A colonoscopy is an example of an endoscopy procedure including an examination of the large intestine or colon through the use of a colonoscope. A colonoscope is a flexible, tube-like inspection device having a camera at its end. Colonoscopies are performed for a variety of medical reasons including detection of inflamed tissue, ulcers, abnormal growths or polyps, and colorectal cancer. Colonoscopy is increasingly used as a screening tool to detect colorectal cancer.
During a colonoscopy, as an example of an endoscopy procedure, a colonoscope is inserted into a patient's rectum and then advanced to the beginning of the colon (an area known as the cecum) in order to examine the lining of the large intestine. The efficiency and accuracy of this procedure is largely dependent on the ease with which the colonoscope can be advanced. During the procedure, the colon may become over-distended or flopped in unnatural directions creating loops that hinder the advancement of the colonoscope and resulting in patient discomfort, longer examination times, and potentially inaccurate or incomplete screenings.
Currently, the difficulty in advancing the scope is addressed by the application of manual pressure by a technician to manually support the patient's colon. The application of manual pressure is time-consuming and varies depending on the particular technician's strength, technique, endurance, and training. In order to apply differential pressure, the technician may roll the patient from the left side to a supine or to a prone position, which can be a difficult task with a sedated patient. The application of manual pressure and movement of the patient in order to support the patient's colon and advance the colonoscope during the procedure places a physical toll on the technician.
In an aspect of the disclosure, a method and apparatus for applying pressure to the abdomen of a patient is provided to ease the passage of an endoscope during procedures used to examine the bowels including colonoscopy, sigmoidoscopy, and enteroscopy. Aspects presented herein exert both broad, uniform lower abdominal pressure as well as additional, location-specific pressure upon the sigmoid colon and/or small bowel to assist with the advancement, withdrawal, and/or visualization as part of an endoscopy, colonoscopy, sigmoidoscopy, or enteroscopy procedure. Aspects presented herein may assist in preventing and reducing intestinal looping, eliminating the need for the application of manual pressure, improving patient safety, comfort, and satisfaction, and preventing musculoskeletal injury to endoscopy healthcare providers. Aspects may improve visualization and/or withdrawal portions of the procedure.
Aspects include a primary wrap sized for placement around a subject's lower abdomen and at least one secondary strap extending from the primary wrap and configured to extend across at least a portion of the primary wrap and to fasten to a third portion of the primary wrap to adjust the amount of pressure applied by the endoscopy support apparatus.
Aspects include a method of applying pressure and support to a patient's abdomen during an endoscopy procedure including applying a primary wrap comprising a band of elastic material to an abdomen of a patient and maintaining tension in the band in order to apply constant pressure and the support to the patient's abdomen through a contraction of the primary wrap in connection with an advancement or a withdrawal of an endoscope during an endoscopic procedure. The method includes adjusting at least one of the primary wrap or at least one secondary strap extending from the primary wrap to adjust compression and support the advancement or the withdrawal of the endoscope through the contraction of the primary wrap and the at least one secondary strap.
Additional advantages and novel features of aspects of the present invention will be set forth in part in the description that follows, and in part will become more apparent to those skilled in the art upon examination of the following or upon learning by practice thereof.
The detailed description set forth below in connection with the appended drawings is intended as a description of various configurations and is not intended to represent the only configurations in which the concepts described herein may be practiced. The detailed description includes specific details for the purpose of providing a thorough understanding of various concepts. However, it will be apparent to those skilled in the art that these concepts may be practiced without these specific details.
Aspects presented herein comprise a primary abdominal wrap that is secured around the abdomen of the patient and a secondary strap that provides directed force and support to the sigmoid colon or small bowel. When the device is securely fastened, the secondary strap may be adjusted to serve as a focused support or ‘splint’ for the sigmoid colon or small bowel. The apparatus may further include visual guides or indicators that provide visual reference marks and guidance for placing the apparatus on a patient and/or for adjusting directed force using the secondary strap.
