US3595239A - Catheter with electrical cutting means - Google Patents

Abstract

A catheter with a flexible catheter tube having an eyelet or ring at the distal end thereof. An obturator in the form of an electrode is removably disposed within the catheter tube and has a tip thereof projecting out of the catheter tube. The ring of the catheter tube limits the extent of the projection of the obturator tip from the catheter tube. A conventional electrosurgical apparatus is connected to the obturator-electrode for producing electrical energy to divide or cut tissue of a body so as to form a passageway through which the catheter tube advances.

Description

United States Patent 2,102,270 12/1937 Hyams 2,888,928 6/1959 Seiger ABSTRACT: A catheter with a flexible catheter tube having an eyelet or ring at the distal end thereof. An obturator in the form of an electrode is removably disposed within the catheter tube and has a tip thereof projecting out of the catheter tube. The ring of the catheter tube limits the extent of the projection of the obturator tip from the catheter tube. A conventional electrosurgical apparatus is connected to the obturator-electrode for producing electrical energy to divide or cut tissue of a body so as to form a passageway through which the catheter 1 tube advances.

PATENTEU JUL27 I97! 3, 595 239 ELECTROSURGICAL FIG. I APPARATUS I N VENTOR. FIG- 2 ROY A.PETERSEN BY k4.

ATTORNEYS CATHETER WITH ELECTRICAL CUTTING MEANS BACKGROUND OF THE INVENTION The present invention relates in general to catheters, and more particularly to a catheter in which an obturator-electrode performs the function of producing a path for electrical energy to divide or cut tissue of a body for forming a passageway through which a catheter tube advances.

Catheters of the suprapubic type have, heretofore. been placed through the abdominal wall into the urinary bladder by several procedures. One commonly employed procedure is open surgery, in which the abdominal wall is actually opened surgically. In this procedure, an opening is also cut into the urinary bladder and the catheter is sewn in place into the bladder. This procedure is considered to be major surgery.

Another method involves the pushing ofa catheter through the abdominal wall into the urinary bladder in a manner similar to inserting a needle in a vein. This method employs a large trocar which is sufficiently large for a catheter tube to pass through its lumen and into the urinary bladder.

The first procedure is not desirable, since it requires an open operation and is considered to be major surgery. The second procedure requires the insertion of a trocar into the tissue of a body with the application of substantial force. This action may cause a disruption of the urinary bladder or sur rounding structure. It may be difficult at times to pass a catheter through the abdominal wall by this procedure when earlier surgery has been performed and there is a firm scar tissue in the area intended to receive the catheter.

The trocar which is urged into the bladder through this procedure is always larger than the catheter advancing through its lumen. This action results in a relatively large opening in the bladder defining a relatively large space around the catheter when the trocar is removed. As a consequence thereof, there is commonly present a leakage of urine from the bladder through the space around the catheter, which may cause an abscess or an infection, and, also, may produce a tendency for excessive bleedings.

SUMMARY OF THE INVENTION The catheter of the present invention employs a removable obturator-electrode to define an electrical path for electrical energy to divide or cut tissue of a body for forming a passageway through which a catheter tube advances. Through this arrangement, the size of the passageway receiving the catheter tube is accurately controlled and the catheter tube can be advanced into the cut or divided tissue with a reduced application of force.

By virtue of this procedure, the passageway fo r the catheter tube is formed at the smallest possible size to minimize injury to the body and to reduce leakage of fluid around the catheter tube. As a consequence thereof, abscesses and infections are reduced. Also, the catheter tube can be advanced into the passageway with reduced applied force. Thus, the catheter tube advances into the passageway without disruptive force and the catheter tube can now be advanced into a cavity in the tissue of a body, although a dense scar tissue is present in the area receiving the catheter tube. With the size of the passageway accurately controlled for receiving the catheter tube, the tissue ofthe body fits snugly or tightly around the catheter tube. As a result thereof, there is a compression of blood vessels and a lessening of excessive bleedings.

While electrical energy performs a dividing or cutting of the body tissue operation, it also performs a coagulating function to seal off bleeding vessels and to prevent excessive hemorraging. Thus, there is a coagulation of bleeding vessels to reduce subsequent hemorrage from the advancement of the catheter tube.

