US3469582A - Hand-held surgical airflow instrument - Google Patents

Description

Sept. 30, 1969 R. R. JACKSON HAND-HELD SURGICAL AIRFLOW INSTRUMENT 3 Sheets-Sheet 1 Filed Jan. 24, 1968 Sept. 30, 1969 R. R. JACKSON 3,469,532

HAND-HELD SURGICAL AIRFLOW INSTRUMENT Filed Jan. 24, 1968 3 Sheets-Sheet 2 Sept. 30, 1969 R. R. JACKSON HAND-HELD SURGICAL AIRFLOWINSTRUMENT 3 Sheets-Sheet Filed Jan. 24, 1968 Sum F m 3,469,582 HAND-HELD SURGICAL AIRFLOW INSTRUMENT Richard Robert Jackson, Marblehead, Mass. 01945 Continuation-impart of application Ser. No. 489,481, Sept. 23, 1965. This application Jan. 24, 1968, Ser.

Int. Cl. A61m 1/00; F161: 15/00, 31/12 U.S. Cl. 128-276 17 Claims ABSTRACT OF THE DISCLOSURE A hand-held medical airflow instrument having supply and ambient openings and a movable member responsive to changes in air pressure to move from a first to a second position, to open and close a main passage. There is a control chamber to which the movable member (e.g., polyethylene film) is exposed for actuation, a control opening adapted to connect the control chamber also to ambient pressure (the control opening located in a position to be opened and closed by the operator) and a tap passage (e.g. through the diaphragm itself) connecting the control chamber to the supply end of the main passage. The pressure in the control chamber can be controlled by the operator to move the movable member between the first and second positions.

Surgical suckers employing this principle, and important constructional techniques are shown.

This application is a continuation-in-part of 'my copending application U.S. Ser. No. 489,481, filed Sept. 23, 1965, entitled Hand-Held Surgical Airflow Instrument, now abandoned.

This invention relates to hand held medical airflow instruments, and especially to surgical sucker devices or suckers.

Surgical suckers are used at the operating table to remove blood, separated tissue and other matter from the patient during surgery. They are especially important in vascular surgery where the surgeon must clear the surgical field of large quantities of blood and rapidly apply sutures.

The type of sucker generally used comprises a tube connected to a vacuum line and having one of numerous available end tips. It makes a continuous hissing sound which distracts the surgeons and assistants and requires them to talk loudly.

If the vacuum could be turned except when the instrument is actually in use, the sound problem would be solved. If the turn-off were located at the sucker, the initial suction, when turned on, would be a surge at substantially full line value, which would remove the blood quicker and easier than possible with continuous suckers. Complete turn-off can ensure release from tissue of the patient to ensure introduction and removal, e.g., of catheters, without harm to the tissue, and can prevent undue evacuation of body cavities.

At first impression this would seem to be an easy problem to solve, but there are numerous requirements to be met which are in apparent conflict with one another. For instance, the sucker valve must be simple and either so inexpensive as to be disposable after single use, or capable of being readily cleaned and autoclaved; it must be lightweight, reliable and safe; it must be easily and swiftly actuated.

The principal object of this invention is to provide an improved hand held valved medical airflow instrument, which in addition may have other uses; and to provide a valved sucker having either rigid or flexible probe portions.

United States Patent 0 Another object is to provide a sucker that permits accurate pickup and release of material with the probe.

Specific objects include providing a surgical sucker which has no noise problem and full line vacuum at the tip on actuation; providing a valved, surgical sucker suitable for manufacture in disposable form; providing a valved surgical sucker which can be easily cleaned; and providing a valved surgical sucker which can be swiftly and simply actuated; and all of the foregoing in combination.

According to the invention, an instrument is provided with a control opening to ambient, e.g., the atmosphere, located to be opened and closed by hand. This opening in open and closed positions, changes the air pressure exerted upon a pressure responsive movable member and changes its position to open and close the main passage.

Advantageously the control opening side of the movable member is also connected by a tap line to a point in the main passage nearer the supply opening than the point where the seal occurs, while the control opening is sized to relieve the effect of this tap line. Accordingly one side of the movable member can be exposed substantially to atmospheric pressure through the control opening while the other side is exposed to air flowing in the main passage. The movable member can thus be displaced to one of its positions. When, however, the control opening is closed, the tap line exposes the corresponding side of the movable member to line pressure, while a pressure closer to that of the atmosphere at the tip of the sucker member acts on the other side of the control member. This new pressure differential moves the control member to its other position.

Advantageously the movable member comprises a thin elastomeric wall or diaphragm defining part of the main passage, and to form a seal, an opposed part of the passage is adapted to be engaged by the diaphragm.

