US2243529A - Colostomy appliance - Google Patents

Description

May 1941# A. GROSSMAN EI'AL 2,243,529

COLOSTOMY APPLIANCE v Filed May 9, 1940 Patented May 27, 1941 UNITED STATES 14 Claims.

This invention relates to a colostomy appliance and has special reference to a device adapted to be associated with artificial orifices in abdominal walls which orifices have been opened into the colon or other parts of the gastro-intestinal tract.

More particularly, this invention relates to a colostomy applianc capable of self-support on the abdominal wall of the user comprising a relatively light-weight, disc-like, self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon, the body portion having an annular groove in the front face thereof and a communicating opening extending through the body portion for connection with a suction device. A partial vacuum is maintained in the annular groove for the support of the appliance, the opening to the groove being controlled by a valve for maintaining the partial vacuum and for releasing the partial vacuum when it is desired to remove the appliance.

Artificial orifices in abdominal Walls, in which the artificial orifices have been opened into the colon or other parts of the lower gastro-intestinal tract, are each ordinarily fitted with a pouch or container strapped to the body for the support thereof. This is the only type of colostomy appliance, of which applicants have knowledge, that is now on the commercial market. The artificial orifice is in continual communication with the pouch and permits a continuous draining of the colon so that invariably the pouch is at least partially filled with the discharge from the colon. If such an appliance is not fitted or adjusted properly or slips from an adjusted position because of movement of the body of the wearer or in any manner a satisfactory sealing of the mouth of the pouch is not had adjacent the incision, a seepage of the limitation from the colon occurs about the mouth onto the skin of the wearer adjacent the artificial orifice which is offensive to the wearer and to the ones coming in contact with the wearer. Furthermore, even if there is no seepage of contents outside of the mouth of the colostomy bag, the pouch is constantly collecting the fecal contents rendering the wearer offensive to himself and those coming in contact with him because of the foul odor. Also, as the pouch fills with feces, a suction effect is exerted on the mouth of the colostomy leading to pain on the part of the wearer and to frequent herniation of the colostomy.

The present invention contemplates the elimination of at least much of the human element heretofore necessitated in making and maintaining a sealed relation between the appliance and the orifice by making it necessary, in order that the colostomy appliance be supported in position, to effect a perfect seal. The present appliance effects a seal upon the abdominal wall surrounding the orifice and preferably employs a soft flexible projection for stopping the opening into the colon. While in the satisfactory performance of the construction of this device it is not neces sary to employ such a projection for entering the colon, it is desirable particularly from the standpoint of centering the device over the artificial orifice. V

The appliance of the present invention is capable of self-support and it is unnecessary to strap the same to the body to the discomfort of the wearer. The appliance is very light in weight and it is necessary merely to support its own weight since it prevents elimination through the colon. If elimination were permitted to be continuously discharged, a pouch or container would be necessitated and this, in turn, would produce a weight outside of the body to be supported on the abdominal wall. In the present instance, elimination from the colon would be discharged at intervals at the desire and convenience of the wearer.

It is contemplated to employ a disc-like, selfsustaining body portion formed of rubber, plastic, or even a substantially paper-thin sheet steel which latter may be coated with a non-toxic material such as certain enamels. The weight of such an appliance is scarcely noticeable to the wearer and may readily be maintained on the body by a very slight vacuum which need not distort the surface of the abdominal wall to such a degree as will cause irritation. While applicants are aware of numerous devices for creating partial vacuums on the surface of a body to enclose a wound or to effect a discharge from an orifice, such constructions cannot be useful for the present purpose since they are not capable of selfsupport and are employed temporarily during the performance of an operation to create a discharge or the like. Such constructions of which applicants are aware in the prior art are for temporary use during the performance of such an operation as above described and are not for permanent wear.