Other and further objects and features of the present invention will appear upon further perusal of the detailed description taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS DESCRIPTION OF THE PREFERRED EMBODIMENT Illustrated in FIGS. l3 is thecatheter 10 of the present invention which comprises a suitableflexible tube 15 made of rubber, plastic or the like and anobturator 20 in the form of a rod-shaped electrical conductor or electrode.

Thecatheter tube 15 is formed at the distal end thereof with a plurality of elongated, axially disposeddrainage openings 16 suitable for the drainage of fluids and the like. At the distal end of thecatheter tube 15 is also located a ring oreyelet 17, which is intended to be sufficiently rigid and strong to withstand applied force and is made of suitable material such as stainless steel or a high-tensile plastic.

Removably disposed within thecatheter tube 15 is an obturator orrod 20 in the form of an electrical conductor or an electrode. Theobturator 20 is basically of a metal wire-type construction, flexible, but more rigid than thecatheter tube 15. Specifically, theobturator 20 comprises a solidcylindrical body 21. At the distal end of thebody 21, therod 20 includes acylindrical tip 22 that is tapered to a sharp needlelike point. Thebody 21 is made of suitable material, such as stainless steel and thesharp tip 22 is made of suitable material, such as tungsten or tungsten-coated steel, or other suitable noncorrosive, electrically conductive material.

Acylindrical member 23, such as a ring or a sleeve, of therod 20 surrounds thebody 21 to form ashoulder 24 at the junction with thetip 22. Surrounding thebody 21 rearward of thering 23 is atubular insulator 25 made of suitable material, such as Teflon.

At the proximal end of theobturator 20 is disposed atubular insulator 30 made of suitable material, such as Teflon. Rearward of thesleeve 30 is located anelectrical terminal connector 35 for theobturator 20, which may be in the form of a receptacle or a plug for establishing an electrical connection with a conventional and well-knownelectrosurgical apparatus 40, which produces high frequency currents and is a source of high frequency electrical energy.

Theinsulator 30 extends to theconnector 35 and projects into thecatheter tube 15 when theobturator 20 is fully inserted in thecatheter tube 15. When theobturator 20 is fully inserted into thecatheter tube 20, thecatheter tube 15 serves as an insulator for theobturator 20 between thetip 22 thereof and the uninsulated portion of thebody 21.

When theobturator 20 is placed into thecatheter tube 15, thetip 22 of theobturator 20 extends beyond the ring or theeyelet 17 of thecatheter tube 15 and the extent of the projection ofthetip 22 out ofthe distal end ofthecatheter tube 15 is limited by the engagement of theshoulder 24 of theobturator 20 against thering 17 of thecatheter tube 15. Theeyelet 17 is of sufficient rigidity and strength as to preclude excessive passage of thetip 22 out of the distal end of thecatheter tube 15 and to withstand the force applied to theobturator 20 by an operator. The Teflonsleeve 25 serves to reduce leakage of electrical current through thering 17 and through the drainage openings in thecatheter tube 15 by reducing arcing at thering 17. Also, it reduces coagulation occurring in the vicinity of thering 17.

In the typical embodiment of thecatheter 10, the length of theobturator 20 is 18 inches and the diameter of thebody 21 is one-sixteenth of an inch. Thering 17 of the catheter tube is of sufficient dimension to pass the maximum width of thetip 22 of the obturator, which is one-sixteenth of an inch. Thetip 22 of theobturator 20 projects approximately one-fourth of an inch to three-eights of an inch beyond the distal end of the catheter tube, when theshoulder 24 engages thering 17 ofthecatheter tube 15. Theshoulder 24 is brazed or welded to thebody 21 or may be integrally formed therewith. The exemplary dimension for theshoulder 24 is three thirty-seconds of an inch in diameter. Thesleeve 25 is preferably of 1 inch to 2 inches in length and has a thickness of one sixty-fourth of an inch.

One side of the electrical output of theelectrosurgical apparatus 40 is connected to theobturator 20 through theconnector 35. The other side of the electrical output for theelectrosurgical apparatus 40 is connected to aconductor plate electrode 41 upon which rests the body P of the patient. Theelectrode 41 is in spaced relation with thetip 22 oftheobturator 20.