The application of manual pressure is time-consuming and places a physical toll on the technician. The effectiveness of the manual pressure varies depending on the particular technician's strength, technique, endurance, and training. In order to apply differential pressure, the technician may roll the patient from the left side to a supine or to a prone position, which can be a difficult task with a sedated patient. The application of manual pressure and movement of the patient in order to support the patient's colon and advance the colonoscope during the procedure places may even lead to injury of the technician.
Many patients undergo colonoscopy while placed in the left lateral decubitus position on the stretcher or operating table. Additional information about the use of such manual pressure can be found in Prechel J A, Hucke R. Safe and effective abdominal pressure during colonoscopy: forearm versus open hand technique. Gastroenterol Nurs 2009; 32:27-30; quiz 31-2, the entire contents of which are incorporated herein by reference. In applying manual pressure, the technician may reach over the patient from the opposite side of the table and to deploy pressure by placing their hands against the patient's sigmoid colon and then leaning backwards, using their bodyweight for leverage to exert force. While these methods are generally effective at generating pressure, they have also been identified as a causative factor for the high rate of work-related injuries among endoscopy nurses and staff. Physicians performing colonoscopy suffer work-related musculoskeletal injury at a particularly high-rate as well. The most frequent site of physician injury is the right upper extremity which experiences peak torque forces when while operators are attempting to advance the scope through (a looping) sigmoid colon. Additional details can be found in Spanarkel M, Hathorn JP. Looping During Colonoscopy: A Major, Implied Cause of Injury Among Endoscopy Healthcare Providers and a Proposed Solution, 2013, the entire contents of which are incorporated herein by reference.
Aspects described herein may similarly be applied for other endoscopic procedures such as sigmoidoscopy and retrograde enteroscopy procedures. Sigmoidoscopy is an examination of only the lower part of the colon, from the anus to the descending colon. An endoscope is inserted into the lower part of the colon. Enteroscopy is an examination of the small bowel. During retrograde enteroscopy, an endoscope is inserted in the anus and passed through the colon and the cecum and into the small bowel. Successfully navigating the loop-prone sigmoid region is necessary to complete both sigmoidoscopy and retrograde enteroscopy and thus aspects described herein can be used to help facilitate colonoscopy, sigmoidoscopy, retrograde enteroscopy, and other endoscopic procedures.
The small bowel is part of the intestine between the stomach and the colon.
It may be difficult to advance an endoscope in order to visualize the patient's entire small bowel due to the length, tortuosity/redundancy of the small bowel.
Push enteroscopy is an antegrade technique in which a physician uses a particular endoscope that is introduced through the patient's mouth. The physician slowly advances the scope, pushing the scope using pressure, as far as possible in order to visual the small bowel. However, this only allows for visualization of a limited portion of the small bowel.
Techniques and technologies may attempt to allow for greater visualization. As examples, single balloon enteroscopy, double balloon enteroscopy, and spiral enteroscopy are designed to overcome the challenge of advancing the scope deep into the small bowel. The three techniques may be considered, or may be referred to as, ‘deep small bowel enteroscopy.’
Each of the techniques can be used via an antegrade approach or a retrograde approach. In an antegrade approach, the scope is introduced through the patient's mouth and is advanced through the stomach in order to visualize the small intestine. In a retrograde approach, the scope is introduced through the rectum and through the colon and cecum in order to visualize the small intestine.
The techniques involve iterative advancement of an endoscope and an endoscopic overtube both of which can be advanced/withdrawn independently of one another.
As an example of balloon assisted enteroscopy, a double balloon enteroscopy (DBE) system may include an endoscope with an 8.5 mm diameter and a 200 cm working length, a 145 cm soft overtube with an outer diameter of 12.2 mm, and a specifically designed pump (the overtube may be backloaded onto the scope, a soft latex balloon may be attached to the tip of the enteroscope. The balloon can be inflated and deflated using a pump through the air channel in the enteroscope. The flexible overtube also has a latex balloon at its tip that can be inflated and deflated.