The invention has other features and advantages which are in part explained and which in part will be found to be inherent.

In the drawings:

FIG. 1 is a longitudinal cross-sectional view of a first embodiment of the invention;

FIG. 2 is a transverse cross-sectional view taken on line 2-2 of FIG. 1;

FIGS. 3 and 4 are transverse cross-sectional views of the movable member of FIG. 1 in different positions;

FIG. 5 is a perspective view of a second embodiment of the invention;

FIG. 6 is a longitudinal cross-sectional view of the embodiment of FIG. 5;

FIG. 7 is a side view, partially in longitudinal crosssection of a third embodiment of the invention;

FIG. 8 is a view taken on line 88 of FIG. 7;

FIGS. 9 and 10 are partial longitudinal cross-sectional views of the movable member of FIG. 7; and

FIG. 11 is a longitudinal cross-sectional view of a fourth embodiment.

FIGS. 12 and 13 are cross-sectional views of a preferred embodiment in the form of a surgical catheter.

FIGS. 14 and 15 are cross-sectional views of a preferred embodiment in the form of a rigid-tube circular sucker.

Referring to FIGS. 1-4 the first embodiment comprises a tubular hand piece orouter tube 10 formed of a rigid or semirigid material, supporting at its forward end thetip 12, and connected at its opposite end to supplyline 14. Within the outer tube is a member which is movable under the influence of change in air pressure, in this case a flexible. thin walledrubber diaphragm tube 16, e.g., .003" wall thickness Penrose drain, extending loosely the length of the outer tube and sealed to its ends, in this case by being turned back over the ends of the outer tube. The inside of thediaphragm tube 16 defines themain passage 20 connecting thesupply line 14 and thetip 12, while the outside of diaphragm tube together and the outer tube define thecontrol chamber 22. A control opening 24, e.g., a inch diameter hole, is formed in theouter tube 10 in a position readily accessible to the hand, the control opening when open exposing thecontrol chamber 22 to atmospheric pressure.

Atap passage 26 from theline 14 to thecontrol chamber 22 is defined by asmall tube 28, e.g., a No. 22 hypodermic needle, which penetrates and is sealed to theflexible tube 16, and is secured to the inner surface ofouter tube 10.

Advantageously, as above, thepassage 26 has a substantially smaller cross-section than the control opening 24, and both open directly into the part of the control chamber in which the valving action occurs. The control opening 24 is more than large enough to substantially relieve thetap passage 26 so that the pressure in the chamber is changed substantially from open to closed positions.

When provided for use with a vacuum line, thecontrol opening 24 is sized relative to the flow restriction of thesucker tip 12 to permit a higher pressure to exist in thecontrol chamber 22 than exists at least at some point along themain passage 20, the specific location depending upon the relative restrictions of the opening and tip.

Thediaphragm tube 16 is specially constructed to allow the opposed walls to seal against each other fully face-toface at least at one region. Referring to FIGS. 3 and 4, this region can be formed by fiat rubber wall members 16a and 161) secured by adhesive 30 along their edges. As shown in FIG. 3, the members are capable of contacting each other fully face-to-face, while in FIG. 4 they are spaced apart to permit air movement. At times it is advantageous to employ aband 27 about the diaphragm tube to limit its lateral distention.

The instant embodiment comprises a surgical sucker,

thesucker tip 12 being an elongated hollow tube termimating in anend piece 12 sized and shaped to remove matter from the surgical region of a patient. 7

With vacuum applied toline 14,tip 12 in standby condition, perhaps held by a nurse, has itscontrol opening 24 uncovered, atmospheric pressure enteringcontrol chamber 22. In the region within themain passage 20 Where the pressure, under the influence ofvacuum line 14, is lower, the flexible walls 16:: and 16b collapse together and seal the passage against the flow of air. If a slight opening should occur between the flexible walls, a fiow of air at high speed would occur which, by reducing the pressure in a Bernoulli effect, would draw the walls together to seal the opening.

With the passage sealed, the only movement is through thetiny tap passage 26 which makes no objectionable sound and permits essentially line vacuum to be present in the hand piece, available for a strong initial surge at the tip when the instrument is actuated.

The surgeon actuates the instrument by simply placing his finger or hand over thecontrol opening 24. Immediately atmospheric pressure air in thecontrol chamber 22 is exhausted through thetap passage 26, producing a vacuum in thecontrol chamber 22. The atmospheric pressure in theforward region 20a of the main passage forces the walls 16a and 16b apart, opening the passage and admitting the vacuum surge to thesucker tip 12.

It will be seen that the valve consists essentially of two tubes and a needle, permitting simple and inexpensive manufacture.

Referring now to FIGS. 5 and 6, the parts of this instrument corresponding to those of the FIG. 1 device are designated by similar numerals.