Theobturator 20 is an electrode and serves as a conductor for high frequency currents. High frequency electrical energy between theelectrode 41 and thetip 22 of theobturator 20 cuts or divides tissue of the body at thetip 22. This action results in the formation ofa passageway in the body tissue for the advancement of thecatheter tube 15. The catheter tube is capable of advancing in the passageway with a reduced application of force. Thecatheter tube 15 follows behind thetip 22 of the obturator in advancing into the passageway. Further, the high frequency energy at thetip 22 of the obturator has a coagulating effect, as well as a cutting effect, which seals off bleeding vessels and reduces hemorraging.

While the present invention shows a balloon-type catheter tube, the inventive concept hereof is equally applicable to catheter tubes of many types and shapes, such as straight simple catheter tubes, mushroom-type catheter tubes, and Mellecott catheter tubes.

lclaim:

l. A catheter comprising a catheter tube of electrical insulating material with a distal end, and an electrical conductor member disposed in said catheter tube with a tip at one end thereof located at the distal end of said catheter tube and with means spaced from said tip for establishing an electrical connection, said electrical conductor member being a rod disposed axially in said catheter tube and being removable therefrom, said tip projects out of the distal end of said catheter tube.

2. A catheter as claimed in claim 1 wherein said catheter tube includes an annular member disposed at the distal end of said catheter tube for receiving said tip ofsaid rod.

3. A catheter comprising a catheter tube of electrical insulating material with a distal end, and an electrical conductor member disposed in said catheter tube with a tip at one end thereof located at the distal end of said catheter tube and with means spaced from said tip for establishing an electrical connection, said electrical conductor being a rod disposed axially in said catheter tube and being removable therefrom, said tip projecting out of the distal end of said catheter tube, said catheter tube including an annular member disposed at the distal end of said catheter tube for receiving said tip of said rod, said rod being formed with a shoulder adjacent said tip for engaging said annular member to limit the extend at which said tip projects out of the distal end of said catheter tube.

4. A catheter as claimed in claim 3 wherein an insulating sleeve is disposed on said rod adjacent to said shoulder and rearward thereof. 7

5. A catheter as claimed in claim 4 in which said catheter tube is formed with drainage openings at the distal end thereof.

6. A catheter as claimed in claim 5 in which said rod is an obturator.

7. A catheter as claimed in claim 6 in which said catheter tube is made of plastic material.

8. A catheter as claimed in claim 7 in which said tip is made of noncorrosive, electrical-conducting material.

9. A catheter as claimed in claim 8 in which said obturator has a body made of stainless steel wire.

10. A catheter as claimed in claim 9m which said obturator includes another insulating sleeve disposed adjacent said electrical connection means and extending into said catheter tube.

Claims (10)

1. A catheter comprising a catheter tube of electrical insulating material with a distal end, and an electrical conductor member disposed in said catheter tube with a tip at one end thereof located at the distal end of said catheter tube and with means spaced from said tip for establishing an electrical connection, said electrical conductor member being a rod disposed axially in said catheter tube and being removable therefrom, said tip projects out of the distal end of said catheter tube.

2. A catheter as claimed in claim 1 wherein said catheter tube includes an annular member disposed at the distal end of said catheter tube for receiving said tip of said rod.

3. A catheter comprising a catheter tube of electrical insulating material with a distal end, and an electrical conductor member disposed in said catheter tube with a tip at one end thereof located at the distal end of said catheter tube and with means spaced from said tip for establishing an electrical connection, said electrical conductor being a rod disposed axially in said catheter tube and being removable therefrom, said tip projecting out of the distal end of said catheter tube, said catheter tube including an annular member disposed at the distal end of said catheter tube for receiving said tip of said rod, said rod being formed with a shoulder adjacent said tip for engaging said annular member to limit the extend at which said tip projects out of the distal end of said catheter tube.

4. A catheter as claimed in claim 3 wherein an insulating sleeve is disposed on said rod adjacent to said shoulder and rearward thereof.

5. A catheter as claimed in claim 4 in which said catheter tube is formed with drainage openings at the distal end thereof.

6. A catheter as claimed in claim 5 in which said rod is an obturator.

7. A catheter as claimed in claim 6 in which said catheter tube is made of plastic material.

8. A catheter as claimed in claim 7 in which said tip is made of noncorrosive, electrical-conducting material.

9. A catheter as claimed in claim 8 in which said obturator has a body made of stainless steel wire.

10. A catheter as claimed in claim 9 in which said obturator includes another insulating sleeve disposed adjacent said electrical connection means and extending into said catheter tube.

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