The DBE can be performed either via the mouth (anterograde approach) or the anus (retrograde approach). The insertion route may be selected according to the estimated location of the suspected lesion(s). With an antegrade examination, the enteroscope may be advanced using repetitive cycles of balloon inflation/deflation and scope advancement. During one cycle of the procedure, the scope may be advanced until no further forward progress is made. The balloon on the tip of the scope may then be inflated, anchoring the small bowel. Once the small bowel is anchored by the enteroscope balloon, the balloon on the overtube may be deflated (having been inflated during the prior cycle) and advanced until it reaches the inflated balloon on the scope. The balloon at the end of the overtube may then be inflated, and with both balloons inflated, the scope and overtube may be gently withdrawn to remove loops and pleat the small bowel onto the overtube. The balloon on the scope may then be deflated, and the cycle may be repeated until the scope can no longer be advanced or the lesion of interest is reached. The procedure may be carried out in reverse during withdrawal of the scope.
The procedure may be similar, or the same, for retrograde examinations. In retrograde examinations, the cycles of the scope advancement and withdrawal may be carried out in the colon, as well as in the small bowel. The cycles of advancement may help to ensure that there is no colonic looping prior to intubation of the terminal ileum, in some aspects.
In a single balloon enteroscopy, a enteroscope having a 200 cm high-resolution enteroscope with a 2.8 mm working channel may be used, for example. As an example, the overtube may be 140 cm long with a 13.2 mm outer diameter. The overtube may be equipped with a silicone balloon at its tip, which can be inflated and deflated.
The technique for single balloon enteroscopy is similar to that used for double balloon enteroscopy. Like double balloon enteroscopy, single balloon enteroscopy may use an overtube with a distal balloon to aid with scope advancement through the small bowel. However, SBE uses the scope's flexible tip to anchor the scope, rather than a second balloon on the tip of the enteroscope shown in
Spiral enteroscopy is an alternative to balloon-assisted enteroscopy for evaluation of the small bowel.
Spiral enteroscopy may use an overtube with a soft raised helix at its distal end. As an example, a118-cm overtube may be compatible with enteroscopes that are 200 cm long and between 9.1 and 9.5 mm in diameter (ie, the enteroscopes used for double balloon or single balloon enteroscopy, but not standard enteroscopes). The spirals on the overtube are either 4.5 mm (low profile) or 5.5 mm (standard profile) high. The overtube has a coupling device that affixes it to the scope, while permitting rotation of the overtube. By rotating the overtube clockwise, the small bowel may be pleated onto the overtube, and the enteroscope is advanced.
Table 1 illustrates example aspects of push enteroscopy and techniques for application of a band that applies elastic compression. Table 2 illustrates example aspects of antegrade double balloon enteroscopy, and Table 3 illustrates example aspects of retrograde double balloon enteroscopy with compression applied through a band. Table 4 illustrates example aspects of antegrade single balloon enteroscopy, and Table 5 illustrates example aspects of retrograde single balloon enteroscopy with compression applied through a band. The band may include aspects described in connection with any of
In the example in Table 3, during the advancement of the endoscope through large intestine (colon)—e.g. colonoscopy—having two secondary straps may allow for the simultaneous targeting of two different areas of the colon. The areas may be any two areas of the abdomen/colon. In some aspects, the two areas may be the sigmoid and transverse colons, which are the two areas in which 90% of looping occurs.
In the case of retrograde deep enteroscopy into the small bowel, having multiple straps provides stability/looping mitigation in the large intestine to be achieved and maintained while the device provides additional, directed compression to help facilitate scope advancement in the small intestine.
