The invention relates to methods and devices for actuating a clearance device to clear obstructive debris from medical tubes. More particularly, it relates to a removable device having magnetic elements that are magnetically coupled to a clearance member to draw such debris proximally in a medical tube without compromising the sterile field.
Millions of medical tubes are used every year to drain bodily fluids and secretions from within body orifices. For example, such tubes can be used to drain fluid from one's bladder, from the colon or other portions of the alimentary tract, or from the lungs or other organs in conjunction with various therapies. Medical tubes also are used to drain blood and other fluids that typically accumulate within the body cavity following traumatic surgery. In all these cases, a tube is inserted into the patient so that its terminal end is provided in or adjacent the space where it is desired to remove accumulated or pooled fluid, and the proximal end remains outside the patient's body, where it is typically connected to a suction source.
U.S. Pat. No. 7,951,243 (incorporated herein by reference) discloses a clearance device for clearing medical tubes (such as chest tubes) of obstructive clot material. That device relies on a shuttle that is fixed and fitted over a guide tube, to actuate a clearance member within the tube via a magnetic coupling between the shuttle and a magnetic guide linked to the clearance member within the tube. The shuttle disclosed in the '243 patent is fixed over the medical tube and not removable. Thus it must be reproduced with and as part of each unit of the device described in the '243 patent. Moreover, that shuttle is not useful with other magnetically actuated clearance devices as the hospital or other medical facility may have on-hand.
A replaceable shuttle for actuating a clearance member. The replaceable shuttle is configured to reversibly engage a tube having a clearance member disposed therein and configured to reversibly engage the clearance member when the shuttle is engaged to the tube.
A replaceable shuttle for actuating a clearance member. The replaceable shuttle including a shuttle body having an elongated recess formed therein and accessible through a longitudinally-extending lateral mouth thereof. The shuttle body is replaceably fitted over and longitudinally translatable along an outer wall of a tube when received in the elongated recess through the lateral mouth. The tube at least partially defines a suction pathway for drawing secretions from a patient. A magnetic element is disposed within the shuttle body adjacent to the elongated recess. The magnetic element is adapted to be magnetically coupled to a magnetic guide of the clearance member through the outer wall of the tube when received in the elongated recess so that translation of the shuttle body along a length of the tube induces a corresponding translation of the clearance member.
A method of clearing obstructions from a tube, including removably positioning a tube within an elongated recess formed in a replaceable shuttle through a longitudinally-extending, lateral mouth thereof; and translating the replaceable shuttle along a length of the tube to correspondingly translate an elongated guide member that is at least partially disposed within the tube and magnetically coupled to the replaceable shuttle.
A device for clearing obstructions from a medical tube, the device including a shuttle guide tube having an inner diameter and an outer diameter. A replaceable shuttle includes a shuttle body having an elongated recess formed therein and accessible through a longitudinally-extending, lateral mouth thereof. The shuttle guide tube being replaceably insertable into and removable from the elongated recess through the lateral mouth. A magnetic element is disposed within the shuttle body adjacent to the elongated recess. An elongated guide member extends through the shuttle guide tube. A clearance member is attached to or formed integrally with the elongated guide member. A magnetic guide is secured to the elongated guide member. The magnetic guide is magnetically coupled to the replaceable shuttle through a wall of the shuttle guide tube so that translation of the replaceable shuttle along a length thereof induces a corresponding translation of the elongated guide member within the shuttle guide tube.
As used herein, the terms proximal and distal are generally to be construed with reference to a patient that has been or is to be fitted with a medical tube, such as a chest tube. For example, the distal end or region of a medical tube (e.g., a chest tube) is that end or region that is to be inserted into or disposed more adjacent (e.g., within) the patient during use, as compared to the opposite end or region of the medical tube (e.g., chest tube). Similarly, a distal element (or the distal side or region of an element) is nearer to the patient, or to the distal end of the chest tube, than a proximal element (or the proximal side or region of an element). Also herein, the “terminal” end of a tube, wire or member refers to its distal end.
