US2593980A - Surgical drainage tube - Google Patents

Description

April 22, 1952 D. J. CALICCHIO 2,593,980

SURGICAL DRAINAGE TUBE Filed July 19, 1950 Inventor David J Gal/calm? by Mam/ Qua Attorneys Patented Apr. 22, 1952 UNI TED STATES PATENT- OFFICE SURGICAL DRAINAGE TUBE David J. Caliochio, Boston, Mass. ApplicationJuly 19, 1950, Serial No. 174,695

The presentinventionrelates to surgery; Afteran abdominal operation, gas and other fluids usually collect in the gastro-intestinal tract, causing distentiomwith resulting gas painsv sary to thread the tube through the nos or the mouth into the stomach, and through the stomach into the intestines; then 'to ,keep the parts external to the patientin proper position for perhaps several days, during both waking and sleeping hours; and, finally, after :the distention has disappeared, to pull the tubetout again, This does not add tosthe comfort of thezpatient during the after-effects ofthe operation..

Ancbject of the presentinventionis to improve upon present-day methodsiof post-operative care of the patient, with the end in View of either eliminating altogether the necessity forthreading the drainagetube through the mouth or the nose, or, if it is decidedto "employ it, to avoid the necessity for withdrawing it later from the patients interior.

Another object is to provide a new and improved drainage tube.

Other and further objects will be explained hereinafter,-and will be particularly pointed out in the appended claims.

With the above objects in view, a feature of the invention resides in a drainage tube of absorbable material, such as plain or chromic catgut; One end of this tube of absorbable material is inserted into the stomach, or the bowel, or both at the very time of the operation; and, according to a feature of the invention, it is inserted, not through the mouth or the nose, but directly through an opening that the surgeon deliberately cuts into the Wall of the stomach or the bowel at the time of the operation, when such wall is accessible to the surgeon for making the cut. The drainage tube, so inserted in the stomach or the bowel, is left in place at the time of the closure of the operative wound. The other end of the drainage tube, led out from the patients interior through a stab wound in the patients abdominal wall, is connected to a conventional pump, with aid of which the contents of the stomach or the intestine or both are removed, in the customary manner, during the next several days, through perforations in the wall of the drainage tube. it is not necessary to add to the patients discomfort by finally removing the drainage tube, however, because, by the time of the patients re- 2 Claims. (Cl. 128-350) covery, his system will have-absorbed thematerial of .whichithe drainage tube is constituted.

According to another feature of the invention,

the surgeon" does not need tocut into the wall of the stomach or :the intestine during the operation. The drainage tube may be inserted postoperatively; through the mouth, or the nose in.

the customary manner, Even in such cases, however, the advantageous feature of the present in vention may still be employed; inthat it is not necessary thereafter toremovethe drainage tube from the patientssystem, because itwill have become absorbed ,during the-period of'the patient's recovery;

The invention will now be described morefully in connection with the accompanying drawings,

in which Fig. 1 is a diagrammatic perspective showing a drainage tube embodying'the present invention inserted into a patients intestine, in

accordance with a feature of the present inven;

the method, involving the tieing of the free end,

of the drainage tube after the patients abdominal distention has disappeared; and Fig. 4 is an elevation illustrating a modified method accordingto the present invention.

The drainage tube of the present invention isconstituted of a material that is absorbable by the human system, such as plain or chromic catgut. It is made in various lengths and different diameters, depending upon the particular use to which it maybe put. One end 2 of the drainage tube 5 is shown provided with a plurality of perforations, for a purpose to be presently described. This end 2 of the drainage tube l is shown open, but it may be expanded into a perforated ball, not shown, at its very tip. It is shown single-compartmented, but it may be longitudinally divided into two compartments, one for suction and the other for inflation.