Tables 1-5 illustrate example aspects in which the primary wrap and/or secondary bands of a compression device may be applied and/or adjusted at various points of the different procedures, e.g., as the scope is iteratively advanced deeper into the small bowel. The different levels of compression, presence/absence of compression, and/or targeted areas of compression may assist with the advancement of the scope, withdrawal of the scope, and/or visualization of the small bowel, colon, etc.
Compression with a band including any of the aspects described in connection with
In an antegrade approach for spiral enteroscopy, the scope may be passed through the fixed ligament of Treitz. Deeper passage into the small bowel may be achieved with the lumen decompressed. In some aspects, compression may be applied or adjusted by a primary wrap and/or secondary band in order to assist insertion and/or advancement. Passage through the small bowel may be achieved with forward rotation of the spiral segment and gentle forward pressure on the enteroscope. The passage may be assisted by application or adjustment of the primary wrap and/or secondary band. In some aspects, sharply angled bends may be encountered, and abdominal compression may be applied, adjusted, or maintained over the area by the primary wrap and/or secondary strap(s) followed by gentle forward pressure on the enteroscope. The sequence of compression application/adjustment and forward pressure on the enteroscope may be repeated until the bend can be successfully traversed by the enteroscope.
In the retrograde approach for spiral enteroscopy, abdominal compression may be applied as needed, through application or adjustment of the primary wrap and/or secondary strap(s) in order to assist the spiral segment to be advanced across the value into the terminal ileum. Compression may also be applied or adjusted while passing through the small bowel in order to avoid looping and/or to address looping that does occur. The compression may be applied or adjusted for the area, and then the forward rotation of the spiral segment may be resumed.
The primary wrap 10 may have a circumferential length between approximately 15 and 75 inches in order to accommodate varying abdominal girths in patients. The width of the primary wrap 10 may be between 6 and 10 inches, although variations having widths of between 3 and 20 inches may be used depending on the size of the patient and to accommodate special circumstances such as an abdominal hernia or a large pannus. For example, the primary wrap may be configured to have a width that allows it to be fastened around the patient's lower abdomen with the upper edge of the wrap just below the umbilicus, or near the umbilicus, and the bottom edge of the wrap along or close to the pubic line. The width of the primary wrap may be selected so as not to be so large that the upper edge conceals the umbilicus and additional areas of the abdomen above the umbilicus. This configuration may be made in order to avoid pressure on the diaphragm or stomach, as pressure on the diaphragm and stomach during colonoscopy can increase the risk of oxygen deprivation and aspiration events, respectively, due to the fact that the patient is generally sedated during the procedure. The primary wrap 10 may comprise, entirely or in part, a flexible, bio-compatible foam, rubber, neoprene, polyester, nylon, non-woven or woven fabric, mesh fabric, synthetic fabric, microfiber fabric, silicon or vinyl plastic, or any other materials generally known to be used in medical fabrics and goods. The primary wrap 10 may be composed of both elastic and inelastic materials. In one example, the primary wrap 10 may comprise multiple layers laminated together. For example, the primary wrap 10 may comprise a neoprene layer and an outer fabric layer laminated on the neoprene layer. The fabric layer may enable the secondary strap to be removably fastened along the length of the primary wrap and may also enable visual indicators to be printed on the fabric, such as a nylon loop fabric. The primary wrap may also comprise an inner layer laminated on the neoprene. The inner layer may comprise a fabric or other material that is selected for skin sensitivity. For example, the inner layer may comprise a fabric or other material that is latex free, biocompatible, and/or skin sensitive. The inner layer may be the layer that is applied against the skin of the patient. In some aspects, the primary wrap may comprise 3D spacer fabrics, which may provide compression, elasticity, cushioning, breathability, air permeability, thermal insulation, temperature regulation, flexibility with resistance to bending/rolling, good draping, adjustable vapor transport, good aging qualities, surface and wash resistance, sterilization capabilities, and diverse surface design capabilities. A 3D spacer fabric may comprise a manufactured textile structure in which two fabric layers are connected by a layer of pile threads, which may be referred to as pile yarns.