Returning to
Exemplary embodiments of the clearance device 100 will now be more fully described. As seen in
A wire clearance assembly 120 is at least partially disposed within the guide-tube passageway 116 as explained in the '243 patent. Briefly, the wire clearance assembly 120 includes an elongate guide member 122 and a clearance member 124 disposed in and secured to the distal region of the guide member 122, preferably at its distal end. Optionally, the guide member 122 can be in the form of a guide wire, and the clearance member 124 can be formed by the guide wire, e.g., as a loop.
A magnetic guide 130 (e.g., permanent magnets) is secured to the guide member 122 in the proximal region thereof, again as described in the '243 patent incorporated herein.
As noted above and illustrated in
Referring to
The elongated recess 141 is contoured and dimensioned such that the replaceable shuttle 140 can be fitted over the guide tube 110 and be slidably and smoothly translated along the length of the guide tube 110 with the guide tube 110 received in the recess 141 (e.g., within or against its inner surface). It is contemplated that the replaceable shuttle 140 may be retained on the guide tube 110 in a snap-fit manner. For example, a single projection 143 may extend from one side of the lateral mouth of the elongated recess 141, thus effectively constraining the height of that mouth to a reduced-height gap. The single projection 143 may be dimensioned such that a gap between it and the opposing surface (or portion of the inner surface of the recess) is less than the outer diameter of the guide tube 110. As such, during insertion or removal of the guide tube 110 into or out of the elongated recess 141 through the lateral mouth thereof, the guide tube 110 will be deflected by the projection 143 as it passes the aforementioned gap so that it deforms to accommodate the reduced height of the gap. Once the guide tube 110 passes the gap and is either fully received in the elongated recess 141, or fully removed through the mouth thereof, the tube elastically returns to its unconstrained, original shape. In the embodiment shown, the replaceable shuttle 140 includes opposing projections 143. It is contemplated that there may be only a single projection, or a plurality of spaced-apart projections along the length of the elongated recess 141, or a continuous projection that extends the entire length of the elongated recess 141.
Optionally, when the guide tube is made from a more rigid material and thus less amenable to being compressed on traversing the gap, one or both of projections 143 can be deflectable on insertion of the guide tube 110 therethrough, so as to accommodate passage of the guide tube 110 through the lateral mouth and into the elongated recess 141. Upon seating the guide tube 110 therein, the deflected projection(s) 143 return(s) to its/their resting configuration, thus laterally retaining the guide tube 110 within the elongated recess 141. To remove that guide tube 110 from the elongated recess 141, it is drawn laterally, against the bias of the projection(s) 143 to allow passage of the guide tube 110 through the lateral mouth, this time out from the elongated recess 141 to separate the replaceable shuttle 140 from the guide tube 110. In this manner, the replaceable shuttle 140 is replaceable on and over the guide tube 110, or successive or multiple such guide tubes when or as needed.
It is also contemplated that other methods can be used to retain the replaceable shuttle 140 on the guide tube 110, such as, but not limited to, an interference fit.
Referring to
As with the magnetic guide 130 discussed above, the magnetic elements 150 can be permanent magnets or, optionally, metal elements having magnetic properties that are not necessarily permanent magnets. However, for reasons that will become clear, either at least the magnetic guide 130 or at least one of the magnetic elements 150 should be a permanent magnet. Optionally, both the magnetic guide 130 and the magnetic elements 150 are permanent magnets.
Optionally, a magnetic shield 152 can be positioned adjacent or over the magnetic elements 150. Referring to
When the magnetic guide 130 and the magnetic elements 150 are magnetically coupled, they all will be disposed within the volume of the replaceable shuttle 140. It is contemplated that the magnetic shield may extend circumferentially around the elongated recess 141 to surround the coupled magnetic guide 130 and magnetic elements 150, except for the lateral mouth through which the tube is inserted into the elongated recess 141. Optionally, the magnetic guide 130 may be provided as metal elements that are not permanent magnets, or as relatively weak permanent magnets, so as not to create strong magnetic fields that may interfere with other equipment when the replaceable shuttle 140 is removed from the guide tube 110. The magnetic guide 130 and the magnetic elements 150 may have a residual flux density (Br) of, e.g., 14-15 kGs, such as 14.3 to 14.8 kGs.
