Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3920023 A
Publication typeGrant
Publication dateNov 18, 1975
Filing dateMar 21, 1974
Priority dateMar 21, 1974
Also published asCA1045493A1
Publication numberUS 3920023 A, US 3920023A, US-A-3920023, US3920023 A, US3920023A
InventorsBinard William J, Dye John F
Original AssigneeKendall & Co
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method and apparatus for placement of a suprapubic catheter
US 3920023 A
Abstract
A suprapubic catheter is inserted into a bladder in a safe, efficient and simple manner by first inserting a hollow, curved and rigid tubing member transurethrally into a bladder. The tubing member has a catheter therewithin onto which a cutting point is attached, and is constructed in such a manner as to permit the cutting point to, when pushed through the distal end thereof, pierce the anterior wall of the bladder after it has been externally palpated for placement. The cutting point, then emerging from the bladder, can be grasped externally and the catheter can be pulled through the tubing member and into the bladder to a premarked point thereon and may be separated from the main body of the catheter and connection made to a conventional drainage and collection assembly. The tubing member is then withdrawn backwardly leaving the catheter tube safely within the bladder in the proper position. A stylet may be employed to remove the catheter when drainage is to be terminated.
Images(3)
Previous page
Next page
Claims  available in
Description  (OCR text may contain errors)

United States Patent 1191 Dye et al.

[ Nov. 18, 1975 METHOD AND APPARATUS FOR PLACEMENT OF A SUPRAPUBIC CATHETER [75] Inventors: John F. Dye, Reedsburg, Wis.;

William J. Binard, Barrington, Ill.

[73] Assignee: The Kendall Company, Boston,

Mass.

22 Filed: Mar. 21, 1974 211 App]. No.2 453,318

Primary Examiner-Richard A. Gaudet Assistant Examiner-Henry S. Layton Attorney, Agent, or Firm-Edward .l. Scahill, Jr.

[57] ABSTRACT A suprapubic catheter is inserted into a bladder in a safe, efficient and simple manner by first inserting a hollow, curved and rigid tubing member transurethrally into a bladder. The tubing member has a catheter therewithin onto which a cutting point is attached, and is constructed in such a manner as to permit the cutting point to, when pushed through the distal end thereof, pierce the anterior wall of the bladder after it has been externally palpated for placement. The cutting point, then emerging from the bladder, can be grasped externally and the catheter can be pulled through the tubing member and into the bladder to a premarked point thereon and may be separated from the main body of the catheter and connection made to a conventional drainage and collection assembly. The tubing member is then withdrawn backwardly leaving the catheter tube safely within the bladder in the proper position. A stylet may be employed to remove the catheter when drainage is to be terminated.

16 Claims, 5 Drawing Figures US. Patent N0v.18, 1975 Sheet1of3 3,920,023

FIG I US. Patent Nov. 18, 1975 Sheet 2 on 3,920,023

US. Patent Nov. 18, 1975 Sheet3of3 3,920,023

M MWF BACKGROUND. OF THE INVENTION This invention relates to a method andapparatus for placement of a suprapubic catheter, and more particularly to a method for suprapubic cystotomy wherein the catheter initially pierces the bladder wall from within and is drawn outwardly therefrom for final placement.

Suprapubic' catheterization is the insertion into the urinary bladder of a drainage tube through the skin in the lower abdomen above the pubic bone, i.e., the suprapubic area. The procedure is normally carried out by placing a regular transurethral catheter into the bladder, and instilling sterile liquid therein until the bladder is sufficiently full that it can be palpated through the skin. This catheter is then removed and the suprapubic catheter is placed into the bladder by one of two means the trocar method or the needle method.

These methods of insertion can be potentially. dangerousunless great care is taken during insertion. Com-.

plications often arise due to over-penetration of the cutting point into the surrounding bowel or bladder area, since these insertions are made blindly.

