US2009825A - Aseptic catheter-handling device - Google Patents

Description

July 30, 1935- R. H. WAPPLER ASEPTIC CATHETER HANDLING DEVICE INVENTOR, I M11. Wa alfl/l; BY W A TTO NE) Filed April-Z6, 1935 NI-TEDYSTAT Patented July 30, 1935 PAT ASEPTIC CATHETER-HANDLING DEVICE Reinhold H. Wapplcr, Yonkers, ,Frederick C. Wappler esecutor of said Reinhold H. Wappler,

deceased Application April 3, 1933, Serial No. 664,165

14 Claims. (01. 128-349) I My present invention relates generally to surgical instruments, and has particular reference to the manipulation of catheters. a

. One of the most difficult problems inurology is the sterile handling of ureteral catheters dur ing the process of catheterization. 'The'fact that .these catheters are inserted deep intothe body,

and are in many cases-employed for the purpose'of withdrawing a-true specimen from the ureters or kidneys, makes it essential that the greatest care be taken in maintaining the catheters in sterile condition, both exteriorly andinteriorly, not only for the purpose of permitting a Wholly uncontaminated specimen to be withdrawn, but also to prevent accidental infection.

The delicate structural characteristics of a cath-etencoupled with its relatively great length, makes it particularly difficult to maintain the catheter in a wholly sterile condition during the process of insertion. The catheter is usuallyinserted into position through a catheter=tunnel forming part of a suitable endoscopic instrument, the instrument being provide-d with illuminating and telescopic means to permit the operator. to control the movements of the catheter under illuminated vision. An instrument of this character is also usually provided with deflecting means which are controllable by .the'operator to guide the, forward end of the catheterinto the proper directions. With his eye glued to the eyepiece of the telescope, and with his mindoccupied with the proper control of the catheter by the deflecting means, it is'necessary for the op- 'erator at the same time to advance the catheter from the rear, step 'by'step, through theinstrument. Not only does this entail'repeated undesirable grasping of the catheter itself by the hands of the operator, but it frequently happens that the catheter brushes against the face of the operator or against the body ,ofthe patient.

Whilethe. procedure is not essentially a diilicult one, it is obviously one whose technique has not been developed, heretofore, .to :a thoroughly aseptic degree.

It is a general object of my present invention to provide a. means for facilitating an aseptic and sterile manipulationof the catheters in general, and especially a procedure of the foregoing character.

It is a more particular object of my] invention to provide an improved catheter-handling device,

of sterilizable characteristics; ,Whioh may be efficiently employed for aseptically 'effectingfan insertion of a catheter into the into one-or the other of the ureters; r

human body, e. g,

My present device consists, briefly'and essentially,;of an elongated, flexible, 'sterilizable tube adapted to accommodate the rearward portion of the catheter, thereby protectively enclosing the latter, in combination with a catheter-grasping member carried or mounted at the forward end of thetube and adapted to releasably engage the forwardlyprojecting portion of the catheter.

From one'aspect, the elongated, flexible tube constitutes by itself an important novel feature of my present invention. The tube is preferably of 'softrubber, of sufficient length to accommodate the entire catheter therein, and of a crosssectional size-which efficiently ensheaths the catheter yet permits it to be loosely accommodated soas to be longitudinally movable.

Another feature of myinvention lies in the association, with a tube of the foregoing character,

of acatheter-grasping member which is easily :manipulable by the operator to effect an aseptic grasp and release of the catheter.

In a preferred embodiment, the grasping member is mounted for longitudinal reciprocation along a direction which forms a smooth continuation -of theaxis of the tube, thereby permitting a step-by-step advancement of the catheter in a forwardly longitudinal direction without any danger of kinking the catheter. A' particular feature ofmy invention lies in providing an efficientiand improved guiding means for the graspingmember, whereby its reciprocal movements are constrained :toa predetermined direction.-

iIn.the pr.efer'red construction hereinbefore alluded to, I also provide a means for securing the presentdevice, forwardly of the catheter-grasping member, to the rear end of a' catheter tunnel. In another embodiment, the catheter-grasping member *is, of simpler structural nature and is associated with the forward end of the tube so as to be manipulable, by means of finger grips, toreleasably grasp the catheter, but without being itself longitudinally reciprocable relative to the tube. g

In general, my present device is one which'is simple in structural nature, inexpensive to manu- 21, isdisposed in the ner in which a device of the present character is associated therewith;

Figure 2 is a side view of a portion of the present device, partly in section;

Figure 3 is a plan view of Figure 2;

Figure 4 is an enlarged cross-sectional view taken substantially along the line 4-4 of Figure 2;

Figure 5 is a view similar to the manner of use;

Figure 6 is a side view of a modified construction;

Figure '7 is a plan view of Figure Q; and

Figure 8 is a cross-sectional View taken substantially along the line 8- -8 of Figure 6.

