WO2009036148A1

WO2009036148A1 - Medical drain tube

Info

Publication number: WO2009036148A1
Application number: PCT/US2008/075987
Authority: WO
Inventors: Yasuyuki Baba
Original assignee: Tyco Healthcare Group Lp
Priority date: 2007-09-11
Filing date: 2008-09-11
Publication date: 2009-03-19
Also published as: JP2009066049A; JP5117800B2

Abstract

A medical drainage tube includes a tube main body, a guidance element, a peristalsis balloon and a guidance balloon. The tube main body is provided with a main lumen which extends from a base end part to a suction-side hole, and secondary lumens which extend from the base end part to a tip end side. A through-hole is provided in the guidance element which communicates with one of the secondary lumens. The guidance balloon can be inflated at the tip end of the guidance element by supplying air via the secondary lumen and the through-hole. The peristalsis balloon can be inflated by the supplying water via another of the secondary lumens. The guidance balloon includes a bag-shaped inflating and deflating part. The base end part of the guidance balloon is in communication with the outer periphery of the inflating and deflating part at the tip end side of the guidance element. A support rod is arranged inside the through- hole of the guidance element so as to be mobile. The tip end part of the support rod can be flexible and is linked to the inner surface tip end of the inflating and deflating part.

Description

MEDICAL DRAIN TUBE BACKGROUND

1. Technical Field

The present disclosure relates to a medical tube which is inserted into the alimentary canal inside the body and used for drainage and removal of residue which has collected in the alimentary canal.

2. Description of Related Art

It is conventional practice to drain residue from the intestines by inserting a tube through the nose of a patient having an intestinal obstruction to reach inside the intestines and suck out the obstruction. Tubes which are used in this kind of procedure are those in which an internal lumen is formed for discharging the internal residue, and which is provided with a guidance element of a prescribed weight at a tip end part. With this catheter (tube), the guidance element includes a plurality of spherical bodies which are provided with a through-hole, and a guide wire can be inserted into each of the through-holes of the plurality of spherical bodies. Consequently, when this catheter is inserted into lhe nose of the patient from the guidance element side and pushed forwards towards the alimentary canal, the guidance element progresses inside the alimentary canal in accordance with its weight and the changes of orientation of the patient's body.

However, with the catheter described above, there are times when the guidance element abuts and bends on the walls of the alimentary canal, becoming caught on the creases and curves etc. of the alimentary canal and is unable to progress into the stenotic parts of the alimentary canal. In such cases, it is necessary to withdraw the catheter slightly, and then re-insert the catheter to change the orientation of the catheter in the patient's body. As a result, the operation of inserting the catheter into a patient's alimentary canal can be troublesome.

SUMMARY

A medical drainage tube is described which includes a tube main body defining a main lumen extending from a base end part to a tip end part of the tube main body. The main lumen communicates with a suction hole formed on the tip end part of the tube main body. A plurality of secondary lumens extend from the base end part to the tip end part of the tube main body. A guidance element is provided at the tip end part of the tube main body, and a through-hole is formed in the guidance element and communicates with a first one of the plurality of secondary lumens. A rear balloon is provided on the outer peripheral surface on the tip end part of the tube main body. The rear balloon is inflated by supplying liquid or air through a second of the plurality of secondary lumens. A front balloon is provided at a tip end of the guidance element. The front balloon is inflated at the tip end of the guidance element by supplying liquid or air through the first of the plurality of secondary lumens and the through-hole.

In one embodiment, the guidance element is substantially rod-shaped and the through- hole is formed along the central axial part of the guidance element. The front balloon is provided at the tip end of the guidance element such that the front balloon can cause closure of a tip end side of the through-hole.

In one embodiment, the front balloon includes a bag-shaped inflating and deflating part having a base end part which is linked to an outer peripheral surface at the tip end side of the guidance element. A support rod is arranged inside the through-hole of the guidance element such that the support rod is mobile in the axial direction. A tip end part of the support rod is linked to an inner surface of a tip end of the inflating and deflating part. When the inflating and deflating part is inflated, the tip end part of the support rod protrudes from the guidance element, and when the inflating and deflating part is deflated, the support rod retreats inside the guidance element.