The primary wrap may comprise two or more sections that vary in material type. In one example, a first set of one or more sections may be composed of a flexible, elastic or semi-elastic, medium-thickness, latex-free neoprene with thin polyester or nylon glued to its interior and exterior sides. Among others, this material may be capable of providing broad, firm, yet comfortable support to the patient's abdominal region. Another set of one or more sections of the primary wrap 10 may comprise a relatively inelastic material, such as a woven fabric. The inelastic section may be provided at the location into which or under which an insert is placed. Upon deployment of the device, the inelastic section may be positioned in the patient's lower left abdominal quadrant, over the sigmoid region.
For the primary wrap to provide appropriate general compression and support, it may be important that the wrap remain flat against the body when fastened around the abdomen. This is notable because certain materials and designs have a tendency to roll-up when stretched or wrapped around the abdomen, particularly when the device is being applied to patients with a large pannus. To prevent roll-up from occurring, aspects of the invention may include reinforcements to ensure that the primary abdominal wrap remains flat against the body when used in patients of varying body sizes. This may be accomplished by the application of serge stitching along the edges of the primary abdominal band.
The primary wrap may also accommodate an insert or attachment that provides specific support to one or more areas of the colon including the sigmoid, transverse, and cecal regions as well as the splenic and hepatic flexures. When the device is securely fastened, the secondary strap, the insert, or both, may be pushed, pulled, or otherwise pressed into the body in a manner that serves to support or ‘splint’ one or more areas of the colon including the sigmoid, transverse, and cecal regions as well as the splenic and hepatic flexures. Aspects described herein may be designed to provide broad lower abdominal support, and additional direct force to one or more areas of the colon including the sigmoid, transverse, and cecal regions as well as the splenic and hepatic flexures of a patient undergoing colonoscopy.
The primary wrap 10 may be placed around the patient's lower abdomen and secured using a closing mechanism 12 consisting of a strip of VELCRO® or hook material 13 placed on the interior of the wrap 10 close to the location of the handle 14 on the opposite side. This hook strip 13 may be fastened to the exterior side of the opposite end of the primary wrap 10.
The edges of the hook strip 13 might not extend to the edges of the primary wrap 10.
This construction may be designed to minimize the chance that the hook strip 13 comes into contact with the patient's skin, or with the gloves of the nurse or assistant deploying the device, as there is a small but known risk of VELCRO®, or a hook and pile material, being capable of tearing medical gloves.
An additional feature designed to reduce the likelihood of patient and provider contact with the hook material. In aspects incorporating this feature, prior to the device being packaged, a thin layer of material may be applied to hook strips that are incorporated into the device. This layer may comprise, e.g., paper, plastic, fabric, silicon, or any other biocompatible material typically used in healthcare products. Additionally, the layer may be lightly adhered to the hook strips so that it remains in place— until it is easily removed and disposed of by the end user just prior to the device's application on the patient. This feature may be helpful in use of a secondary strap 72, because it may be helpful for the secondary strap 72 to remain unfastened until the primary wrap 10 is fastened and properly positioned. Having a layer covering the hook strip 75 on the secondary strap 72 helps to ensure that the secondary strap will not be accidentally fastened while the user is securing the primary wrap 10 around the patient's abdomen.
The addition of one or more appendages on the exterior of the primary wrap facilitates the application of additional directed force, e.g., without requiring adjustment of the primary wrap. The appendages may comprise one, or multiple, straps attached on one side to the edge or edges of non-elastic section.