The endoscopic instrument of Figure 1 is merely illustrative of the type which may embody a catheter tunnel and which'n ay be. employed 10); the purpose of inserting a catheter into one of the ureters. The illustrated endoscope 10 has a lateralfenestra H, and an illuminating lamp I2 is mounted at the forward end. A telescope I3 is associated with the instrument and is provided with the usual eyepiece l4 and with a forward V objective lens (not shown) which coinmands a view out of the fenestra l I. ment I'have shown is also provided with a deflector I 5 which is controlled from the rearward Fi r ho in portion of the instrument by the rotatable knob [6. Rotation of this member causes the deflector to assume positions of varying obliquity, whereby the deflector is caused to bear downwardly upon the forward end of a catheter I1 and thereby guide the latter into the proper direction.

The instrument is provided with a catheter tunnel l8 whose rearward end is shown at [9 in Figures 1 and 2. The forward end of this tunnel is in the tube l0 near the fenestra ll, so that a catheter pushed through this tunnel from the rear will emerge through the fenestra II and in a position ready to be acted upon by the deflector [5. Y

The present device consists ofan elongated, flexible tube 20, preferably of rubber, and of sufficient length to accommodate almost the, entire catheter I! when, the latter is in its retractedposition. Since the catheter of Figure l is shown partly projected from the fenestra l- I, the rear end midportion of the. tube 20.. Before the catheter is inserted into the tunnel la, the, rear end is positioned in the tube nearer to the rear end'22 of the. latter.

I have. illustratively shown the rear end 2| of the. catheter I! plugged with a device 23 of the. character illustrated and described in my patent application Serial Number 543,081, new Patent No. 1,906,678, dated May 2, 1933, although, obviously, the. employment of this plugging. device is not essential.

The. forward end of the tube 20. is mounted on a nipple 24. which ispreferably in screw-threaded engagement with the rear arm 25. of the device shown most clearly in Figures 2 and 3. Projecting. forwardly from the. arm. Z5v is the squared metallic guide. rod 26; and at the forward end of the latter is a means for attaching the. device to the rear end [9. of the tunnel I8. I have illustratively shown a disc-shaped end member 21., preferably knurled on its periphery, and. provided with the forwardly projecting, slightly'tapered nipplev 28. On; the rear of themember 2'|.'is another nipple .29; upon whichv I M ier. to mount a rubber sleev 3!].

he parts r o co s r cted. a d arr nsedthat be 11: 6 aral e utoflse r miihc idsoi provide a direction of the axis of The instru the tube 20, and the nipple 29 is lined up with the nipple 24, and hence with the axis of the tube 20.

Slidably mounted on the rod 26 is the cathetergrasping device which consists of a sleeve 3| encircling the rod 26, and a pair of depending, resilient, metallic arms or jaws 32. These arms preft b y term nate a their re lower edges in the k u l d ng r n 1- On the inner surfaces of the members 32 I pair of opposed complementary grasping jaws 34 which are somewhat elongated in the the device, and are of concave configuration so as to conform substantially to the cross sectional curvature of the catheter t1, shown most clearly in Figures 4 and 5.

Inthe device illustrated, the resilience of the jaws lgeeps them normally in spaced relationship, on opposite sides of the catheter l1, whereby a slight pres nrcbyth thumb and forefinger of the operator (indicated by the reference numerals 35 and 3B in Figure 5,) will squeeze the jaws together to eifect a releasable grasp of the catheter.