In one embodiment, an engagement structure is provided for preventing the support rod from coming out of the guidance element. The engagement structure is formed on a rear end portion of the support rod and engages the tip end portion of an inner peripheral surface of the through-hole of the guidance element.

In one embodiment, the support rod is flexible.

In one embodiment, the cross-sectional shape orthogonal to a direction of movement of the front balloon when the front balloon is inflated is non-circular and a space is created between the front balloon and walls of an alimentary canal.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of one embodiment of the presently disclosed medical drainage tube;

FIG. 2 is a cross-sectional view taken along section lines 2-2 of FIG. 1 ;

FIG 3a is an elongated side view of the distal end of the medical drainage tube shown in FIG. 1 in a deflated state;

FIG. 3b is a front view of the distal end of the medical drainage tube shown in FIG. 1 in a deflated state;

FIG. 4a is an elongated side view of the distal end of the medical drainage tube shown in FIG. 1 in an inflated state; FIG. 4b is a front view of the distal end of the medical drainage tube shown in FIG. 4a in an inflated state;

FIG. 5a is an elongated side view of the distal end of an alternate embodiment of the presently disclosed medical drainage tube in an inflated state; and

FIG. 5b is a front view of the distal end of the medical drainage tube shown in FlG. 5a in an inflated state.

DETAILED DESCRIPTION

A detailed description will be given below of a First Embodiment of the medical drainage tube pertaining to the present disclosure, with reference to the figures. Figure 1 shows a medical drainage tube 10 pertaining to the first embodiment of the disclosure. Medical tube 10 is used for removing residue and gas etc. from the body which has accumulated in a blocked part or around a blocked part of a patient's intestines. The medical tube 10 is provided with a tube main body 1 1 which comprises a long, narrow tube which can be made of resin, four branch pipes 12, 13, 14, 15 which can be made of resin which branch out from a base end part 1 1 a of the tube main body 1 1 , and a guidance clement 16 which is provided at the tip end part of the tube main body 1 1.

An irrigation-side hole I Ib is formed on the peripheral surface of the tip end portion of the tube main body 1 1. Furthermore, a plurality of suction-side holes 1 1 c which act as the suction holes of the present disclosure are formed along the axial direction at different positions in the peripheral direction, in the area around the rear of the irrigation-side hole 1 Ib on the peripheral surface of the tube main body 1 1. A peristalsis balloon 17 which acts as the rear balloon of the present disclosure and can inflate and deflate is provided to the rear of the irrigation-side hole 1 Ib (base end side of the tube main body 1 1) on the peripheral surface of the tube main body 1 1. Furthermore, as shown in Figure 2, a large-diameter main lumen 1 Id is formed at the centre, inside the tube main body 1 1 , with three small secondary lumens 1 1 e, 1 1 f, 1 Ig being formed around the main lumen 1 Id. It should be noted that an imaging line comprising an agent which is impermeable to X-rays is formed between the tip end side and the base end side of the tube main body 1 1 , although this is not depicted.

The base end part 1 Ia of the tube main body 1 1 is provided with four flow channels which are in communication with the main lumen 1 1 d and the secondary lumens 1 1 e, 1 1 f, 1 1 g, respectively. The main lumen 1 Id extends from the flow channel formed at the centre of the base end part 1 Ia to the tip end side of the tube main body 1 1, and is in communication with each of the suction-side holes l ie. Furthermore, the rear end part of the main lumen 1 Id is in communication with the branch pipe 12 via a flow channel inside the base end part 1 Ia. The branch pipe 12 is configured as a tube which has approximately the same diameter as the tube main body 1 1. A connecting part 12a of somewhat larger diameter is formed at the rear end part of the branch pipe 12. A storage vessel such as a liquid discharge bag or a suction device such as an aspirator may be connected to connecting part 12a.

By connecting a storage vessel or suction device to the connecting part 12a, residue from inside the intestines can be spontaneously removed or removed by aspiration via the branch pipe 12, main lumen 1 Id and the suction-side holes 1 Ic. The secondary lumen 1 I e (FlG. 2) extends from a prescribed flow channel formed in the base end part 1 1 a to the tip end side of the tube main body 1 1 to link with the irrigation-side hole 1 Ib. Furthermore, the rear end part of the secondary lumen 1 1 e is in communication with the branch pipe 13 via a prescribed flow channel inside the base end part 1 1 a. The branch pipe 13 includes a tube of smaller diameter than the branch pipe 12, and an attachment part 13a formed at its rear end part. A non-return valve 18 is attached to the attachment part 13 a.