Although it is preferable to employ a projection for entering the colon to prevent elimination of the colon, such elimination has particular reference to the liquid or solid feces. It is desirable for the comfort of the wearer to permit the passage of flatus, and the present invention cn templates means associated with the projection entering the colon for permitting such a desirable characteristic. Further, while in some instances it may be desirable to form the body portion of a substantially rigid material such as composition, plastic or sheet metal, where the size of the incision and the physique of the wearer permit, it is often desirable to employ a body portion of a relatively soft pliable rubber so as to conform to alterations in the contour of the body wall, for example, during changes in the position of the wearer. Also, a face portion of the appliance overlying the colostomy may preferably be slightly convex so as to prevent undue pressure on the mucous membrane at the site of the colostomy.

One of the objects of this invention is to 'provide a colostomy appliance of the character indicated above which is of relatively light weight, is of disc-like shape, and is capable of selfsupport on the abdominal wall of a user.

Another object of this invention is to provide a colostomy appliance of the type hereinabove mentioned wherein an effectual seal is maintained about an artificial orifice in the abdominal wall of a user by means of a partial vacuum.

It is also an object of this invention to provide a colostomy appliance of the hereinabove mentioned type wherein the orifice is closed by a relatively flexible member extending from a disc-like body portion, the latter providing a seal on the surface of the abdominal wall adjacent the artificial orifice.

Other objects and advantages of this invention will hereinafter be more particularly pointed out and, for a more complete understanding of the characteristic features of this invention, reference may now be had to the following description when taken together with the accompanying drawing, in which latter: 7

Figure 1 is a front elevationalview of the colostomy appliance embodying the features of this invention as applied to the abdominal wall of a user shown fragmentarily, the appliance being connected to a'suction device shown partially in section;

Fig. 2 is an enlarged fragmentary sectional view taken on the line 2-2 of Fig. 1;

Fig. 3 is a view similar to Fig. 2 showing a modified form of colostomy appliance;

Fig. 4 is a perspective view of the colostomy appliance of Fig. 3;

Fig. 5 is a view similar to Fig. .2 showing a still further modified form of colostomy appliance embodying the features of this invention; and

Fig. 6 is a perspective view of the projection forming a part of the device of Fig. 5.

Referring now to the drawing and more particularly to Figs. 1 and 2 thereof, the colostomy appliance embodying the features of this invention is shown as comprising a substantially rigid body portion H} for overlying the abdominal wall I I in which an artificial orifice 12 has been opened into the colon i3.

It is usual, in an operation for making a permanent opening to the colon, for the colon to be severed and the severed end of the colon fixed to the abdominal wall about an opening out therein as shown more particularly in Fig. 2. The body portion 16 of the appliance is centered over the opening !2 communicating with the colon l3 and, in order that the appliance be capable of self-support on the abdominal wall adjacent the opening 12, an annular groove [4 is provided in the front face thereof. An opening IS in the body portion communicates with the annular groove M on the front side of the body portion and extends therethrough to receive the end of a tube It.

A manually operable valve I! is connected to the tube I6, there being a flexible tube l8 connected to the valve for communication with a suction device IS. The suction device 19 may be of any desired type, the example illustrated in the drawing being a glass container 20 having a glass piston 2i fitting the bore thereof and slidable therein for operation in the direction of the axis of the container to induce a partial vacuum in the groove l4 when the body portion IU of the appliance is placed adjacent the abdominal wall. It is desirable to provide a coating of Vaseline or a similar adhesive substance on the front face of the disc-like body portion or on the abdominal wall, or both, in order to augment the sealing necessary for the production of the vacuum. Only a partial vacuum need be obtained in the annular groove so that the abdominal wall is not distorted to any marked degree but merely tends to enter the annular groove, the groove being substantially deeper than the extent to which the abdominal wall enters therein.

The manually operable valve I 1, for maintaining a partial vacuum in the annular groove l4 and for releasing the vacuum when it is desired to remove the appliance, is shown for purposes of illustration as comprising an enlarged head 22 having a reduced threaded extension 23 engaging the threaded bore of the tube It, the bore of the tube being provided with a constricted portion of substantially conical shape in communication with the opening l5. A reduced projection 24, extending from the threaded extension 23, has a pointed end 25 for fitting the conicalshaped constricted portion of the bore of the tube I 6 to seal the annular groove [4. An axial opening 26 is provided in the extension 23 and projection 24 for communication with a transverse aperture opening into the space between the reduced portion 24 and the bore of the tube Hi. It is readily apparent that unscrewing the valve I! will provide communication between the valve H and the annular groove I 4 for creating or for releasing a partial vacuum in the groove.

