USRE46306E1 - Fecal impaction removal tool - Google Patents
Fecal impaction removal tool Download PDFInfo
- Publication number
- USRE46306E1 USRE46306E1 US14/168,464 US201414168464A USRE46306E US RE46306 E1 USRE46306 E1 US RE46306E1 US 201414168464 A US201414168464 A US 201414168464A US RE46306 E USRE46306 E US RE46306E
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- US
- United States
- Prior art keywords
- article
- impaction
- body member
- grappling
- rectum
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M3/00—Medical syringes, e.g. enemata; Irrigators
- A61M3/02—Enemata; Irrigators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22037—Fecal impaction removal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
Definitions
- the invention relates generally to tools for removal of fecal impactions and particularly to such a tool configured for ease of useage and safety of operation for rapid and reliable removal of a fecal impaction.
- fecal impactions can occur in otherwise healthy individuals, those suffering from certain medical conditions including neuromuscular diseases and severe debilitation as well as those in the general geriatric population are susceptible to the spontaneous development of fecal impactions. Accordingly, fecal impaction is a commonly encountered condition in patients not only presenting in an emergency situation at a medical facility but also for patients hospitalized for other conditions.
- Whitaker discloses a device insertable into the rectum followed by extension of a hinged scoop-like element intended to capture a portion of an impaction for removal.
- Sourwine in U.S. Pat. No. 833,759, discloses a double loop handle connected to a distal and proximal dilator as well as expandable blade elements intended to permit more ready insertion and engagement of the impaction.
- Sims in U.S. Pat. No. 1,448,158, discloses blades disposed closely along a shaft for insertion into the rectum with spreading of the blade after insertion to engage the fecal mass.
- the patents to Sourwine and Smith further disclose use of central channels in the respectively disclosed devices for introduction of enema solutions while said devices are contained within the rectal vault.
- fecal disimpaction devices have previously been suggested in the art, the art still experiences a need for a simple, inexpensive, safe and efficacious tool for removal of fecal disimpactions, the fecal disimpaction tool disclosed herein meeting these needs long-felt in the art through provision of a tool having distal and proximal dilators facilitating insertion into and withdrawal from the anus of a patient as well as flexible, arcuately configured finger-like elements formed of a flexible though non-elastic material collapsible against a central shaft during insertion and opening once within the rectal vault to engage the fecal mass for removal.
- the fecal disimpactor of the invention is shown to produce the functions and advantages thus referred to as is shown and described herein.
- a preferred embodiment of the invention comprises an elongated shaft having a central lumen extending longitudinally therethrough, the lumen being provided proximally with a connection mechanism such as a Luer lock or similar coupling mechanism adapted for connection to a water jet or enema administration system that could comprise a syringe or the like.
- a handle such as can be comprised of twin loops can be integrally formed on the shaft adjacent the proximal opening of the lumen.
- the shaft of the tool terminates distally in a shaped dilator permitting ease of insertion into the anus of a patient suffering from a fecal impaction.
- a second dilator spaced from said first dilator along the shaft facilitates withdrawal of the tool from the patient, a series of flexible, arcuately configured grappling elements being disposed between the first and second dilators.
- the elements are preferably formed of a resinous material having a lower durometer relative to that of the resinous material forming the shaft, the dilator and remaining portions of the tool.
- the grappling elements are shaped to cant backwardly from the first dilator and toward the second dilator, insertion of the tool into the anus of a patient causing the elements to compress inwardly behind the first dilator as the tool advances into the rectum to penetrate the fecal compaction.
- the tool is inserted sufficiently to cause the second dilator to be inserted through the anus of the patient so that the first and second dilators as well as the series of elements are disposed completely within the patient's rectal vault and have essentially pierced the fecal impaction.
- the tool can then be manipulated such as by twisting and by inward and outward movements of the tool short of withdrawal of the second dilator from the anus so that the impaction can be loosened and portions thereof can be fractured or subjected to a grasping action by the elements which extend outwardly of the shaft on manipulation such as can include partial back and forth movements of the tool within the rectal vault.
- the tool can simply be withdrawn after insertion as aforesaid thereby to cause outward extension of the elements and engagement between the elements and the fecal impaction prior to complete withdrawal of the tool through the patient's anus to thereby remove at least portions of the fecal impaction engaged with the elements and subject to loosening and fragmentation by the actions of the tool.