The flow of air or liquid from the outside towards the inside of the branch pipe 13 passes through the non-return valve 18, but the valve is configured so that air or liquid etc. does not pass from inside the branch pipe 13 to the outside. The secondary lumen 11 e and the irrigation-side hole 1 Ib are provided to supply air so that the walls of the alimentary canal do not adhere to the suction-side holes 1 Ic when aspiration is performed by the suction device via the main lumen 1 Id, by means of the release inside the body of air supplied from the branch pipe 13, and in order to inject contrast agent into the alimentary canal. Residue inside the patient's intestines are prevented from being released to the outside via the irrigation-side hole 1 Ib, secondary lumen 1 Ie and branch pipe 13 because of the non-return valve 18.

The secondary lumen 1 1 f (FIG. 2) extends from a prescribed flow channel formed in the base end part 1 Ia to the tip end side of the tube main body 1 1, and is in communication with the peristalsis balloon 17. The rear end part of the secondary lumen 1 I f is in communication with the branch pipe 14 via a flow channel inside the base end part 1 Ia. The branch pipe 14 includes a tube having approximately the same diameter as the branch pipe 13, and a connecting part 14a of somewhat larger diameter formed at its rear end part. A supply device such as a syringe for sending water to the peristalsis balloon 17 is connected to said connecting part 14a. The peristalsis balloon 17 can be caused to inflate to a suitable degree by means of the operation of the supply device. The peristalsis balloon 17 is in a state of close contact with the outer peripheral surface of the tube main body 1 1 when it is deflated, but becomes fusiform when it is inflated. The secondary lumen 1 1 g extends from the remaining flow channel formed in the base end part 1 Ia to the tip end side of the tube main body 1 1, and is in communication with the guidance element 16. Furthermore, the rear end part of the secondary lumen 1 Ig is in communication with the branch pipe 15 via a flow channel inside the base end part 1 Ia. The branch pipe 15 includes a tube having the same shape as the branch pipe 14, and an air supply device for supplying air to a guidance balloon 20 via the guidance element 16. Balloon acts as the front balloon of the present disclosure (to be described later). Branch pipe 15 is connected to a large-diameter connecting part 15a formed at its rear end part. The guidance balloon 20 can be caused to inflate to a suitable degree by means of the operation of the air supply device.

The guidance element 16 has a pipe-shaped support pipe part 16b which is inserted through the through-holes of a plurality of weights 16a which in one embodiment are made of metal and in which through-holes are formed running through the central part, and the outer peripheral surface of the weights 16a is covered by a film layer (not depicted) comprising a resin material (see Figures 3 and 4). The support pipe part 16b is provided with a flow channel which acts as a through-hole, and which communicates with the secondary lumen 1 Ig of the tube main body 1 1. The film layer covering the outer peripheral surface of the weights 16a is configured from the same or a similar resin material as the resin material which configures the tube main body 1 1. The film layer and the tube main body 1 1 are integrally formed. The guidance balloon 20 which is made of resin is provided at the tip end part of the guidance element 16.

The guidance balloon 20 includes a bag-shaped inflating and deflating part 21 which is able to inflate and deflate, and a support rod 22 which comprises a flexible rod body. The base end part of the inflating and deflating part 21 is in communication with the outer periphery of the support pipe part 16b at the tip end side. When the inflating and deflating part 21 is deflated, as shown in Figure 3, the inflating and deflating part 21 covers the tip end portion of the support pipe part 16b in a state of close contact. When the inflating and deflating part 21 is inflated, as shown in Figure 4, the inflating and deflating part 21 inflates to a spherical shape at the tip end of the support pipe part 16b. The support rod 22 is arranged so as to be mobile inside the support pipe part 16b in a state in which a space enabling air or liquid to pass between the inner peripheral surface of the support pipe part 16b and the rod 22. The tip end part of the support rod 22 is in communication with the inner peripheral surface of the inflating and deflating part 21 at the tip end thereof. The support rod 22 may be a solid rod or a hollow or cylindrical rod.