In use, the. catheter is first threaded into. the tube 2a through the forward end thereof, so that only the forward portion of the catheter protrudes. The entire assembly, from the nipple 28 rearwardly, may then be sterilized by boiling or otherwise. The entire assembly may then be removed from the. sterilizing chamber without any danger of recontaminating the catheter, either exteriorly or interiorly, since the latter is. protectively enclosed by the tube 2.0. A convenient grasp may be obtained at the finger grips 33, or elsewhere along the metallic portion of the device. The device isthen attached tothe tunnel l8, preferably in a frictional manner, and this is preferably accomplished after the endoscopic device is in position withinv the body. By then manipulating the grasping member, the catheter may be engaged,

advanced, released, reengaged, and readvanced, so. as to accomplish a step-.by-step threading of the catheter, first through the nipples 29 and 28, and then through the tunnel 18. It is to be observed that this is all accomplished without the slightest danger of contaminating the sterile catheter. Even if the tube 20 brushes against the face of the. operator, or elsewhere, the enclosed catheter is. nevertheless protected in an aseptic manner.

Themanipulation of the slidable member along the rod 26. is. extremely simple, and the operator maysafely keep. his eye at the eyepiece l4, and keep. his mind on the guidance of the inner end of. the catheter in the body, without any danger of kinking, twisting, or contaminating the catheter. The guiding effect of the rod 26' assures straightforward proper advancement of the oatheter, step by step, into and through the tunnel l8 After the catheter has been entirely inserted, it is a relatively simple matter to disconnect either the tube 20 (byunscrewing the nipple 2), or the entire device (by releasing the nipple 2 8). In either event, the tube or the device is withdrawn rearwardly over the rear end of the catheter. In some. instances, it is also desirable to withdraw the endoscopic instrument, itself, rearwardly, over. theinsertedcatheter, thereby leaving the catheter alone in. the body, with its. inner end p pe y. itione and ts te end. projectin immt-bebo .fher m ra o h plu sins dei .3. we we. s. us he r. a e a e y simple matter, and a. specimen may safely-be dition.

In the event that the catheter is to be manipulated rearwardly during the operative procedure,

this may also be accomplished in an aseptic manner, by simply manipulating thegrasping member in an opposite direction, 1. e., causing it to grasp the catheter toward the front, and releasing the catheter after it has been retracted along the guide rod 26.

In Figures B8, I have illustrated a slight modification in which an elongated, flexible tube 31,

similar to the tube 20, is associated at its forward end with an elongated tubular member 38, the latter being split longitudinally, as at 39, to provide two opposed complementary jaws 40 and 42. These jaws are also elongated in a longitudinal direction and. are adapted to engage the catheter 4| in a releasablemanner as' the latter 20 projects from the forward end of the tube 31.

The difference between the jaws 40 and 42 and .the jaws 34, previously described, is that it is preferable to construct the jaws 40 and 42 in a resilient manner, whereby they normally engage the catheter between them. The' disengagement may be effected by providing finger grips 43 and 44, each grip being carried by the remote jaw. That is, the grip 43 is carried by .the jaw '40, while the grip 44 is carried by the jaw 42, as shown most clearly in Figure 8. By pressing upon these grips with the thumb and forefinger 45 and 46, as indicated in Figure 6, the

jaws 40 and 42 are caused to spread and thereby release the catheter. This permits the jaws to be moved longitudinally along the catheter into a difi'erent position at which a new grasp may be obtained.

In using this device, the catheter is accommodated within the tube 31, as before, with its forward end projecting slightly from the for-' Ward end of the jaws 40, 42. The entire assembly may then be sterilized, and when it is withdrawn from the sterilizing chamber it may be handled with safety without any danger of contaminating the catheter 4 i. The device is not attached to the catheter tunnel, as is the preferred embodiment, but the operator is enabled to feed the catheter forwardly through the tunnel by alternately releasing, shifting, and reengaging the catheter by means of the jaws. For example, the finger grips 43, 44 are pressed together to release the jaws; the entire device is slid rearwardly over the catheter for about an inch; the finger grips are then released to enable the jaws to engage the catheter; and the catheter may then be forced forwardly through the tunnel for a corresponding distance. These steps are then repeated until the desired amount of the catheter has been inserted. The catheter-grasping device of this embodiment moves with the tube 31 in each case, and not relative to the tube as in the construction of Figures l5. The objective, viz., to manipulate the advancement and retraction of the catheter in an aseptic manner, is, however, the same and is accomplished with facility, despite the absence of any guiding effect of a supporting rod of the character shown at 26.