When provided as permanent magnets, the North pole of the magnetic guide 130 aligns with the South pole of the magnetic element(s) 150 in the replaceable shuttle 140, and the South pole of the magnetic guide 130 aligns with the North pole of those magnetic element(s) 150 when the replaceable shuttle 140 is fitted over the guide tube 110, located in its recess 141. The selection of particular magnets, having appropriate magnetic strength, is well within the capability of a person having ordinary skill in the art. Optionally, the magnetic guide 130 and magnetic element(s) 150, and their cooperative attractive strengths, are selected to allow a high degree of attractive force to prevent as much as possible instances of magnetic de-coupling between the magnetic guide 130 and the replaceable shuttle 140, while at the same time minimizing their weight and bulk.
A shuttle stop 160 is secured to the outer circumference 118 of the guide tube 110 in a distal region thereof, preferably just proximal to the distal end of the guide tube 110. The replaceable shuttle 140 and shuttle stop 160 can have complementary first and second surfaces 145 (
Referring now to
With the clearance device 100 and chest tube 10 fitted together as described above, the guide member 122 and the clearance member 124 disposed at its distal end may be advanced into and withdrawn from the chest tube 10 to assist in clearing debris therefrom as follows. In use, the magnetic guide 130 and the magnetic elements 150 of the replaceable shuttle 140 are magnetically attracted and coupled to one another when the replaceable shuttle 140 is fitted over the guide tube 110. This results in coupling the magnetic guide 130 to the replaceable shuttle 140 via magnetic forces that act through the guide tube 110 wall. Consequently, longitudinally sliding or translating the replaceable shuttle 140 along the length of the shuttle guide tube 110 induces a corresponding translational movement of the magnetic guide 130 magnetically coupled thereto, and of the guide member 122 that is secured to the magnetic guide 130. In
In operation, with the distal end of the chest tube 10 inserted in a body cavity of a patient and the shuttle guide tube 110 being connected to a suction source 200 at its proximal end, fluid from the body cavity is drawn into and through the chest-tube passageway, then through the guide-tube passageway 116 to be collected or disposed of in any suitable or conventional manner, such as in a conventional collection canister (not shown). Optionally, the clearance member 124 is in the form of a wire loop that scrapes the inner diameter of the chest tube 10 as it translates along the chest-tube 10 length.
As noted above, the clearance member 124 (e.g., loop) is normally disposed adjacent the distal end of the chest tube 10 inside the chest-tube passageway. To help clear the chest tube 10 of clots and other debris 400 accumulated therein, a nurse, physician, or other operator places the replaceable shuttle 140 on the tube 110 (
As will be appreciated, while the replaceable shuttle 140 is being used to actuate a clearance member 124 within a medical tube, if it becomes de-coupled from the magnetic guide 130 within the guide tube 110, the replaceable shuttle 140 and the magnetic guide 130 may be magnetically re-coupled by advancing the replaceable shuttle 140 forward until magnetic coupling is re-established. Alternatively, the operator may squeeze the chest tube 10 or guide tube 110 to manually engage the guide member 122 through the tube wall and hold it in position while the replaceable shuttle 140 is translated to magnetically re-engage the magnetic guide 130 through the guide-tube 110 wall.
Although the invention has been described with respect to certain preferred embodiments, it is to be understood that the invention is not limited by the embodiments herein disclosed, which are exemplary and not limiting in nature, but is to include all modifications and adaptations thereto as would occur to the person having ordinary skill in the art upon reviewing the present disclosure, and as fall within the spirit and the scope of the invention as set forth in the appended claims.
Number | Date | Country | |
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63079096 | Sep 2020 | US |