128/2 B Aug. 20, 1974 2/1972 Takahashi et a1 128/6 FOREIGN PATENTS OR APPLICATIONS 1,211,360 2/1966 Germany 128/6 Primary ExaminerLucie H. Laudenslager Attorney, Agent, or FirmSperry and Zoda [5 7] ABSTRACT A bronchoscope is provided with means permitting the introduction or removal of fluids into or from a patients lungs while at the same time performing a biopsy or obtaining specimens by means of a brush or otherwise. Moreover, the operations being performed may be continually observed by one or more persons who can manipulate the equipment readily and without interrupting the procedure to carry out the various different operative steps.
10 Claims, 5 Drawing Figures PAIENTEDmczomm SHEET 1 or 2 MULTIPLE PURPOSE STOPCOCK ARRANGEMENT FOR SUCTIONING, INJECTION,-
OXYGEN CESSORY EQUIPMENT FIELD OF INVENTION Bronchoscopes known as fiberoptic bronchoscopes, have been developed which are characterized by their increased flexibility and range of visualization while affording greater comfort or tolerance to the patient. However, in performing many examinations and treat ments of a patient, it is desirable to perform two or more operations simultaneously, as when it becomes necessary to aspirate or inject fluids through the bronchoscope while leaving biopsy forceps or other instruments in place.
Such procedures have not been possible heretofore due to the necessity of removing the forceps, suction or aspirating equipment, or the like, in order to carry out another operative step of the examination or procedure.
In accordance with the present invention, means are provided in the nature of valves or control means which can be readily manipulated by the operator during examinations to allow the introduction or removal of fluids or instruments or both without withdrawing other equipment from the bronchoscope. In particular, the present invention may be in the form of an accessory device adapted for attachment to fiberoptic bronchoscopes to increase the utility and capabilities thereof.
THE DRAWINGS FIG. 1 is a diagrammatic illustration of a fiberoptic bronchoscope having a typical embodiment of the present invention applied thereto as an accessory.
FIG. 2 is an enlarged sectional view of the elements of the accessory shown in FIG. 1 in one position thereof; and FIGS. 3, 4, and 5 are views similar to FIG. 2 illustrating alternative positions of the elements of the device.
PREFERRED EMBODIMENT In that form of the invention chosen for purposes of illustration in the drawings, the bronchoscope is preferably of the type known as a flberoptic bronchoscope and is provided with a body 2 having an eyepiece 4 on one end thereof and a tube 6 connected to the opposite end thereof for insertion into a patients lung'. A light tube '8 is also connected at one end to the body 2 and has an electrical connector 10 on the opposite end thereof for providing illumination in carrying out an examination'or performing an operation. If desired, a secondary eyepiece 12 may be connected to the eyepiece 4 to permit an assistant or student to observe the operations'being performed by the doctor using the bronchoscope.
'In accordance with the present invention, a unit 14 is connected to the body 2 of the bronchoscope and has a passage 16 therethrough for the insertion and removal of an instrument 18 such as biopsy forceps, curettes, brushes, or'the like, which may be passed into and out of the tube 6 for obtaining cytological specimens or'performing operative or other procedures. The
outer end of the unit 14 and passage 16 are normally closedby a membrane or closure element 20 (FIGA) which is movable to permit the insertion and removal of instruments 18, whereas the opposite or inner end of the unit 14 is provided with threads or other attaching means 22 by which the unit 14 may be secured tov the body 2 of the bronchoscope.
The passage 16 between the closure element 20 and the outlet end 23 thereof is enlarged in cross section so as to provide a space 25 about the instrument 18 for the flow of fluids into and out of the tube 6 of the bronchoscope while the instrument remains in place within the passage 16.
The unit 14 is provided at about the mid-point thereof with a lateral extension 24 for connection with a tube or conduit 26 by which fluids may be passed into or out of the passage 16 of the unit through an opening 28 in the enlarged portion of the passage. A member 30 in the general form of a stop cock is located in the enlarged portion of the passage 16, adjacent the opening 28. The member 30 has three ports therein arranged with the ports 32 and 34 on opposite sides of the .member 30 and of such size as to permit the instrument represented at 18 to be passed freely through the ports. The third port 36 is positioned at right angles to the ports 32 and 34 and designed to cooperate with the opening 28 in passage 16 of the unit 14 to permit the flow of fluids through the unit to and from the conduit 26 and the tube 6 of the bronchoscope. A handle 38 connected to the member 30 projects outward at the end of the unit 14 to permit the member 30 to be moved to the position of FIG.2 wherein the ports 32 and 34 are located so as to allow the passage of an instrument 18 through the unit. At the same time, the port 36 is brought into registry with the opening 28 in the unit 14 to provide communication of the conduit 26 with the tube of the bronchoscope. However, when no instrument is being used, the member 30 may be moved to the position of FIG. .5 to provide only for fluid flow through the unit 14 and conduit 26 under .control of a valve 40.
The conduit 26 may be of any suitable or convenient length, say about 20 centimeters, and is connected to control means such as the valve 40. The valve is .designed to control the flow of fluids to and from the unit 14 and tube 6 to permit oxygen, fluid medication, or the like, to be administered to the patient and to permit body fluids, mucous, blood, or the like, .to be withdrawn from the patients lungs.