When the inflating and deflating part 21 is deflated, the support rod 22 retreats inside the support pipe part 16b due to the deflation force of the inflating and deflating part 21 , as shown in Figure 3. Furthermore, when the inflating and deflating part 21 is inflated, the support rod 22 is pulled to the tip end part of the inflating and deflating part 21, and, as shown in Figure 4, the rod protrudes at the tip end side of the support pipe part 16b. The support rod 22 maintains the shape of the inflating and deflating part 21 when it is inflated, preventing the inflating and deflating part 21 from inverting. Furthermore, when the guidance balloon 20 passes through the curved parts of the intestines, the support rod 22 can bend to follow the curved parts of the intestines, and the inflating and deflating part 21 can pass smoothly through the curved parts of the intestines. It should be noted that the medical tube 10 is used together with a guide wire, although this is not depicted.

In this configuration, when the medical tube 10 is used to release residue from inside the intestines of a patient, the medical tube 10 in the state shown in Figure 1 is first of all inserted from the guidance element 16 side into the nose. Then, when the guidance element 16 of the medical tube 10 arrives inside the stomach, the guide wire is inserted from the branch pipe 12 up to the tip end side of the tube main body 1 1. Then, when the medical tube 10 is further inserted and the guide element 16 has reached the duodenum or the small intestine, water is supplied from the supply device to inside the peristalsis balloon 17 via the branch pipe 14 and the secondary lumen 1 If, thereby inflating the peristalsis balloon 17. By virtue of this, the peristalsis balloon 17 is pulled inside the body due to peristalsis of the alimentary canal, and the medical tube 10 is successively inserted into the body.

In this case, an operation is performed in which the patient's body is irradiated with X- rays, and the position of the imaging line formed in the tube main body 1 1 is ascertained by visualizing the imaging line. Furthermore, the contrast agent is injected inside the parts of the alimentary canal including the stomach and intestines from the branch pipe 13, via the secondary lumen 1 Ie and the irrigation-side hole 1 Ib, and the position and shape thereof are ascertained. Then, when the guidance element 16 reaches the pylorus, constituting the boundary between the stomach and the intestines, and becomes caught in the curved parts of the alimentary canal or the creases in the walls of the alimentary canal, air is supplied from the air supply device to inside the guidance balloon 20, via the through-hole of the secondary lumen 1 1 g and the support pipe part 16b, causing the inflation of the inflating and deflating part 21 of the guidance balloon 20. By virtue of this, the support rod 22 of the guidance balloon 20 protrudes forwards from the tip end part of the support pipe part 16b, so as to maintain the shape and the positioning of the inflating and deflating part 21 (FIG. 4).

As a result, the inflating and deflating part 21 proceeds inside the intestines without becoming caught on the walls of the stomach or intestines and without inverting. When the guidance balloon 20 and guidance part 16 have passed through the pylorus, the guide wire is pulled out from the medical tube 10 and the medical tube 10 is further inserted. Next, when the guidance balloon 20 reaches the stenotic parts of the intestines, the storage vessel is connected to the connecting part 12a of the branch pipe 12. By virtue of this, residue inside the intestines are gradually released and accumulate inside the storage vessel. Furthermore, by performing an operation in which the suction device is connected to the connecting part 12a of the branch pipe 12, instead of the storage vessel, it is possible to remove residue inside the intestines by aspiration.

At this time, air is supplied from the branch pipe 13 to inside the intestines, via the secondary lumen 1 Ie (FIG. 2) and the irrigation-side hole 1 Ib so that the walls of the intestines do not adhere to the suction-side holes 1 1 c. Furthermore at this time, the non-return valve 18 prevents residue in the intestines from flowing back through the branch pipe 13 and from being released to the outside. When the residue in the intestines has been completely discharged, the practitioner waits for the intestinal obstruction to improve, and removes the medical tube 10 from the patient's body. To accomplish this, the water inside the peristalsis balloon 17 and also the air inside the guidance balloon 20 are drawn out to deflate the balloons 17 and 20, so that the medical tube 10 can be removed from inside the body by pulling it.

