US3595239A - Catheter with electrical cutting means - Google Patents

Catheter with electrical cutting means Download PDF

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US3595239A
US3595239A US813543A US3595239DA US3595239A US 3595239 A US3595239 A US 3595239A US 813543 A US813543 A US 813543A US 3595239D A US3595239D A US 3595239DA US 3595239 A US3595239 A US 3595239A
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catheter
catheter tube
tip
distal end
obturator
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US813543A
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Roy A Petersen
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy

Definitions

  • FIG. I APPARATUS I N VENTOR.
  • FIG- 2 ROY A.PETERSEN BY k4.
  • 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.
  • 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 of a 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.
  • 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.
  • 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.
  • the catheter tube can be advanced into the passageway with reduced applied force.
  • 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.
  • 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.
  • FIGS. l3 Illustrated in FIGS. l3 is the catheter 10 of the present invention which comprises a suitable flexible tube 15 made of rubber, plastic or the like and an obturator 20 in the form of a rod-shaped electrical conductor or electrode.
  • the catheter tube 15 is formed at the distal end thereof with a plurality of elongated, axially disposed drainage openings 16 suitable for the drainage of fluids and the like.
  • a ring or eyelet 17 At the distal end of the catheter tube 15 is also located a ring or eyelet 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.
  • the obturator 20 is basically of a metal wire-type construction, flexible, but more rigid than the catheter tube 15. Specifically, the obturator 20 comprises a solid cylindrical body 21. At the distal end of the body 21, the rod 20 includes a cylindrical tip 22 that is tapered to a sharp needlelike point.
  • the body 21 is made of suitable material, such as stainless steel and the sharp tip 22 is made of suitable material, such as tungsten or tungsten-coated steel, or other suitable noncorrosive, electrically conductive material.
  • a cylindrical member 23, such as a ring or a sleeve, of the rod 20 surrounds the body 21 to form a shoulder 24 at the junction with the tip 22.
  • a tubular insulator 25 Surrounding the body 21 rearward of the ring 23 is a tubular insulator 25 made of suitable material, such as Teflon.
  • a tubular insulator 30 made of suitable material, such as Teflon. Rearward of the sleeve 30 is located an electrical terminal connector 35 for the obturator 20, which may be in the form of a receptacle or a plug for establishing an electrical connection with a conventional and well-known electrosurgical apparatus 40, which produces high frequency currents and is a source of high frequency electrical energy.
  • the insulator 30 extends to the connector 35 and projects into the catheter tube 15 when the obturator 20 is fully inserted in the catheter tube 15.
  • the catheter tube 15 serves as an insulator for the obturator 20 between the tip 22 thereof and the uninsulated portion of the body 21.
  • the tip 22 of the obturator 20 When the obturator 20 is placed into the catheter tube 15, the tip 22 of the obturator 20 extends beyond the ring or the eyelet 17 of the catheter tube 15 and the extent of the projection ofthe tip 22 out ofthe distal end ofthe catheter tube 15 is limited by the engagement of the shoulder 24 of the obturator 20 against the ring 17 of the catheter tube 15.
  • the eyelet 17 is of sufficient rigidity and strength as to preclude excessive passage of the tip 22 out of the distal end of the catheter tube 15 and to withstand the force applied to the obturator 20 by an operator.
  • the Teflon sleeve 25 serves to reduce leakage of electrical current through the ring 17 and through the drainage openings in the catheter tube 15 by reducing arcing at the ring 17. Also, it reduces coagulation occurring in the vicinity of the ring 17.
  • the length of the obturator 20 is 18 inches and the diameter of the body 21 is one-sixteenth of an inch.
  • the ring 17 of the catheter tube is of sufficient dimension to pass the maximum width of the tip 22 of the obturator, which is one-sixteenth of an inch.
  • the tip 22 of the obturator 20 projects approximately one-fourth of an inch to three-eights of an inch beyond the distal end of the catheter tube, when the shoulder 24 engages the ring 17 ofthe catheter tube 15.
  • the shoulder 24 is brazed or welded to the body 21 or may be integrally formed therewith.
  • the exemplary dimension for the shoulder 24 is three thirty-seconds of an inch in diameter.
  • the sleeve 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 the electrosurgical apparatus 40 is connected to the obturator 20 through the connector 35.
  • the other side of the electrical output for the electrosurgical apparatus 40 is connected to a conductor plate electrode 41 upon which rests the body P of the patient.
  • the electrode 41 is in spaced relation with the tip 22 ofthe obturator 20.
  • the obturator 20 is an electrode and serves as a conductor for high frequency currents.
  • High frequency electrical energy between the electrode 41 and the tip 22 of the obturator 20 cuts or divides tissue of the body at the tip 22. This action results in the formation ofa passageway in the body tissue for the advancement of the catheter tube 15.
  • the catheter tube is capable of advancing in the passageway with a reduced application of force.
  • the catheter tube 15 follows behind the tip 22 of the obturator in advancing into the passageway.
  • the high frequency energy at the tip 22 of the obturator has a coagulating effect, as well as a cutting effect, which seals off bleeding vessels and reduces hemorraging.
  • 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.
  • 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.
  • 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.
  • a catheter as claimed in claim 4 in which said catheter tube is formed with drainage openings at the distal end thereof.
  • a catheter as claimed in claim 8 in which said obturator has a body made of stainless steel wire.
  • 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.