- Practice of the invention can include use of the disimpaction tool more than once after cleaning.
- the use of more than one tool is desired since the procedure proceeds more rapidly if cleaning is not practiced.
- the tool of the invention is therefore preferably manufactured as a disposable item.
- the shaft can be formed with a centrally disposed lumen terminating proximally in an opening adapted to be fitted with a conventional lock configured to be connected to a reservoir of enema fluids including gently pressurized fluid, fluid flow through the hollow shaft and exiting the shaft via ports located in the shaft between the first and second dilators resulting in contact between and entry of enema fluid into the fecal mass to facilitate loosening and fragmentation of the mass such that the grappling elements of the tool can grasp at least portions of the mass for removal.
- Embodiments of the invention can conveniently be provided with three to four sets of the grappling elements, the sets of elements either being oriented identically along the shaft or rotated relative to adjacent sets to produce an interdigitated arrangement or even a “swirling” arrangement.
- the elements are preferably shaped with arcuate outer edges, each edge being disposed in opposing relation to the edge of said element located on the opposite side of the shaft.
- the elements are preferably formed with ridges extending at right angles to the shaft and disposed in proximity to edges of each element and on surfaces of the elements facing the proximal end of the tool, the ridges acting to engage the fecal mass more effectively.
- a reinforcing strut can be formed in each element set on proximal surfaces thereof and on portions of the elements on each side of the shaft. Pairs of ports communicating with the lumen of the hollow shaft are preferably formed in the shaft immediately proximally to each set of elements.
- a primary object of the invention is to provide a reliable, inexpensive and easily and safely used tool for removing a fecal impaction, the tool having a shaped distal dilator facilitating insertion of the tool through the anus of a patient as well as for fragmentation of the impaction, the shaft being further formed with arcuately recurved grappling elements disposed proximally of the distal dilator and capable of compression toward the shaft during insertion and expansion into engagement with the impaction on full insertion into the rectal vault, the elements facilitating removal of at least portions of the impaction on removal of the tool through the patient's anus.
- FIG. 1 is a perspective view of a first embodiment of the invention shown from a distal end of the invention
- FIG. 2 is a perspective view of the article shown in FIG. 1 seen from an anterior end;
- FIG. 3 is a side elevational view of the article seen in FIG. 1 ;
- FIG. 4 is a side elevational view of the article seen in FIG. 3 and rotated ninety degrees about a longitudinal axis from the position seen in FIG. 3 ;
- FIG. 5 is a plan view of the article seen in FIG. 1 ;
- FIG. 6 is a bottom view of the article seen in FIG. 1 ;
- FIG. 7 is a side elevational view in section of the article as seen and as oriented in FIG. 3 ;
- FIG. 8 is a detail perspective view of the article seen in FIG. 1 ;
- FIG. 9 is a perspective view of a second embodiment of the invention.
- FIG. 10 is a side elevational view of the article shown in FIG. 9 ;
- FIG. 11 is a side elevational view of the article seen in FIG. 10 and rotated ninety degrees about a longitudinal axis from the position seen in FIG. 10 ;
- FIG. 12 is a plan view of the article seen in FIG. 9 ;
- FIG. 13 is a perspective view of a third embodiment of the invention.
- FIG. 14 is a side elevational view of the article shown in FIG. 13 ;
- FIG. 15 is a side elevational view of the article seen in FIG. 14 and rotated ninety degrees about a longitudinal axis from the position seen in FIG. 14 ;
- FIG. 16 is a plan view of the article seen in FIG. 13 ;
- FIG. 17 is a perspective view of a fourth embodiment of the invention.
- FIG. 18 is a side elevational view of the article shown in FIG. 17 ;
- FIG. 19 is a side elevational view of the article seen in FIG. 18 and rotated ninety degrees about a longitudinal axis from the position seen in FIG. 18 ;
- FIG. 20 is a plan view of the article seen in FIG. 17 .
- a fecal impaction removal tool configured according to a first embodiment of the invention is seen at 10 to comprise an elongated shaft 12 preferably formed of a resinous or “plastic” material of a durometer imparting a desired rigidity such that a medical practitioner can insert distal portions of the tool 10 through the anus of a patient and into the rectal vault to engage an impacted fecal mass lodged therein.