As depicted in
The secondary strap 72 may be coupled, e.g., sewn, to a portion of the wrap that is configured for placement over a left side of the patient's lower abdomen. The portion of the secondary strap 72 that is coupled to the primary wrap may be referred to as the secured end and may be non-removably coupled to the strap, such as sewn or formed as an extension of the primary wrap material. The strap can be configured to be pulled from left to right, e.g., to stretch across the lower abdomen and/or left lower abdominal quadrant from the left side of the patient's body towards right side of the patient's body. This placement of the secondary strap 72 may enable the compression to be easily adjusted as the patient lies on their left side during the procedure. As the strap pulls from left to right across the lower abdomen, additional leverage and compression may be generated by the patient's body when the strap is in place. As the strap stretches from left to right cross the patient's abdomen, the level of compression generated by the device can easily be adjusted during the procedure, e.g., while the patient is lying on their left side.
In some aspects, the secured end of the strap 72 may be connected to the wrap 10 in a manner that the secured end of the strap is under the patient during a procedure.
As illustrated in
As described above, multiple secondary straps may be provided on the device. FIG.
8 illustrates an example on which the indicators 62 and 64 are provided on different secondary straps. For example, the device may include two secondary straps, as shown in
Mechanisms for indicating stretch and compression, such as those described in connection, may be provided so that the device includes a mechanism to visually indicate the magnitude of force being applied, such as the mark 80 labeled “Logo” which stretches and deforms when the secondary strap 72 is stretched and fastened. With this mechanism, users may compare the deformed mark with a picture or illustration included in the product instructions or packaging to determine that the device has been applied correctly.
The visual indicator may help a technician to properly place the primary wrap to the patient so that the secondary straps are in the appropriate location to apply targeted compression to particular areas of the abdomen, such as to a sigmoid colon region or to a transverse colon region.
In some examples, one vertical side of the secondary strap may be fixed to the primary wrap, and the other side may be removably fastened to the primary wrap, such as through a Velcro closure. In other examples, the secondary strap 72 may be fully detachable from the primary wrap, and may have fastening mechanisms at both ends that allow the strap to be secured the exterior side of the primary wrap. The secondary strap in this aspect may be either re-usable or disposable, and may be capable of being stretched and maintaining tension, or may use another mechanism to exert compressive force, when it is secured to the primary band. The strap in this example might not wrap fully around the patient but instead may be stretched directly about the location on the patient's body where force is desired. The strap may be equipped with fastening mechanisms on each end, e.g., to allow the strap to adhere directly to the patient's body.
Improving patient comfort and reducing complications, both during and following endoscopic procedures is very important. Aspects presented herein reduce patient discomfort and complications by helping to prevent and reduce sigmoid looping, which can be a primary cause of patient pain and discomfort.
Patients often become cold or uncomfortably chilled once they change into the garments such as hospital gowns typically worn while undergoing an endoscopic procedure. Many patients request and are provided with blankets, and some facilities provide electric heated blankets, or blankets that have been previously warmed. The heated blankets provide physical warmth, but also they tend to relax the patient and relieve anxiety or discomfort the patient may be experiencing. Aspects presented herein may also help the patient to feel warm and comfortable during the procedure.
The device illustrated in
At 902, the method includes wrapping a primary wrap about the abdomen of a patient between the hips and umbilicus of the patient, such as described in connection with
At 904, the method includes securing the primary wrap by attaching a first end of the primary wrap to a second portion of the primary wrap after wrapping the primary wrap about the abdomen of the patient.
At 906, the method includes adjusting compression applied to the abdomen of the patient by pulling at least one strap extending from the primary wrap across at least a portion of the primary wrap and to fasten the strap to at least a third portion of the primary wrap, such as illustrated in
The application and/or adjustment of the primary wrap or secondary strap(s) may be performed at particular points of the procedure to assist in passage of the scope.
The compression may be adjusted for multiple target locations through the adjustment of more than one strap. For example, as described in connection with
As an example,
At 1602, a user applies a primary wrap comprising a band of elastic material to an abdomen of a patient. The primary wrap may include any of the aspects described in connection with
At 1604, the user maintains tension in the band in order to apply constant pressure and the support to the patient's abdomen through a contraction of the primary wrap in connection with an advancement or a withdrawal of an endoscope during an endoscopic procedure.