Another technique of inserting suprapubic catheters involves inserting a rigid instrument having a curved distal portion that has a clamp thereon into the bladder and depressing the handle of the instrument so as to cause a protrusion on the suprapubic area. An incision is made from without at this point down to the tip of the distal portion of the rigid instrument, which is then brought throughthe incision. The clamp on the distal end' thereof is opened to accept and grasp a catheter, which is then withdrawn backwardly into the bladder. The clamp is released and the catheter is retained within the bladder while the rigid instrument is withdrawn through the urethra. This method of insertion also can produce dangerous complications. For example, whenever a separate incision must be made there is always the attendant possibility of infection. This possibility is further increased in that the distal portion of the rigid instrument is first pushed out into the local environment and exposed to possible contamination and is then drawn back into the bladder and out through the urethra.

Still another prior art suprapubic insertion technique is described in U.S. letters Pat. No. 3,640,281 to Robertson. This technique can be described as including the steps of: inserting a curved distal portion of a rigid instrument into the bladder through the urethra, the curved distal portion having a closure thereon; inflating the bladder with a fluid through the instrument; engaging the distal end of the instrument with the anterior wall of the bladder with sufficient force to provide a visible protrusion of the suprapubic region of the abdominal wall; making an incision through the abdominal wall and the anterior wall of the bladder in register with the distal end of the instrument; displacing same outwardly through the incision, and removing the closure from the distal endofthe instrument; inserting a portion of a catheter into the distal end of the instrument; withdrawing theinstrument through the incision from the bladder and the urethra, leaving a portion of the catheter within the bladder; and inflating the inflatable portion of the catheter within the bladder to insure retention. This technique, while it appears to be more satisfactory than the others mentioned herein, stillhas 2 an increased possibility of contamination and infection since the distal portion of the instrument comes up through the bladder and through the externally made incision, is handled at that position from without, and is then withdrawn backwardly through the incision, bladder and urethra.

Accordingly, it is an object of this invention to provide a means of inserting suprapubic catheters that minimizes infection, or the possibility thereof by employing a unidirectional movement of a catheter through the bladder and through the abdomen from within to the external environs.

Another object of this invention is to provide a means of making an incision in the anterior wall of the bladder and the abdominal wall from within the bladder, so as to reduce the possibility of contamination from without.

A further object of the present invention is to provide a method of inserting a suprapubic catheter into the bladder that insures that no portion of the catheter or inserting apparatus must pass from the bladder to the outside and back to the bladder.

SUMMARY OF THE INVENTION Apparatus for, and a method of, inserting a suprapubic catheter into the bladder is provided in a safe, efficient and simple manner comprising a hollow, curved and rigid tubing member having a shielded catheter therewithin onto which a cutting point is attached. The tubing member is inserted transurethrally into a bladder in such a manner as to permit the cutting point to, when pushed through the distal end thereof, pierce the wall of the bladder from within after the bladder has been externally palpated. The cutting point, then emerging from the abdomen, is grasped externally and the catheter is pulled through the bladder and abdominal wall, via the tubing member, to a predetermined and premarked point thereon. The curved tubing member can then be easily withdrawn therefrom, leaving the catheter tube safely within the bladder in the proper position. This technique provides a novel and efficient means for inserting suprapubic catheters transurethrally while minimizing the possibility of infection.

BRIEF DESCRIPTIONTOF THE DRAWINGS DESCRIPTION OF THE PREFERRED EMBODIMENTS Referring to the drawings, FIG. 1 shows the device 10 used in this invention to insert a suprapubic catheter into a patients bladder transurethrally. The device 10 includes a rigid, curved, hollow, tubing member, being curved in such a manner as to permit the member to easily beinserted transurethrally into a patients bladder. The member is open at both ends, the distal end 11 being the curved portion and having an opening 12 thereon. while the proximal end 13 has an opening 15 thereon and can have a pair of flanging rings 14 or the like attached thereto for holding and guiding the member into the bladder. It should be noted that the rings 14 are added for convenience, and are not necessary parts in this invention.