- the flexible shaft 12 is sufficiently rigid to allow partial insertion of the tool 10 into the rectum as well as manipulation of the tool 10 while engaged with an impaction followed by withdrawal to remove at least fragments of an impaction created by manipulation of the tool 10 .
- the shaft 12 is terminated proximally by a handle 14 formed of loops 16 each capable of receiving one of a practitioner's fingers for ease of use of the tool 10 such as by application of torque to the tool 10 and especially for withdrawal of the tool 10 from the patient.
- the loops 16 are preferably formed integrally with the shaft 12 with each loop 16 being disposed in opposed relation in proximity to the proximal end of the shaft 12 .
- the handle 14 is dimensioned to prevent entry of the entire tool 10 into the anus to prevent “loss” of the tool 10 into the rectum.
- the shaft 12 terminates at it's proximal end in a locking adaptor 18 such as a conventional Luer lock.
- the locking adaptor 18 is disposed at the proximal end of a lumen 20 extending through the shaft 12 internally thereof thus forming a channel within the shaft 12 and causing the shaft 12 to be hollow through a substantial extent thereof from the proximal end inwardly toward a distal end of said shaft 12 .
- the lumen 20 serves as a conduit for delivery of fluids such as enema fluids under pressure, the locking adaptor 18 facilitating connection to an apparatus (not shown) acting as a reservoir of such fluids with the unshown apparatus providing a capability to deliver enema fluids into the lumen 20 .
- Such apparatus can comprise a syringe (not shown) or other device capable of secure coupling to the proximal end of the shaft 12 for delivery of an enema fluid into the lumen 20 .
- the fluids thus introduced into the interior of the hollow shaft 12 are chosen for facilitation of stool softening, lubrication and/or mechanical absorption of an impacted fecal mass disposed in a patient's rectum.
- Such fluids can be introduced concurrently with or independently of manipulation of an impaction such as prior to intended manipulation.
- the shaft 12 is formed with ports 22 disposed in spaced relation along the shaft 12 at locations along the shaft 12 near the distal end of said shaft.
- the ports 22 communicate the lumen 20 with an impaction or with the interior of the rectal vault so that enema solution introduced as aforesaid into the hollow shaft 12 is caused to contact an impacted fecal mass to facilitate softening and/or fragmentation of the mass either prior to or during manipulation of the tool 10 such as by application of torque by a practitioner manually grasping the loops 16 of the handle 12 and/or by a series of small inward and outward displacements of the tool 10 .
- the ports 22 are typically formed in the shaft 12 in pairs with one each of the ports 22 in a pair of ports being located oppositely across the width or diameter of the shaft 12 . As will be further described herein, the ports 22 are typically disposed immediately adjacent to and proximally of sets 24 of flexible, arcuately configured grappling elements formed on the shaft 12 as will be further described hereinafter.
- the shaft 12 terminates distally in a first dilator 28 of a substantially ogive conformation with a rounded tip 30 , the dilator 28 preferably being formed integrally with the shaft 12 .
- the dilator 28 is formed distally in a cruciform configuration from a plurality of regularly spaced elements 32 that taper toward the tip 30 and join proximally to a substantially circular base 34 joined to the shaft 12 .
- the elements 32 as well as surfaces of the base 34 are relieved, that is, essentially rounded such that the dilator 28 can be inserted into and withdrawn from a patient's anus with case and with minimal discomfort to the patient.
- the dilator 28 can be lubricated prior to insertion even though the material from which the dilator 28 as well as the shaft 12 inter alia is formed is chosen to exhibit low surface friction.
- the dilator 28 is shaped and sized such that insertion minimally distends an impacted fecal mass as well as the rectal vault to minimize patient discomfort.
- a proximal dilator 36 is formed integrally with the shaft 12 in spaced relation to the distally disposed dilator 28 .
- the dilator 36 is conically shaped proximally to facilitate removal of the tool 10 once manipulation of an impacted fecal mass has occurred.
- the dilator 36 can be formed with smooth, low friction surfaces over the exterior thereof and can be formed in a cruciform configuration as is the dilator 28 is formed distally except with such cruciform shape extending in the direction of withdrawal of the tool 10 .
- the dilator 36 is intended to be received through the anus of a patient during insertion of the tool 10 and is therefore configured with an inwardly rounded annular shoulder 38 formed distally of the dilator 36 .