In this way, with the medical tube 10 pertaining to this embodiment, the peristalsis balloon 17 is provided at the rear part portion of the guidance element 16 on the outer peripheral surface of the tube main body 1 1. Consequently, when the guidance element 16 reaches a prescribed portion in the alimentary canal, the peristalsis balloon 17 moves inside the alimentary canal due to peristalsis of the alimentary canal, even if the medical tube 10 is not pushed inside the body, by means of the inflation of the peristalsis balloon 17. Furthermore, the guidance element 16 is provided with weights 16a which can be made of metal and are of a prescribed weight, and therefore the peristalsis balloon 17 moves more smoothly inside the alimentary canal by changing the orientation of the patient's body so that the direction of advance of the guidance element 16 is downwards.

Furthermore, with the medical tube 10 pertaining to this embodiment, the guidance balloon 20 is provided at the tip end of the guidance element 16. Consequently, when the guidance element 16 reaches the pylorus between the stomach and the intestines, the guidance balloon 20 and the guidance element 16 can progress smoothly, due to the inflation of the guidance balloon 20. As a result, the physical load for the patient and the practitioner can be lessened. Furthermore, the guidance balloon 20 is configured by the inflating and deflating part 21 of which the base end part is linked to the outer periphery of the tip end portion of the support pipe part 16b, and the support rod 22 which is arranged inside the through-hole of the support pipe part 16b so as to be mobile, the tip end part of which is linked to the inner surface tip end of the inflating and deflating part 21.

Consequently, when the inflating and deflating part 21 is inflated, it is supported on the support pipe part 16b via the support rod 22, and the guidance balloon 20 is prevented from inverting or being crushed to make insertion easier. Furthermore, the support rod 22 is flexible, and therefore the guidance balloon 20 bends appropriately in accordance with the curved parts etc. of the intestines. Consequently, the medical tube 10 can move smoothly inside the twists and bends of the intestines.

Figure 5 shows the main parts of a medical tube pertaining to a second Embodiment of the present disclosure. With this medical tube, the shape of a guidance balloon 30 when an inflating and deflating part 31 is inflated is not spherical, but it is formed with a circular shape when seen from the side, and approximately panduriform when seen from the front (the surface seen from the tip end). In other words, the shape seen from the front when the inflating and deflating part 31 is inflated is a shape which is provided with respective recessed parts 3 Ia, 3 Ib on both sides of a circular shape. The structural components other than this of the medical rube which is provided with the guidance balloon 30 are the same as those of the medical tube 10 of the first Embodiment described above. Accordingly, the same components carry the same reference numbers and a description of them will be omitted.

By virtue of this, when the guidance balloon 30 is inflated inside the intestines, a space is created between the recessed parts 31a, 31b of the inflating and deflating part 31 and the walls of the intestines. Consequently, when there is gas or liquid etc. inside the intestines, the guidance balloon 30 moves inside the intestines while the gas or liquid etc. passes through the space formed between the guidance balloon 30 and the walls of the intestines, and the guidance balloon 30 moves inside the intestines without closing off the intestines. By virtue of this, it is possible to smoothly insert the guidance balloon 30 inside the intestines, and while easily releasing gas and liquid. The operational effects of the medical tube other than this are the same as the operational effects of the medical tube 10 which was described above.

Furthermore, as a variant example of the present disclosure, it is possible to make the inner diameter at the tip end side of the through-hole provided in the guidance element 16 smaller than the inner diameter of the other portions, and also to make the diameter of the rear end portion of the support rod 22 greater than the diameter of the other portions, so that the rear end portion of the support rod 22 can engage with the inner peripheral surface at the tip end side of the through-hole. By virtue of this, it is possible to prevent the guidance balloons 20, 30 from inflating any more than is necessary, and to prevent the support rod from separating from the guidance element. The guidance balloons 20, 30 can be inflated to a prescribed size. Furthermore, the medical tube pertaining to the present disclosure is not limited to the embodiments described above, and appropriate modifications may be implemented. For example, in the embodiments described above, water is supplied to inside the peristalsis balloon 17 in order to inflate the peristalsis balloon 17, and air is supplied to inside the guidance balloons 20, 30 in order to inflate the guidance balloons 20, 30. Alternatively, air may be supplied to inside the peristalsis balloon 17, and water may be supplied to inside the guidance balloons 20, 30. Furthermore, water may be supplied to both the peristalsis balloon 17 and the guidance balloons 20, 30, or air may be supplied to both. In addition, another liquid which is not harmful to the human body may be supplied instead of water, and a gas which is not harmful to the human body other than air may be supplied instead of air.