A catheter 16, such as a spring catheter, having a cutting point 17 thereon, is preloaded in a rigid, hollow plunger 18 having an opening on at least the proximal end thereof, The plunger 18 can advantageously have a ringed configuration. such as shown by 19, situated at the proximal end thereof, The ringed configuration 19 provides a convenient means for handling the plunger 18 and for convolutely storing the catheter 16 therewithin. Such a ringed arrangement is, of course, preferred but is not necessary. The distal end of the plunger 18 is telescopically placed within the curved member so that when the plunger 18 is pushed all the way into the member the cutting point 17 is capable of extending out through the opening 12 of the curved member.

Referring now to FIGS. 2, 3 and 4, a suprapubic catheter can easily and efficiently be inserted into a patients bladder 30, by externally palpating the bladder and inserting the device 20, by urethral entry, into the bladder so that the curved distal portion 21 points toward the abdomen and until resistance of the anterior wall of the bladder is felt against the catheter tip 22 having the opening thereon. At this point, an internal to external puncture can be made in the suprapubic region by pushing the plunger 28 inwardly, thereby forcing the cutting point 27 to pierce through the bladder wall 31 and abdominal wall 32 and exiting through the outer surface of the skin. As can be seen from the drawings, the curved distal portion of the insertion device is shaped so that it can easily be inserted through the urethra, and so that the plunger 18 can be handled and operated from a convenient position. The emerging cutting point 27 can then be grasped externally and the catheter 26 can be pulled therethrough to a predeter mined and premarked point 41 thereon. The device 20 can then be withdrawn backwardly, as shown in FIG. 4, leaving the suprapubic retention catheter 26 safely within the patients bladder at the proper level. A .stylet can then be employed to remove the catheter when drainage is to be terminated.

The catheter tube can advantageously have a coiled configuration 34 on the end thereof for assisting in the retention of the catheter intracystically. This coiled portion may advantageously have a plurality of openings 35 thereon for facilitating drainage.

Turning finally to FIG. 5, a sectional view of the catheter assembly 10 shows the catheter 16 having a predetermined mark or shoulder 41 which serves a two-fold purpose. The shoulder 41 serves firstly as a means of enabling the plunger 18 to push the catheter 16 out through the opening 12 of the device 10, and secondly, as a marker to show how far the catheter 16 should be pulled out of the patient's bladder. As shown in FIG. 4, the catheter is properly placed when the shoulder 33 becomes visible externally. The catheter assembly should have sufficient compressive strength so that an axial force applied to it from plunger 18 by means of the shoulder portion 41 will be transmitted axially to the cutting point 17 sufficiently to drive the point 17 through an abdominal wall. The catheter 16 is shown here as a semi-rigid vinyl tubing of a relatively heavy 4 wall, but it can be of a variety of materials, such as a more flexible tubing containing a reinforcement such as a bead chain or tightly wound spring running from the shoulder 41 to the cutting point 17.

The cutting point 17 is advantageously a beveled, three sided, electropolished metal point. Other configurations of cutting points should work as well, and excessive cutting action should be avoided which could cause hematuria and clogging of the catheter.

This method of insertion makes a small, clean, pinpoint incision from within the bladder, and does not allow any possible sources of contamination to come into contact with the incision. An obvious advantage of this invention is, of course, that complications that often arise due to over-penetration of the trocar or cutting point into the surrounding bowel area or the like, are completely eliminated, since the cutting point does not come into contact with any body parts until its exact location is precisely known.

While it is preferred that the curved, hollow tubing member and the hollow plunger are of a sturdy metallic material, any rigid, durable material such as an impregnated or reinforced plastic, or the like would work with similar results. The length and diameter of the device should be such that it can be suitably used for human beings, and will vary according to whether it is to be used for male or female patients. The drawings here, of course, show the device being used on female patients.

Since it is obvious that many changes and modifications can be made in the above-described details without departing from the nature and spirit of the invention, it is to be understood that the invention is not limited to said details except as set forth in the appended claims.