- the dilator 36 configured as aforesaid facilitates the atraumatic withdrawal of the tool 10 through dilation of the anus and relaxation of the anal sphincter. Such relaxation and dilation permit withdrawal of at least portions of an impacted fecal mass engaged with the tool 10 with minimal effort and with minimal discomfort to the patient.
- the shaft 12 of the tool 10 is further seen to be configured with spaced sets 24 of the flexible, arcuately configured grappling elements 26 disposed between the distally disposed dilator 28 and the proximal dilator 36 .
- the tool 10 is provided with three of the sets 24 while other drawings illustrate tools having three sets of grappling elements arranged in differing orientations as will be described hereinafter.
- the number of the sets 24 used in a particular tool configured according to the invention can vary and be other than is shown herein, the relative orientation between the sets 24 also varying as seen hereinafter and as is contemplated according to the invention.
- Each of the grappling elements 26 comprising each one of the sets 24 can be identical and can comprise a substantially straight-edged inner body portion 27 having arcuate perimetric portions 29 at each end of said body portion 27 .
- the elements 26 are preferably formed on and about the shaft 12 by co-extrusion of a “plastic” or resinous material of lesser durometer than forms the shaft 12 during formation of the tool 10 .
- the material forming the elements 26 are thus preferably formed of a “softer” material to allow flexure of a sufficient degree to permit each element 26 of each arcuately-shaped set 24 to bend inwardly toward the shaft 12 on insertion of the tool 10 into the anus of a patient.
- the elements 26 can bend sufficiently to compress inwardly to positions wherein the perimetric portion 29 of each said element 26 virtually lies per se along the shaft 12 such that said element 26 need not create an entry path into the anus or into an impacted fecal mass. However, on full receipt into the fecal mass, compressing pressure on the elements 26 is either released due to restoring spring-like forces provided by the elements 26 per se and/or by manipulation of the tool 10 in one or more series of short inward and outward movements of the tool 10 .
- the elements 26 during engagement with a fecal mass thus extend outwardly of the shaft 12 to positions similar to those existing prior to insertion.
- the fecal mass is thus engaged by the elements 26 in a “hooking” action and can be fragmented while embedded within the mass. Ridges 31 formed on rearwardly facing surfaces of the elements 26 act to increase retention of at least portions of the fecal mass on the tool 10 .
- Each set 24 of the elements 26 are seen to be oriented in an aligned relation to adjacent sets 24 as seen in FIGS. 1 through 8 . As will be described hereinafter, the sets 24 can be otherwise oriented.
- the orientations herein shown as well as other orientations and numbers of the sets 24 contemplated by the invention function to produce the intended result of removal of fecal impactions.
- the impacted fecal mass is engaged and then manipulated through manual movement of the handle 14 by a practitioner, these movements being translated along the shaft 12 to the opposite end of the tool 10 carrying the dilators 28 and 36 as well as the sets 24 of grappling elements 26 .
- the length of the shaft 12 is chosen to be sufficient to efficiently permit insertion of the dilators 28 and 36 as well as the elements 26 and to effectively transmit forces exerted on the handle 14 to the distal end of the tool 10 .
- the grappling elements 26 can be formed in alternate embodiments of a sufficiently rigid material, such as the material forming the shaft 12 , so that the sets 24 do not appreciably deform toward the shaft 12 .
- the pairs of the oppositely aligned ports 22 can best be seen in FIGS. 1, 3 and 8 to be disposed between adjacent sets 24 of the elements 26 , the elements 26 collapsing in preferred embodiments on insertion of the tool 10 as aforesaid such that the ports 22 are shadowed by portions of said elements 26 and are thus protected from fecal occlusion by the collapse of a portion of said elements 26 over each port 22 .
- fluid can exit the ports 22 while the elements 26 are collapsed thereover although abduction of the elements 26 after insertion permits pressurized fluid exiting the ports 22 to be more effectively directed against an impacted fecal mass.
- a second embodiment of the invention designated as tool 40 is seen to be essentially identical in all respects to the embodiment of FIGS. 1 through 8 with the exception of the relative orientation of sets 42 of grappling elements 48 .
- the tool 40 is seen to be provided with distal and proximal dilators 44 and 46 respectively in a manner identical to the structure of the tool 10 .
- the sets 42 and the grappling elements 48 are seen to be rotated angularly relative to each other by approximately 45° which, for a tool having four sets 42 of the grappling elements 48 as does the tool 40 , produces a “swirling” arrangement of the sets 42 .