The method may include adjusting compression applied to the abdomen of the patient by pulling at least one strap extending from the primary wrap across at least a portion of the primary wrap and to fasten the strap to at least a third portion of the primary wrap, such as illustrated in
At 1606, the user adjusts at least one of the primary wrap or at least one secondary strap extending from the primary wrap to adjust compression and support the advancement or the withdrawal of the endoscope through the contraction of the primary wrap and the at least one secondary strap. Adjusting the at least one of the primary wrap or the at least one secondary strap may include iteratively adjusting the at least one of the primary wrap or the at least one secondary strap in combination with, in correlation with, and/or triggered by, iterative advancement of the endoscope, e.g., as shown at 1714 in
The application and/or adjustment of the primary wrap or secondary strap(s) may be performed at particular points of the procedure to assist in passage of the scope. The compression may be adjusted for multiple target locations through the adjustment of more than one strap. For example, as described in connection with
For example, the user may adjust at least one of the primary wrap or the at least one secondary strap includes iteratively adjusting the at least one of the primary wrap or the at least one secondary strap in combination with iterative withdrawal of the endoscope. The user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with inflation or deflation of a balloon. The endoscope may comprise an enteroscope, and the user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with the advancement or a retraction of an overtube for the enteroscope. The endoscope may comprise an enteroscope, and the user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with the advancement of the enteroscope to a cecum. The endoscope may comprise an enteroscope, and the user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with the advancement of the enteroscope across a terminal ileocecal valve into a terminal illieum. The endoscope may comprise an enteroscope, and the user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with advancement of the enteroscope into a small bowel of the patient. The endoscope may comprise an enteroscope and the endoscopy procedure may comprise a spiral enteroscopy, and the user may adjust at least one of the primary wrap or the at least one secondary strap is performed in correlation with a passive pleating or unpleating of a bowel of the patient. The endoscope comprises an enteroscope, and the endoscopy procedure comprises a spiral enteroscopy, and the user adjusts at least one of the primary wrap or at least one elastic secondary strap is performed in correlation with a spiral rotation of the enteroscope. The adjustment of the compression may assist in the advancement of the endoscope, may prevent looping, may improve visualization, and/or may improve the ease and comfort of advancement or withdrawal of the endoscope.
In some aspects, such as illustrated at 1716, the user may maintain the compression with the primary wrap for a period of time following the withdrawal of the endoscope. The maintenance of the compression may reduce symptoms of bloating and abdominal pain by assisting with expulsion of gas introduced into the patient as part of the procedure.
To additionally enhance patient comfort, certain aspects of the invention are designed to be single-use, and to remain fastened in place on the patient during the procedure and/or following the procedure. For example, maintaining the compression applied by the device during the withdrawal phase of the procedure and while imaging is performed may help improve the detection of adenoma. The device may be maintain on the patient to reduce the common post-procedure complications of bloating and abdominal pain caused by bloating. Otherwise known as gaseous distention, bloating occurs following endoscopy procedures because physicians often use compressed air or carbon dioxide to insufflate parts of the bowel that are difficult to see and examine. The gas opens up the area to allow for a more complete visualization, enhancing the efficacy of the procedure. However, the gas also remains in the patient until it is either absorbed or expelled. Expulsion is the primary gas removal mechanism as absorption is a very inefficient process. Gaseous distention is a primary post-procedure complication and a frequent complaint from patients. However, when the wrap described herein remains in place after the procedure, the lower abdominal compression generated by the device allows the bowel to more rapidly evacuate trapped by directing excess gas towards the rectum. As a result, the severity and duration of post-procedure bloating and associated abdominal pain may be reduced.