What is claimed is:

1. A method of placement for a suprapubic catheter comprising:

inserting the distal end of a rigid, hollow tubing member having an opening at both ends thereof through the urethra and into the bladder, said distal end being curved;

locating the opening on said distal end against the anterior wall of the bladder in the suprapubic region thereof; pushing a cutting point through said tubing member and through said opening on said distal end so as to pierce the anterior wall of the bladder and abdomen in the suprapubic region and through the outer surface of the skin, said cutting point having a catheter attached thereto;

pulling said cutting point outwardly away from said tubing member leaving a portion of said catheter within the bladder; and

withdrawing said tubing member backwardly from said bladder leaving said catheter at the desired position within said bladder.

2. The method of claim 1 wherein said bladder is externally palpated prior to locating said opening on said distal end against the anterior wall of said bladder.

3. The method of claim 1 wherein said catheter is withdrawn from the bladder to a predetermined mark on said catheter.

4. The method of claim 1 wherein said catheter tube has a coiled configuration on the end thereof, and said coiled configuration has a plurality of openings thereon.

5. The method of claim 1 wherein said cutting point is pushed through said distal end of said tubing member by means of a rigid plunger in telescopic relationship with said tubing member.

6. The method of claim 5 wherein said plunger is hollow and open at at least one end thereof, and said catheter is contained therein prior to insertion into the bladder and abdomen.

7. A device for inserting a suprapubic catheter comprising:

a rigid, hollow, tubing member having a curved distal end portion thereon, said tubing member having an opening at both ends thereof;

a rigid, hollow, metal plunger tube open at at least one end thereof, in which a catheter tube may fit within, is disposed telescopically within said tubing member for pushing a cutting point disposed within said tube outwardly through said distal end portion, said plunger tube has a ringed configuration on the proximal end thereof for holding and guiding said plunging means and for convolutely storing said catheter tube therearound prior to insertion into a bladder, said cutting point having said catheter tube attached thereto.

8. The device of claim 7 wherein said plunger tube is open at both ends.

9. The device of claim 8 wherein said plunger tube and said tubing member are of a metal.

10. The device of claim 8 wherein said plunging means and said tubing member are of a reinforced plastic material.

11. The device of claim 10 wherein said tubing member has a pair of flanging rings on the proximal end thereof for holding and guiding said tubing member.

12. The device of claim 7 wherein said catheter tube has a coiled configuration on the end thereof for retaining said tube intracystically, and said coiled configuration has a plurality of openings thereon.

13. The device of claim 12 wherein said catheter tube is marked to show the proper level for positioning said tube within the bladder.

14. The device of claim 13 wherein said mark on said tube is a shouldered portion that also serves as an engaging means for enabling said plunger tube to push said catheter out of said tubing member.

15. The device of claim 13 wherein said cutting point is a beveled, three-sided, electropolished needle.

16. A device for inserting a suprapubic catheter comprising:

a rigid, hollow, metal tubing member having a curved distal end portion thereon, said tubing member having an opening at both ends thereof, and having a pair of flanging rings on the proximal end thereof; and,