- the functions of the tool 40 are essentially identical to the functions of the tool 10 shown in FIGS. 1 through 8 supra.
- a tool 60 is seen to be substantially identical to the tools 10 and 40 described herein with the common exception of the orientation of sets 52 of grappling elements 68 .
- the tool 60 is provided with distal and proximal dilators 64 and 66 respectively as is common to the tools 10 and 40 .
- the sets 62 of the grappling elements 68 are rotated at 90° angles relative to adjacent sets.
- the tool 60 is provided with four of the sets 62 as is seen best in FIGS. 13 through 15 .
- the tool 60 functions as to results essentially identically to the function of the tools 20 and 40 .
- a tool 70 is seen to be substantially identical to the tools described above with the exception of the orientation of sets 72 of grappling elements 78 .
- the tool 70 is provided with distal and proximal dilators 74 and 76 respectively as is common to the tools described above.
- the second and third sets 72 of the grappling elements 78 from the tip of the tool 70 are rotated at 45 degree angles, the tool 70 having a total of three of the sets 72 .
- a complete “footprint” of the sets 72 is seen to be provided by the use of three of the sets 72 rotated as shown in FIGS. 17 through 20 .
- the tool 70 functions as to results essentially identically to the function of the tools described above.
- the invention has been described herein in relation to particular embodiments thereof, it is to be understood that the invention can be configured other than as explicitly disclosed and described herein.
- the elements 26 can be configured other than as described herein, varying configurations of the elements 26 contemplated by the invention being intended to connect to, grasp, clasp, dig into and/or engage with an impacted fecal mass as disclosed herein and being capable of formation other than as detailed herein.
- the articles of the invention can further be formed of differing materials consistent with the function of the articles or portions thereof without departing from the scope of the invention. Accordingly, the scope of the invention is to be interpreted in light of the appended claims.
Abstract
Description
Claims (49)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US14/168,464 USRE46306E1 (en) | 2008-08-11 | 2014-01-30 | Fecal impaction removal tool |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US12/228,132 US8105335B1 (en) | 2008-08-11 | 2008-08-11 | Fecal impaction removal tool |
US14/168,464 USRE46306E1 (en) | 2008-08-11 | 2014-01-30 | Fecal impaction removal tool |
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US12/228,132 Reissue US8105335B1 (en) | 2008-08-11 | 2008-08-11 | Fecal impaction removal tool |
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USRE46306E1 true USRE46306E1 (en) | 2017-02-14 |
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US12/228,132 Ceased US8105335B1 (en) | 2008-08-11 | 2008-08-11 | Fecal impaction removal tool |
US14/168,464 Active 2029-07-02 USRE46306E1 (en) | 2008-08-11 | 2014-01-30 | Fecal impaction removal tool |
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US12/228,132 Ceased US8105335B1 (en) | 2008-08-11 | 2008-08-11 | Fecal impaction removal tool |
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
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US11103260B2 (en) | 2019-07-18 | 2021-08-31 | Medline Industries, Inc. | Fecal impaction removal device |
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AUPR790901A0 (en) * | 2001-09-25 | 2001-10-18 | Mccloskey, Jenny Colleen | Inactivation of papillomavirus |
DE102012016439B4 (en) * | 2012-08-18 | 2014-06-05 | Reinhold Lang | SURGICAL INSTRUMENT FOR THE TREATMENT OF FISTLES |
CN103860213B (en) * | 2012-12-18 | 2016-01-13 | 李沂泽 | Rocket cone type anal excrement removing device |
US10285717B2 (en) * | 2014-09-03 | 2019-05-14 | Wayne L. Anderson | Fecal matter removing tool |
PL3192451T3 (en) * | 2014-09-13 | 2023-02-20 | Yusuke Shimizu | Medical hook |
US10413643B2 (en) | 2014-12-04 | 2019-09-17 | Alessio Pigazzi | Devices and methods for cleaning contaminated body cavities |
USD787287S1 (en) | 2016-01-05 | 2017-05-23 | Michael Anthony Martinez | Shears |
US9701031B1 (en) | 2016-01-05 | 2017-07-11 | Michael Anthony Martinez | Shears |
SG11202005186QA (en) | 2017-12-05 | 2020-07-29 | Jenny Colleen Mccloskey | Device for treatment of a body canal and adjacent surfaces |
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