The valve 40 is preferably constructed to be operated manually by one hand so that the doctor or assistant will have the other hand free .tohandle 'instrumentsor the like. For this purpose the valve is preferably ,provided with a tubularbody 42 within which aplunger 44 is axially movable. A spring 46 located in the base of the tubular body 42'bears against the lower end of the plunger 44 to urge it outward in the valve body, whereas the plunger may be depressed against the .ac-
' tion of the spring 46 by pressure appliedtotheplunger nication with a cylindrical connector 58 secured to the body 42 of the valve to which the tubular conduit 26 is attached. Further, the plunger 44 is provided with a through passage 60 by which the conduit 26 may be brought into communication with a connector 62 carried by the body 42 of the valve for the application of suction to remove fluids from the patients lung through tube 6, unit 14 and conduit 26 under control of the valve 40.
The construction thus provided is capable of varied uses permitting the application or removal of fluids to or from a patients lung at all times while the tube 6 of the bronchoscope is in place and further, renders it possible to apply or remove such fluids while employing instruments or carrying out and observing the operations being performed. Moreover, it is not necessary to remove the instruments from the unit and bronchoscope in order to introduce or remove fluids to or from the area being observed or upon which operations are being performed.
Accordingly, in using the equipment as shown in FIG. 2, the member 30 of unit 14 is moved by handle 38 to a position in which the ports 32 and 34 are aligned with the passage 16 whereby the instrument 18 may be passed through the closure element 20 at the upper end of the unit and into the tube 6 of the bronchoscope for performing the desired operations. At the same time, the port 36 of the member 30 is brought into registry with the opening 28 in the unit 14 for communication with the conduit 26. Thereafter, if it is desired to introduce oxygen or other fluids into the patients lung, the plunger 44 of valve 40 may be depressed against the action of spring 46 to bring the lateral opening 56 in cavity 50 of the plunger into communication with the conduit 26, as shown in FIG. 3. Fluid may then flow from the cavity 50 through conduit 26 to the passage 16 in unit 14, and, thence through the space 25 about the instrument l8 and into the tube 6 of the bronchoscope, as indicated by the arrows 64 of FIG. 2.
In the alternative, if fluid is to be removed from the patients lung through tube 6 of the bronchoscope, the plunger 44 of the valve 40 may be moved to a position of FIG. 4 in which the plunger provides communication between conduit 26 and connector 62 for the application of suction to the unit 16 and tube 6 of the bronchoscope. Fluid will then flow through the tube and unit past the instrument 18, as indicated by the arrow 66 of FIG. 4, to conduit 26 and valve 40 for discharge through connector 62.
The flow of fluid into or out of the patients lung can thus be effected without removal of the instrument l8 and without obstruction to the view of the operator using the bronchoscope.
Further, in using the equipment of the present invention when no instruments are being employed, the handle 38 of the unit 14 may be moved to rotate the member 30 within the unit to position shown in FIG. 5, wherein the port 36 in member 30 communicates with the tube 6 of the branchoscope and port 32 communicates with the conduit 26 controlled by the valve 40. The operator may then depress the plunger 44 of the valve against the action of spring 46 to either the position as shown in FIG. 3, wherein the laterally directed opening 56 will be brought into communication with the conduit 26 or to the position of FIG. 4, wherein the through passage 60 therein serves to bring the conduit 26 into communication with connector 62 for the application of suction to bronchoscope tube 6 to remove fluids from the patients lung.
The movement of the plunger 44 of valve can be effected by a finger of one hand grasping the valve and if desired, the amount of suction or pressure applied in supplying or removing fluids to or from the conduit 26 and tube 6 may be varied by th operator by depressing the plunger in a controlled manner to bring the opening or through passage in the valve into limited or full registry with the connector 58 to which the conduit 26 is attached.
In the alternative and if more convenient, oxygen or the like or suction may be applied directly to the unit 14 through the membrane or movable closure element 20 at the outer end of the unit 14. In that event, the valve 40 need not be employed and the plunger 44 will remain in its uppermost position, as shown in full lines in FIG. 2.
While one preferred embodiment of the invention and methods of using the equipment have been shown and described above, it will be apparent that numerous changes may be made in the form, construction and arrangement of the various elements of the combination. In view thereof, it should be understood that the particular embodiment of the invention illustrated in the drawings is intended to be illustrative only and is not intended to limit the scope of the following claims.
1. In combination with a bronchoscope embodying a flexible tube for insertion into a patients lung; a detachable unit adapted to be connected to said bronchoscope and formed with a passage therethrough to permit insertion and removal of instruments through said unit and into said tube; a conduit connected to said unit and control means connected to said conduit through which fluids may be passed to and from said conduit, unit, and tube.
2. A bronchoscope as defined in claim 1, wherein said control means is movable to alternative positions to permit either the introduction or the removal of fluids through said tube.
3. A bronchoscope as defined in claim 1, wherein said passage has an opening therein through which fluids may be passed to or from said passage, and valve means for selectively opening and closing said passage and opening.
4. A bronchoscope as defined in claim 1, wherein said control means includes a spring pressed valve manually operable to selectively permit flow of fluid in opposite directions therethrough.
5. A bronchoscope as defined in claim 1, wherein said passage has a closure adjacent one end thereof movable to permit the insertion and removal of an instrument through said passage, the opposite end of said passage having an internal cross section sufficient to permit the flow of fluids into and out of said passage past an instrument extending through said passage, and an opening communicating with said passage between said ends thereof through which fluids may flow into and out of said tube and passage.
6. A bronchoscope as defined in claim 5, wherein said passage has an enlarged portion between the opposite ends thereof and a member is located in said enlarged portion movable into and out of a position to permit the movement of an instrument through said passage.
9. The combination as defined in claim 8, wherein said conduit has valve means therein movable to alternative positions to permit the flow of fluid either into or out of said passage and tube.
10. The combination as defined in claim 8, wherein said passage has means therein for blocking said passage to prevent insertion of an instrument into said tube while permitting the flow of fluid into or out of said tube and conduit.