During the performance of an abdominal surgical operation, at a time when the walls of the operative wound E in the abdomen 8 of the patient 23 are held open by retractors I, the

surgeon, in accordance with a feature of the invention, temporarily interrupts the operation to make a small puncture incision 3 in the anterior wall of the small bowel 5 or the stomach 26 or any other viscus. Where the incision 3 is made depends upon the location that the surgeon may desire to deflate. He then inserts one end 2 of the drainage tube I through the opening in the viscus produced by the incision 3. If he should produce the incision 3 in the stomach 26, for example, he would thread the end 2 of the drainage tube I into the stomach 2B and, through the pylorus 27, as far down into the small bowel as he may consider to be desirable. By providing a sufiicient length of the end 2 of the drainage tube I with perforations, this will enable draining both the stomach 26 and any desired length of the small intestine 5. The Walls of the opening in the viscus produced by the incision 3 are closed around the drainage tube with the aid of suitable stitching material 4. In Figs. 1 and 2, the stitching material 4 is shown producing a purse-string suture. The purse-string suture may be reinforced by several additional interrupted sutures, not shown. A tab of omentum may be patched around the opening produced by the incision 3 to seal it more promptly, but this is omitted from the drawings, in order to simplify the disclosure.

The other end of the drainage tube may be brought out from the interior of the patient 23 either through the same surgical incision, 6 or through an additional stab-wound incision 8 in the abdominal wall, after which the surgeon pro ceeds with the operation, ultimately closing said surgical wound 6 at II. The other end of the drainage tube I is then connected to a drainage pump in any well known manner for which reason it is shown unperforated. As an illustration, the said other end of the drainage tube I is shown connected by means of a glass tube 22 to one end of a rubber hose 2| the other end of which, together with one end of a rubber hose I8, are shown connected at I9 to a vacuum vessel 20. The other end of the rubber tube l8 and one end of a rubber tube It are shown connected at I5 to an inverted liquid-containing vessel I2 provided with a vertically disposed glass tube I3, the lower end of which is connected to the rubber tube I8, and a vertically disposed glass tube I4 the lower end of which is connected to the said end of the rubber tube I6. The upper ends of the glass tubes I3 and I4 are disposed respectively above and below the level of the liquid in the vessel I2. As the liquid in the vessel I2 therefore tends to flow by gravity through the glass tube Id and the rubber tube It into a vessel l1 upon the floor, below the patient, a vacuum tends to be produced above the level of the liquid in the vessel I2, resulting in the pumping out, by suction in the vessels I2 and 20, of gas and liquid in the stomach 2B or the intestine 5 or both through the perforations in the end 2 of the drainage tube I.

' esophagus 25, into the stomach 26.

Stitching material 4 may, of course, be employed around the incision 9, as well as around the incision 3.

When the patient 23 has recovered sufficiently so that drainage or decompression is no longer needed, the drainage tube I is disconnected from the pump, it is tied into a knot In close to the abdomen 8, and its excess above the knot I0 is cut away. It is not necessary to remove the portion of the drainage tube remaining in the patient, for it will become absorbed by his system, in the same manner that catgut sutures are absorbed.

According to another feature of the invention, illustrated in Fig. 4, the end 2 of the drainage tube I may be inserted into the stomach 26 and, if desired, through the pylorus 21, into the intestine 5, by the customary method, dreaded by all patients, of threading it through the nose or mouth 2% and down the esophagus 25. In that event, of course, it is desirable that the drainage tube I be of the same small diameter as the red rubber tubes that are customarily to-day passed through the nose or the mouth 24, down the The other end of the drainage tube I may be connected to the pump in the same manner already described. ihe present invention has the advantage however, that, unlike present-day practice, it is not necessary to remove the drainage tube I, for it will become absorbed.

Further modifications will occur to persons skilled in the art, and all such are considered to fall within the spirit and scope of the invention, as defined in the appended claims.

What is claimed is:

1. A drainage tube of material that is absorbable by the human system provided with a plurality of perforations at one end and that is unperforated at its other end.

2. An absorbable catgut drainage tube provided with a plurality of perforations at one end and that is unperforated at its other end.

I DAVID J. CALICCI-IIO.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,374,808 Bethune Apr. 12, 1921 2,127,903 Bowen Aug. 23, 1938 2,489,067 Wild Nov. 22, 1949 2,508,690 Schmerl May 23, 1950

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