The hand piece andmain passage 20 is defined by top and bottomseparable members 40, 42, held together byreleasable bail 44. Between the two a thinfiat rubber diaphragm 16 is secured. Thebottom member 42 defines the entry I and exit 0 to themain passage 20 with aridge 21 in between, positioned to be engaged by the diaphragm 16' to seal the passage. The upper member defines a cavity above the diaphragm serving as a control chamber. A control opening 24' located to be closed by hand (FIG. 5) is connected bypassage 25 to the control chamber 22'. A tap passage 26' extends from the inlet side of themain passage 20 to the region of theopening 24 where it connects topassage 25.

The operation of this instrument can be exactly the same as described above. With the control opening 24' open and vacuum applied topassage 20, diaphragm 16' seals againstridge 21; with opening 24' closed, the diaphragm rises and suction is applied to tip 12'.

As illustrated by this embodiment, the passage requirements for the invention can be satisfied by straight bores readily accessible to be cleaned by conventional obturators, and the diaphragm can be expendible, or cleaned separately.

The embodiment of FIGS. 7-10 is similar to that of FIG. 1, with the following principal exceptions. Arigid end tube 14a extends through aplug 15 into thehand piece 10". An opening 26a through the wall of this tube serves as tap passage to thecontrol chamber 22". Theinterior end 17 oftube 14a is closed by two convergingwalls 17a, 17b, in which are two holes (FIG. 8). The thinrubber diaphragm tube 16 is secured and sealed to tube upstream of itsend 17. As shown in FIG. 9, when vacuum is applied alongtube 14a, and controlopening 24 is open, thediaphragm tube 16" collapses upon thetube end 17, sealing the openings therein. When control opening 24" is open, thetube 16 expands, see FIG. 10, unsealing themain passage 20".

The embodiment of FIG. 11 is similar to FIG. 7, but having fewer parts and capable of inexpensive assembly. The hand piece 10' includes an integral end section 10b closely surrounding the stem of thesucker tip 12. The other end of the hand piece is closed by an end plug 23 having a flange section 23a of the diameter of theouter tube 10", and a smaller cylindrical section 23b closely surrounded by thetube 10". It will be observed that each of these members is of a shape easily formed of plastic.

For assembly thesucker tip 12 is thrust to the left through end section 1011 until is protrudes left beyondouter tube 10". Thediaphragm tube 16 is then sealed to the end of the sucker tip and to thetube 14a, the sucker tip is pulled to the right to the position shown and end plug 23 is secured to thetube 10", completing the unit.

It will be understood that the device described can have other medical uses. For instance, it can control the flow of a vacuum catheter used to extract fluid from the trachea for patients under intensive care. By means of the valve the vacuum may be turned off, to enable insertion into the trachea; then it can be turned on with a surge of full line value to remove the fluid.

Referring to FIGS. 12 and 13 there is shown, magnified four times, a hand held suction instrument in the form of a surgical catheter and control.

Thehand piece 140 comprises abody member 142, adome member 144 and adiaphragm 146. The body member defines asupply nipple 148 to which a suction hose can be attached and the dome member defines anambient nipple 150 to which aflexible catheter 152 may be permanently attached.

In this embodiment the body member defines anannular chamber 154 which communicates withnipple 150. The inner wall of that chamber is defined by anannular wall 156 which terminates in a circular upwardly directedledge 158. Apassage 160 extends down from this ledge tonipple 148.

Thedome member 144 is recessed in the region overlying the ledge. A movable member in the form of aflexible diaphragm 162, preferably a nonelastic thin film material, and presently most preferably, a polyethylene film of one or a few thousandths thickness, is secured at its periphery between the outer matching rim 142r and 1441" of the body and dome members. The recess of the dome member extends above the diaphragm when the diaphragm rests uponledge 158 of the body member, defining acontrol chamber 164.

The outer surface of the dome member is centrally raised and has a control opening 166 connecting the control chamber to ambient pressure being located in a position to be opened and closed by the operator as the hand piece lies in the operators hand.

In this embodiment atap passage 168 is formed in the diaphragm itself, aligned to communicate with thesupply passage 160. It may be formed by passing a #25 hypodermic needle throughopening 166 until it punctures the diaphragm.

Advantageously an anticoagulant coating such as citric acid is applied to the surfaces of the control chamber.

Similar to the other embodiments, when control opening 166 is open, a pressure approximating atmospheric is exerted in the control chamber, vacuum is exerted on the opposite side of themovable member 162, and the movable member seats onledge 158, forming a seal. With the vacuum thus stopped off, the catheter can be inserted into the patient without hindrance. When it is desired to withdraw fluid, the operator may place his finger over control opening 166. The vacuum inpassage 160 draws air from thecontrol chamber 164 throughtap passage 168, in this case located in the diaphragm itself. The higher pressure in thenipple 150 andannular chamber 154 causes the movable member to rise from the ledge, and suction is thus applied to the catheter and the patient.