It will be obvious that changes in the details herein described and illustrated, for the purpose of explaining the nature of my invention, may be made by those skilled in the art without departing from the spirit and scope of the invention as expressed in the appended claims. It is, therefore, intended that these details be interpreted as illustrative, and not in a limiting sense.

Having thus described my invention, and illustrated its use, what I claim as new and desire to secure by Letters Patent is 1'. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, and a manually controllable member carried by the forward end of said tube for releasablygrasping the forward portion of the catheter, said member comprising a pair of resilient jaws adapted to engage the catheter between them, and finger grips controlling the opening and closing of said jaws.

2. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, and a manually controllable member carried by the forward end of said tube for releasably grasping the forward portion of the catheter, said member comprising a pair of resilient jaws normally engaging the catheter between them, and finger grips controlling the opening of said jaws.

3. A sterilizable device for aseptically controlling the movement of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, and a manually controllable member carried by the forward end of said tube.

for releasably grasping the forward portion of the catheter, said member comprising a pair of elongated, resilient jaws having complementary cylindrical grasping surfaces adapted to conform to and engage the catheter between them, and finger grips carried by said jaws and controlling the opening and closing of said jaws.

4. A sterilizable device for aseptically controlling the movements of a cathetrn through a 5. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, and a manually controllable member carried by the forward end of said tube for releasably grasping the forward portion of the catheter, said member comprising an elongated, tubular element aligned with said flexible tube and longitudinally split to provide a pair of complementary elongated jaws adapted to engage the I catheter between them.

6. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, a manually controllable member carried by the forward end of said tube for releasably grasping the forward portion of the catheter, and means for mounting said member so as to permit longitudinal movement thereof relative to said tube.

7. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, a manually controllable membercarried by the forward end of said tube for releasably grasping the forward portion of the catheter, means for mounting said member so as to permit longitudinal reciprocations thereof relative to said tube, and means for: guiding said reciprocations along a predetermined direction forming a smooth continuation oi the axis of said tube. V

8. A sterilizable device for aseptically'controlling the movements of a catheter through'a catheter tunnel, comprising an elongated flexible tube adapted to accommodate the rearward portion of the catheter, a rigid, longitudinal supporting rod carried by the forward end of said tube, and a manually controllable member slidably mounted on said rod and adapted to releasably grasp the forward portion otthe catheter.

9. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, a squared longitudinal guide rod carried by the forward end of said tube, and a manually controllable member for releasably grasping the forward portion of the catheter, said member being slidably mounted on said guide rod.

10. A sterilize-ble device for aseptically controlling the movements of catheter through a catheter tunnel, comprising an elongated, ilexi-- ble tube adapted to accommodate the rearward portion of the catheter, a rigid, longitudinal supporting rod carried by the forward end of tube, a manually controllable catheter-grasping member slidably mounted on said rod, and means for securing said device at the forward portion of said rod to the rear end of said tunnel.

11. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate the rearward portion of the catheter, a rigid, longitudinalsupsaid of said rod and aligned with the axis of said fiexii ble tube, said nipple being adapted to secure the device to the rear end of said tunnel.

12. A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an elongated, flexible tube adapted to accommodate therearward portion of the catheter, a squared longitudinal guide rodcarried by the forward end of said tube,

a manually controllable catheter-grasping member slidably mounted on said guide rod, an attachment nipple carried bythe. forward end of said rod and adapted to secure the device to the rear end of said tunnel, anda flexible bushing in said'nipple and aligned with the axis of said flexible tube.

13.- A sterilizable device for aseptically controlling the movements of a catheter through a catheter tunnel, comprising an. elongated, flexible tube adapted to accommodate the rearward portion of the catheter, a squared longitudinal guide rod carried by the forward end of said tube, a manually controllable catheter-grasping member slidably mounted on said guide rod, and an attachment nipple carried by the forward end of said rod for securing the device to the rear end of said tunnel, said catheter-grasping member comprising a saddle engaging said rod, and a pair of complementary jaws carried by said saddle.

14. In a device for aseptically controlling the movements of a catheter through a catheter tunnel, a guide rod, means at the forward end of the rod for securing it to the rear end of said tunnel, meansat the rear end of the rod for sup porting the forward end of an elongated, flexible tube, and a catheter-grasping member car-

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