Furthermore, in the embodiments described above, the peristalsis balloon 17 is fusiform when it is inflated, but it may be bale-shaped, spherical or elliptical. In addition, in the embodiments described above, the weights 16a may also be made of rubber, plastic or ceramics. Furthermore, in the second embodiment, the shape of the inflating and deflating part 31 when it is inflated and seen from the front is approximately panduriform, but it may be any shape provided that it creates a space between the inflating and deflating part 31 and the walls of the intestines, e.g., it may be polygonal, triangular, quadrilateral, etc.

Furthermore, in the embodiments described above, the through-hole runs through the central part of the weights 16a. By causing the through-hole to communicate with the main lumen 1 Id, a flow channel which acts as the through-hole of the present disclosure may be provided in a portion close to the outer periphery of the guidance element 16 to communicate with the secondary lumen I Ig. In this case, the guidance balloon is provided at the tip end opening side of the through-hole which communicates with the secondary lumen 1 Ig. The guidance balloon in this case may have an annular structure which is formed around the tip end opening side of the guidance element, or it may include a plurality of spherical structures which communicate with one another and are arranged around the tip end opening side of the guidance element. Furthermore, in this case too, the guidance balloon may be configured by the bag- shaped inflating and deflating part and the support rod.

Although the illustrative embodiments of the present disclosure have been described herein with reference to the accompanying drawings, it is to be understood that the disclosure is not limited to those precise embodiments, and that various other changes and modifications may be effected therein by one skilled in the art without departing from the scope or spirit of the disclosure.

Claims

What is Claimed Is:

1. A medical drainage tube comprising: a tube main body defining a main lumen extending from a base end part to a tip end part of the tube main body, the main lumen communicating with a suction hole formed on the tip end part of the tube main body, and a plurality of secondary lumens which extend from the base end part to the tip end part of the tube main body; a guidance element provided at the tip end part of the tube main body, a through-hole formed in the guidance element which communicates with a first one of the plurality of secondary lumens; a rear balloon provided on the outer peripheral surface on the tip end part of the tube main body, said rear balloon being inflated by supplying liquid or air through a second of the plurality of secondary lumens; and a front balloon provided at a tip end of the guidance element, said front balloon being inflated at the tip end of the guidance element by supplying liquid or air through the first of the plurality of secondary lumens and the through-hole.

2. A medical drainage tube according to Claim 1 , wherein the guidance element is substantially rod-shaped, and the through-hole is formed along the central axial part of the guidance element, and wherein the front balloon is provided at the tip end of the guidance element such that the front balloon can cause closure of the tip end side of the through-hole.

3. A medical drainage tube according to Claim 1 or 2, wherein the front balloon includes a bag-shaped inflating and deflating part having a base end part which is linked to an outer peripheral surface at the tip end side of the guidance element, and a support rod which is arranged inside the through-hole of the guidance element such that the support rod is mobile in the axial direction, a tip end part of the support rod being linked to an inner surface of a tip end of the inflating and deflating part; wherein when the inflating and deflating part is inflated, the tip end part of the support rod protrudes from the guidance element, and when the inflating and deflating part is deflated, the support rod retreats inside the guidance element.

4. A medical drainage tube according to Claim 3, further including an engagement structure for preventing the support rod from coming out of the guidance element, wherein the engagement structure is formed on a rear end portion of the support rod, the engagement structure engaging the tip end portion of an inner peripheral surface of the through-hole of the guidance element.

5. A medical drainage tube according to Claim 3 or 4, wherein the support rod is flexible.

6. A medical drainage tube according to any one of Claims 1 to 5, wherein the cross- sectional shape orthogonal to a direction of movement of the front balloon when the front balloon is inflated is non-circular wherein a space is created between the front balloon and walls of an alimentary canal.