In order to assist in locating the body portion l0 centrally over the artificial orifice in the abdominal wall and further to assist the seal provided by the partial vacuum 1n the annular groove M, a projection 21 is fixed to the body portion 10 in any suitable manner, the location of the projection being preferably substantially coaxial with respect to the annular groove. The body portion I D is preferably formed of a relatively light-weight rigid plastic material and the projection 21 may be secured thereto in any suitable manner, the projection being preferably of a. soft flexible rubber. While the plastic body portion is shown as having an extension 28 formed integrally for frictionally engaging a recess on the projection, the body portion may be formed of a relatively rigid rubber with the projection being vulcanized thereto. The projection disposed substantially at right angles to the main body portion asists in. supporting the colostomy appliance in position on the abdominal wall, the partial vacuum in the groove being the primary support therefor. The weight of the disc-like body portion is very light and the partial vacuum created in the annular groove is sufiicient in itself to support the appliance but, as above stated,

the projection 21 assures the correct position between the appliance and the artificial orifice in the abdominal wall and tends to augment the action of the partial vacuum in the annular groove in the prevention of vertical displacement along the abdominal wall when the user is in an erect position.

Referring now more particularly to Figs. 3 and 4 of the drawing, the modified form of colostomy appliance shown therein comprises a light-weight, disc-like, substantially rigid body portion 29 having a front face for overlying a portion of the abdominal wall 30 adjacent an artificial orifice 3! in communication with the colon 32. The front face of the body portion 29 is provided with an annular groove 33 in communication with an opening 34 extending from the front face to the rear face thereof. A tube 35 is inserted in the opening 34 for communication with the annular groove, the tube having a valve 36 connected thereto for controlling the opening to the annular groove. A section device is connected to the valve in the same manner as is shown in Fig. 1, the valve being supported by the body portion with the flexible tube and the suction device being detachable therefrom.

The body portion 29 in the particular instance shown in Figs. 3 and 4 may be moulded of a sheet of plastic material and is of substantially uniform thickness throughout. It may also be desirable to form the body portion of a sheet metal, such for example as sheet steel of substantially paper thickness. The sheet steel when so employed is provided with a coating of a nontoxic material such as non-toxic enamel, or other coatings which are inert to body oils and the like, so that the appliance may be kept in a perfectly sanitary condition. Of course, the above materials, such as rubber, plastics and sheet metal, are preferable for the nature of the appliance although any material which may form a sub stantially rigid body portion may be substituted therefor. It is, of course, to be understood that the front face of the body portion, inclusive of the annular groove, as in the previously described modification should be substantially nonporous or have a very smooth surface in order that a proper seal may be obtained.

A projection 3'! is provided on the front face of the body portion 29 to extend therefrom angularly thereto and preferably in a coaxial rela- 4 tion therewith. The'projection 31 is preferably of a soft flexible material and may be formed of a soft rubber which is affixed in any usual manner to the body portion.

The constructions above described have reference to a substantially rigid body portion in the sense that the material thereof will retain any given shape, Referring now to Figs. 5 and 6 of the drawing, the material of the construction disclosed thereby has the same characteristics of retaining its shape, although it is formed of a soft pliable material such as soft rubber. The body portion 38 is substantially of disc-like shape and of non-uniform thickness. The body portion, being soft and pliable, conforms readily to alterations in the contour of the body wall during changes in position of the wearer. While the body portion may be of uniform thickness, it has been found desirable to relieve thickness over certain portions thereof to permit of the flexibility of the structure and to build up the thickness at the supporting portions such as adjacent the projection supporting portion and adjacent the annular groove.