a rigid, hollow, metal plunger tube, being open at at least one end thereof, and having a ringed configuration on the proximal end thereof, disposed telescopically within said tubing member for pushing a cutting point disposed within said tubing member outwardly through said distal end portion thereof, said cutting point being a beveled, three-sided, electropolished needle and having a catheter tube attached thereto, said tube having a coiled configuration on the end thereof and a plurality of openings thereon, and said'tube has a mark thereon for properly positioning said tube within the bladder.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US1640311 *Jan 13, 1925Aug 23, 1927Dawes Willard CSurgical instrument
US3295527 *Jan 27, 1966Jan 3, 1967Sheridan CorpIntercostal catheter
US3342175 *Nov 23, 1964Sep 19, 1967Bulloch Robert TCardiac biopsy instrument
US3530860 *Jan 9, 1967Sep 29, 1970Majoros MartonMethod and apparatus for inserting a tube through the ear drum
US3606878 *Oct 4, 1968Sep 21, 1971Howard B Kellogg JrNeedle instrument for extracting biopsy sections
US3640281 *Jan 2, 1970Feb 8, 1972Jack R RobertsonMethod of inserting a suprapubic catheter
US3742952 *Apr 28, 1971Jul 3, 1973Alpha Ind IncSurgical suction pump assembly
US3744495 *Jul 19, 1971Jul 10, 1973Johnson MMethod of securing prolapsed vagina in cattle
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US4212304 *Apr 7, 1978Jul 15, 1980Medical Engineering Corp.Uretheral catheter stent
US4289132 *Jun 25, 1979Sep 15, 1981Rieman Robert DSurgical instrument and method of using the same
US4405314 *Apr 19, 1982Sep 20, 1983Cook IncorporatedApparatus and method for catheterization permitting use of a smaller gage needle
US4512765 *Jun 9, 1983Apr 23, 1985Rudolph MutoSelective tracheal bronchial catheter
US4531933 *Dec 7, 1982Jul 30, 1985C. R. Bard, Inc.For maintaining drainage between the kidney and bladder
US4568338 *Sep 22, 1983Feb 4, 1986C. R. Bard, Inc.Preformed catheter
US4671795 *Nov 19, 1984Jun 9, 1987Mulchin William LPermanent/retrievable ureteral catheter
US4681570 *Dec 26, 1985Jul 21, 1987Dalton Michael JPeritoneal catheter
US4684369 *Aug 19, 1985Aug 4, 1987Wildemeersch Dirk A AInstrument for suprapubic drainage of the bladder, inserted through the urethra
US4694838 *Jan 23, 1985Sep 22, 1987Mallinckrodt, Inc.Loop coronary catheter
US4738667 *Nov 4, 1986Apr 19, 1988Galloway Niall T MPreformed catheter assembly
US4769031 *Jun 25, 1986Sep 6, 1988Mcgough Edwin CVentricular access device and method
US4773431 *Mar 3, 1987Sep 27, 1988Medical Associated Services, Inc.Intra-amniotic loop catheter
US4938741 *Oct 31, 1989Jul 3, 1990Ballard Medical ProductsMedical ventilating and aspirating apparatus and methods
US5109830 *Apr 10, 1990May 5, 1992Candela Laser CorporationApparatus for navigation of body cavities
US5151086 *Oct 22, 1991Sep 29, 1992The Regents Of The University Of CaliforniaLaparoscopic tube placement method
US5232443 *Jul 17, 1992Aug 3, 1993Leach Gary ECombined urological retractor and instrument for inserting suprapubic catheter and method of use
US5694922 *Aug 19, 1994Dec 9, 1997Ballard Medical ProductsSwivel tube connections with hermetic seals
US5795319 *Mar 7, 1997Aug 18, 1998Circon CorporationEasily removable ureteral stent
US6186981 *Mar 23, 1999Feb 13, 2001Peter ChoCavo-atrial cannula
US6332892Mar 2, 1999Dec 25, 2001Scimed Life Systems, Inc.Medical device with one or more helical coils
US6482175Oct 20, 1999Nov 19, 2002Btg International LimitedTwo-part surgical incision implement for forming an opening in the skin
US6494203Nov 12, 1999Dec 17, 2002Ballard Medical ProductsMedical aspirating/ventilating closed system improvements and methods