This control is particularly immune to the clogging effects of drying of blood because the member forming the tap passage 163 is the flexible diaphragm itself, which flexes during operation and is thus self-cleaning.

The antocoagulant is helpful where the catheter is used, e.g., for blood, to prevent coagulation of any blood that might enter the control chamber.

Referring to FIGS. 14 and a construction similar to FIGS. 12 and 13 can be employed for a rigid tube surgical sucker. The elements wiihinitial digits 2 correspond to the elements with initial digits 1 in the embodiment of FIGS. 12 and 13.

Various modifications of the structures shown within the spirit and scope of the invention will occur to those skilled in the art.

What is claimed is:

1. A hand-held medical airflow instrument comprising a hand piece having a supply opening and an ambient opening connected by a main passage, a movable member responsive to changes in air pressure to move from a first to a second position, in said first and second positions said movable member adapted respectively to open and close said main passage, means defining a control chamber to which said movable member is exposed for actuation, a control opening adapted to connect said control chamber to ambient pressure, said control opening located in a position to be opened and closed by the operator, and a tap passage connecting said control chamber to the supply end of said main passage, whereby when a differential pressure is applied between the supply and ambient, the pressure in said control chamber can be controlled by said control opening to move said movable member between said first and second positions.

2. The instrument of claim 1 adapted for use as a medical sucker, the control member forming a boundary of said main passage and adapted to rest against an opposed surface to seal said passage, the position of the movable member determined by the pressure in said main passage and the pressure in said control chamber, the passages of said instrument constructed and arranged so that when said control opening is open to the atmosphere,

said control member seals said passage and when said control openings is closed, said control member opens said passage.

-3. The instrument ofclaim 2 adapted for use as a surgical sucker, including an elongated sucked tip member supported by said hand piece as a continuation of said main passage, and terminating in an end piece sized to remove matter from the body of a person undergoing surgery.

4. The instrument of claim 1 wherein said movable member comprises a flexible diaphragm defining a boundary of said main passage, said diaphragm arranged to engage an opposed surface to seal said passage, the positron of said diaphragm dependent upon the pressure difference between said main passage and said control chamber.

5. The instrument ofclaim 4 wherein said diaphragm comprises a thin walled flexible tube, at least one wall portion of which is adapted to deflect to form said seal.

6. The instrument of claim 5 wherein said diaphragm tube in the sealing region comprises a pair of face-to-face exposed strips joined along their edges and adapted to seal face-to-face against each other.

7. The instrument of claim 5 wherein a relatively rigid end tube extends in the direction from said supply into said diaphragm tube, said end tube terminating in at least one end wall having an opening exposed to a wall of said diaphragm tube, and arranged to be sealed thereby.

8. The instrument ofclaim 7 wherein said end wall lies at an angle to the axis of said tube.

9. The instrument ofclaim 8 wherein a pair of said end walls are provided in converging relation, a pair of openings in said walls arranged to be engaged by opposite wall portions of said diaphragm tube.

10. The instrument of claim 1 wherein said control member, said hand piece and the means connecting them are all coaxial, arranged to be connected by relative axial movement, whereby said instrument is adapted to be made as a disposable unit.

11. The instrument of claim 1 wherein said movable member comprises a flexible diaphragm and said top passage comprises an opening in said diaphragm.

12. The instrument ofclaim 11 wherein said control opening is aligned with said tap passage, permitting the formation of said tap passage by the insertion of a member through control passage.

13. The instrument ofclaim 11 including a coating of anticoagulant material in the vicinity of said diaphragm.

14. The instrument ofclaim 11 including a flexible surgcal catheter member connected to said ambient opening of said main passage.

15. The instrument ofclaim 11 including a circular ledge arranged to be engaged by said flexible diaphragm to form said seal.

16. The instrument of claim 1 wherein the flexible diaphragm is comprised of nonelastic film material.

17. The instrument ofclaim 16 wherein said film material is comprised of polyethylene on the order of 0.001" thickness.

References Cited UNITED STATES PATENTS 2,449,497 9/1948 McLeod 128276 3,071,402 1/ 1963 Lasto et a1. 3,146,987 9/1964 Krayl 128276 XR 3,232,578 2/1966 Cousins 128-276 X 3,319,628 5/1967 Halligan 128276 CHARLES F. ROSENBAUM, Primary Examiner U.S. Cl. X.R.

l375l0, 801; 25l331

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