The body portion 38 overlies the abdominal wall 39 in which an artificial orifice 40 has been opened into the colon M. An annular groove 42 is formed in the body portion 39 on the front face thereof, the thickness of the material of the body portion being relatively heavy thereat and tapering radially outwardly therefrom in a relative light skirt portion 43. A central portion of the disc-like body portion is somewhat convex to prevent pressure on the mucous membrane 54 on the bowel at the Side of the colostomy.

The convex central portion of the body portion is provided with an opening to secure a projecting member 45 in position relative to the opening into the colon M, the thickness of the body portion surrounding the opening being preferably relatively thick to support the projecting member and to protect the mucous membrane from pressure. The projecting member 45 preferably comprises an apertured disc 46 having an annular peripheral groove .41 for disposition in the opening of the body portion, the disc being forced in the opening by pressure. The outer face of the disc is relieved and a thin rubber membrane 48 is fixed by means of an adhesive or the like to a peripheral portion thereof, the membrane having an elongated slit 49 therethrough. The inner face of the disc 46 is enclosed by a soft rubber nipple 50 having an opening 5| at the forward end thereof, the nipple being of a size to snugly fit the opening of the colon.

The projecting member 45 has all of th desirable characteristics of the corresponding projecting members of the previously described embodiments of this invention and further, by reason of the provision of the slit membrane 48 covering the apertured disc and nipple portions, permits the escape of flatus. Such a construction is, of course, adaptable to the use of the other constructions, although shown only in connection with the present modification.

In all of the above noted modifications, the material and the construction thereof into the pres ent appliance provides a relatively light-weight construction. The use of a partial vacuum in an annular groove permits the appliance to be capable of self-support onthe abdominal wall of a user without irritation to that portion of the abdominal wall adjacent the artificial orifice. A projection of soft flexible material is preferably provided coaxially with respect to the annular groove for the purpose of fitting within the colon to obstruct the passage outwardly thereof, the projection also augmenting the normal seal provided by the partial vacuum in the annular groove for supporting the appliance on the body of the wearer.

\Vhile but two embodiments of this invention are herein shown and described it is to be understood that various modifications thereof may be apparent to those skilled in the art without departing from the spirit and scopeof this invention, and therefore, the same is only to be limited by the scope of the prior art and the appended claims.

We claim:

. l. A colostomy appliance capable of se1f-support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having a. front face for overlying thatportion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastor-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, a projection extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening to maintain a partial vacuum in said annular groove for the support of said appliance and for sealing said artificial orifice and to release the partial vacuum when it is desired to remove said appliance.

2. A colostomy appliance capable of self-support on the abdominal wall of a user comprising light-weight disc-like self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, a relatively soft flexible projection extending from said front face substantially ccaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening to maintain a partial vacuum in said annular groove for the support of said appliance and for sealing said artificial orifice and to release the partial vacuum when it is desired to remove said appliance.

3. A colostomy appliance capable of self-support on the abdominal wall of a user comprising a light-weight disc-like self-sustaining rubber body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating. opening extending through said body portion for connection with a suction device, a relatively soft rubber projection fixed to and extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening to maintain a partial vacuum in said annular groove for the support of said appliance and for sealing said artificial orifice and to release the partial vacuum when it is desired to remove said appliance.

4. A colostomy appliance capable of self-support on the abdominal wall of a user comprising a relatively light-Weight disc-like substantially rigid plastic body portion of substantially uniform thickness having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said body portion havingv an annular groove in the front fact thereof and a communicating opening extending through said body portion for connection with a suction device, a relatively soft flexible projection fixed to and extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening to maintain a partial vacuum in said annular groove for the support of said appliance and for sealing said artificial orifice and to release the partial vacuum when it is desired to remove said appliance.

5. A colostomy appliance capable of self-support on the abdominal wall of a user comprising a relatively light-Weight disc-like substantially rigid sheet steel body portion having a non-toxic permanent coating thereover, said body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the g'astor-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, a relatively soft flexible projection fixed to and extending from said front face substantially co axially with respect to said annular groove for said disposition in said artificial orifice, and a valve for controlling said opening to maintain a partial vacuum in said annular groove for the support of said appliance and for sealing said artificial orifice and to release the partial vacuum when it is desired to remove said appliance.