US6620202Oct 16, 2001Sep 16, 2003Scimed Life Systems, Inc.Medical stent with variable coil and related methods
US6656146Apr 27, 1999Dec 2, 2003Scimed Life Systems, Inc.Medical device with tail(s)
US6719804Oct 24, 2001Apr 13, 2004Scimed Life Systems, Inc.Medical stent and related methods
US6849069Nov 6, 1996Feb 1, 2005Boston Scientitfic CorporationMedical device with tail(s) for assisting flow of urine
US6945950Sep 12, 2003Sep 20, 2005Boston Scientific Scimed, Inc.Ureteral stent with small bladder tail(s)
US6991614Apr 4, 2003Jan 31, 2006Boston Scientific Scimed, Inc.Ureteral stent for improved patient comfort
US7037345Jun 27, 2003May 2, 2006Boston Scientific Scimed, Inc.Medical stent with variable coil and related methods
US7182745Mar 25, 2003Feb 27, 2007Boston Scientific Scimed, Inc.Retaining stent
US7291180Jan 27, 2004Nov 6, 2007Boston Scientific Scimed, Inc.Medical stent and related methods
US7678154Jan 9, 2006Mar 16, 2010Boston Scientific Scimed, Inc.Ureteral stent for improved patient comfort
US7951206 *Nov 5, 2007May 31, 2011Boston Scientific Scimed, Inc.Medical stent
US7996976Jan 22, 2007Aug 16, 2011Boston Scientific Scimed, Inc.Retaining stent
US8002764Apr 2, 2008Aug 23, 2011Swan Valley Medical IncorporatedCystotomy catheter capture device and methods of using same
US8118736Sep 26, 2008Feb 21, 2012Swan Valley Medical, IncorporatedMethod of accessing a bladder and associated apparatus therefor
US8118826Sep 26, 2008Feb 21, 2012Swan Valley Medical, IncorporatedMethod of performing a suprapubic transurethral cystostomy and associated procedures and apparatus therefor
US8177772Sep 26, 2006May 15, 2012C. R. Bard, Inc.Catheter connection systems
US8235971Sep 10, 2010Aug 7, 2012C. R. Bard, Inc.Catheter connection systems
US8328877Mar 19, 2002Dec 11, 2012Boston Scientific Scimed, Inc.Stent retention element and related methods
US8337475Oct 12, 2005Dec 25, 2012C. R. Bard, Inc.Corporeal drainage system
US8382785May 28, 2010Feb 26, 2013Swan Valley Medical IncorporatedApparatus and method for performing cystotomy procedures
US8636721Nov 22, 2004Jan 28, 2014Henry M. Jackson Foundation For The Advancement Of Military Medicine, Inc.Portable hand pump for evacuation of fluids
USRE34021 *Nov 13, 1989Aug 4, 1992Abbott LaboratoriesPercutaneous fixation of hollow organs
DE2905703A1 *Feb 15, 1979Oct 11, 1979Medical Eng CorpHarnleiterkatheter
DE3211576A1 *Mar 29, 1982Oct 13, 1983Hans Georg Prof Dr BenderVorrichtung zur drainage der harnblase
DE3919740A1 *Jun 16, 1989Dec 20, 1990Dimitrov PentchoBladder fistula prodn. instrument - has inflatable balloon attached to end of catheter
DE4321792A1 *Jun 30, 1993Jan 19, 1995Urotech Med Tech GmbhCatheter arrangement
DE4321792C2 *Jun 30, 1993Jul 29, 1999Urotech Med Tech GmbhKathetervorrichtung
EP0091895A1 *Apr 6, 1983Oct 19, 1983Dirk Alfons August WildemeerschDevice for the suprapubic drainage of the bladder introduced through the urethra
WO1983003355A1 *Mar 23, 1983Oct 13, 1983Hans Georg BenderBladder drainage device
WO1993007930A1 *Sep 23, 1992Apr 29, 1993Univ CaliforniaLaparoscopic tube placement method
WO1998047433A1 *Apr 9, 1998Oct 29, 1998British Tech GroupSurgical implement
WO2000056382A1 *Mar 22, 2000Sep 28, 2000Peter ChoCavo-atrial cannula
Classifications
U.S. Classification604/506
International ClassificationA61M25/06, A61M1/00
Cooperative ClassificationA61M25/06, A61M1/008
European ClassificationA61M25/06, A61M1/00T
Legal Events
DateCodeEventDescription
Feb 1, 1989ASAssignment
Owner name: MANUFACTURERS HANOVER TRUST COMPANY, AS AGENT
Free format text: SECURITY INTEREST;ASSIGNOR:KENDALL COMPANY, THE;REEL/FRAME:005251/0007
Effective date: 19881027