The contents of each of U.S. application Ser. No. 15/256,019, entitled “METHOD AND APPARATUS FOR ENHANCED VISUALIZATION DURING ENDOSCOPY,” and filed on Sep. 2, 2016; U.S. application Ser. No. 13/344,715, entitled “METHOD AND APPARATUS FOR TENSILE COLONOSCOPY COMPRESSION,” and filed on Jan. 6, 2012; U.S. application Ser. No. 14/575,860, entitled “ENDOSCOPY BAND WITH SIGMOID SUPPORT APPARATUS,” and filed on Dec. 18, 2014; U.S. Provisional Application Ser. No. 61/917,469, entitled “COLONOSCOPY BAND WITH SIGMOID SPLINT” and filed on Dec. 18, 2013; U.S. Provisional Application Ser. No. 61/944,658 entitled “ENDOSCOPY BAND WITH SIGMOID SUPPORT APPARATUS” and filed on Feb. 26, 2014; U.S. Provisional Application No. 62/214,747, entitled “IMPROVED BOWEL STABILITY AND ENHANCED VISUALIZATION DURING ENDOSCOPY” and filed on Sep. 4, 2015, are expressly incorporated by reference herein in their entirety.
Example aspects of the present invention have now been described in accordance with the above advantages. It will be appreciated that these examples are merely illustrative of aspects of the present invention. Many variations and modifications will be apparent to those skilled in the art.
It is understood that the specific order or hierarchy of steps in the processes disclosed is an illustration of exemplary approaches. Based upon design preferences, it is understood that the specific order or hierarchy of steps in the processes may be rearranged. Further, some steps may be combined or omitted. The accompanying method claims present elements of the various steps in a sample order, and are not meant to be limited to the specific order or hierarchy presented.
The previous description is provided to enable any person skilled in the art to practice the various aspects described herein. Various modifications to these aspects will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other aspects. Thus, the claims are not intended to be limited to the aspects shown herein, but is to be accorded the full scope consistent with the language claims, wherein reference to an element in the singular is not intended to mean “one and only one” unless specifically so stated, but rather “one or more.” The word “exemplary” is used herein to mean “serving as an example, instance, or illustration.” Any aspect described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other aspects. Unless specifically stated otherwise, the term “some” refers to one or more. Combinations such as “at least one of A, B, or C,” “at least one of A, B, and C,” and “A, B, C, or any combination thereof” include any combination of A, B, and/or C, and may include multiples of A, multiples of B, or multiples of C. Specifically, combinations such as “at least one of A, B, or C,” “at least one of A, B, and C,” and “A, B, C, or any combination thereof” may be A only, B only, C only, A and B, A and C, B and C, or A and B and C, where any such combinations may contain one or more member or members of A, B, or C. All structural and functional equivalents to the elements of the various aspects described throughout this disclosure that are known or later come to be known to those of ordinary skill in the art are expressly incorporated herein by reference and are intended to be encompassed by the claims. Moreover, nothing disclosed herein is intended to be dedicated to the public regardless of whether such disclosure is explicitly recited in the claims. No claim element is to be construed as a means plus function unless the element is expressly recited using the phrase “means for.”
This application is a continuation-in part of U.S. application Ser. No. 17/180,676 entitled “Endoscopy Band with Visual Indicator to Assist Placement” and filed on Feb. 19, 2021, which claims the benefit of and priority to U.S. Provisional Application No. 62/978,797 entitled “Endoscopy Band with Visual Indicator to Assist Placement” and filed on Feb. 19, 2020, and also claims the benefit of and priority to U.S. Provisional Application Ser. No. 63/271,156, entitled “Endoscopy Band” and filed on Oct. 24, 2021, the entire contents of each of which are expressly incorporated by reference herein in its entirety.
Number | Date | Country | |
---|---|---|---|
62978797 | Feb 2020 | US | |
63271156 | Oct 2021 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 17180676 | Feb 2021 | US |
Child | 17972581 | US |