6 A colostomy appliance for support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, an apertured projection extending from said front face for disposition in said artificial orifice, and valve means associated with said apertured projection for permitting escape of flatus from said colon and for preventing the escape of liquid or solid feces.

'7. A colostomy appliance for support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, an apertured projection extending from said front face for disposition in said artificial orifice, and an automatically actuated valve in said apertured projection for permitting escape of flatus from said colon and for preventing the escape of liquid or solid feces 8. A colostomy appliance for support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, a projection extending from said front face for disposition in said artificial orifice, said projection comprising an apertured disc removably held in an aperture of said body portion, a soft flexible apertured nipple extending from one side of said disc, and a slit membrane fixed on the other side of said discfor permitting escape of flatus from said colon through said apertured nipple and disc and for preventing the escape of liquid or solid eces.

9. A colostomy appliance for support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having a front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, an apertured projection extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening of said body portion, said body portion being of a pliable material of non-uniform thickness providing relatively thin fiexing portions and relatively heavy supporting portions.

10. A colostomy appliance for support on the abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining body portion having an arcuate front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said arcuate face relieving pressure about the site of the colostomy, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, an apertured projection extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, and a valve for controlling said opening of said body portion.

11. A colostomy appliance for support onrthe abdominal wall of a user comprising a relatively light-weight disc-like self-sustaining rubber body portion having an arcuate front face for overlying that portion of the abdominal wall in which an artificial orifice has been opened into the colon or other portion of the gastro-intestinal tract, said body portion having an annular groove in the front face thereof and a communicating opening extending through said body portion for connection with a suction device, an apertured projection extending from said front face substantially coaxially with respect to said annular groove for disposition in said artificial orifice, a valve for controlling said opening of said body portion, and means associated with said apertured projection for permitting escape of fiatus from said colon and for preventing the escape of liquid or solid feces.

12. A colostomy appliance comprising a discshaped base member, a flexible, pliable and resilient stopper carried by and projecting from the central portion of the base member, said stopper being adapted to be inserted into the outlet of a colon on which there has been a colostomy operation so as to position the base member adjacent the patients body, and means to hold the base member and stopper in position on the patients body.

13. A colostomy appliance comprising a discshaped base member, a flexible, pliant and resilient stopper carried by and projecting from the central portion of the base member, said stopper being adapted to be inserted into the outlet of a colon on which there has been a colostomy operation so as to position the base member adjacent the patients body, valve means associated with said stopper for permitting escape of flatus from said colon and for preventing the escape of liquid or solid feces, and means to hold the base member and stopper in position on the patients body.

14. A colostomy appliance comprising a discshaped base member, a flexible, pliant and resilient stopper carried by and projecting from the central portion of the base member, said stopper being adapted to be inserted into the outlet of a colon on which there has been a colostomy operation so as to position the base member adjacent the patients body, an automatically actuated valve associated with said stopper for permitting escape of flatus from said colon and for preventing the escape of liquid or solid feces, and means to hold the base member and stopper in position on the patients body.

ABRAHAM GROSSMAN. LOUIS JERG.

CERTIFICATE OF CORRECTION. Patent No. 2,215,529. May 27, 19hr.

' ABRAHAIVI GROSSMAN, ET AL.

It is hereby certified that error appears in the printed specification of the above numbered patent requiring correotionas follows: Page 1, first column, line DD, for "limitation" read -elimination; page 2, second column, line 69, for"as ists" read -assists; page i first column, line 1, claim 1, for "gastor-intestinal" read -gastro-intestina l; line 62, claim 1;, for "fact" read -face-; and second column, line '7, claim 5, for "gastorintestinal" read --gastrointestinal-; line 1b., same claim, strike out "said" before "disposition"; and that the said Letters Patent should be read with this correction therein that the same may conform to the record of the case in the Patent Office- Signed and sealed this 15th day of July, A. 13519141.

Henry Van Arsdale,

(Seal) Acting Commissioner of Patents.

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