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 the catheter 10 of the present invention which comprises a suitable flexible tube 15 made of rubber, plastic or the like and an obturator 20 in the form of a rod-shaped electrical conductor or electrode.
The catheter tube 15 is formed at the distal end thereof with a plurality of elongated, axially disposed drainage openings 16 suitable for the drainage of fluids and the like. At the distal end of the catheter tube 15 is also located a ring or eyelet 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 the catheter tube 15 is an obturator or rod 20 in the form of an electrical conductor or an electrode. The obturator 20 is basically of a metal wire-type construction, flexible, but more rigid than the catheter tube 15. Specifically, the obturator 20 comprises a solid cylindrical body 21. At the distal end of the body 21, the rod 20 includes a cylindrical tip 22 that is tapered to a sharp needlelike point. The body 21 is made of suitable material, such as stainless steel and the sharp tip 22 is made of suitable material, such as tungsten or tungsten-coated steel, or other suitable noncorrosive, electrically conductive material.
A cylindrical member 23, such as a ring or a sleeve, of the rod 20 surrounds the body 21 to form a shoulder 24 at the junction with the tip 22. Surrounding the body 21 rearward of the ring 23 is a tubular insulator 25 made of suitable material, such as Teflon.
At the proximal end of the obturator 20 is disposed a tubular insulator 30 made of suitable material, such as Teflon. Rearward of the sleeve 30 is located an electrical terminal connector 35 for the obturator 20, which may be in the form of a receptacle or a plug for establishing an electrical connection with a conventional and well-known electrosurgical apparatus 40, which produces high frequency currents and is a source of high frequency electrical energy.
The insulator 30 extends to the connector 35 and projects into the catheter tube 15 when the obturator 20 is fully inserted in the catheter tube 15. When the obturator 20 is fully inserted into the catheter tube 20, the catheter tube 15 serves as an insulator for the obturator 20 between the tip 22 thereof and the uninsulated portion of the body 21.
When the obturator 20 is placed into the catheter tube 15, the tip 22 of the obturator 20 extends beyond the ring or the eyelet 17 of the catheter tube 15 and the extent of the projection ofthe tip 22 out ofthe distal end ofthe catheter tube 15 is limited by the engagement of the shoulder 24 of the obturator 20 against the ring 17 of the catheter tube 15. The eyelet 17 is of sufficient rigidity and strength as to preclude excessive passage of the tip 22 out of the distal end of the catheter tube 15 and to withstand the force applied to the obturator 20 by an operator. The Teflon sleeve 25 serves to reduce leakage of electrical current through the ring 17 and through the drainage openings in the catheter tube 15 by reducing arcing at the ring 17. Also, it reduces coagulation occurring in the vicinity of the ring 17.
In the typical embodiment of the catheter 10, the length of the obturator 20 is 18 inches and the diameter of the body 21 is one-sixteenth of an inch. The ring 17 of the catheter tube is of sufficient dimension to pass the maximum width of the tip 22 of the obturator, which is one-sixteenth of an inch. The tip 22 of the obturator 20 projects approximately one-fourth of an inch to three-eights of an inch beyond the distal end of the catheter tube, when the shoulder 24 engages the ring 17 ofthe catheter tube 15. The shoulder 24 is brazed or welded to the body 21 or may be integrally formed therewith. The exemplary dimension for the shoulder 24 is three thirty-seconds of an inch in diameter. The sleeve 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 the electrosurgical apparatus 40 is connected to the obturator 20 through the connector 35. The other side of the electrical output for the electrosurgical apparatus 40 is connected to a conductor plate electrode 41 upon which rests the body P of the patient. The electrode 41 is in spaced relation with the tip 22 ofthe obturator 20.
The obturator 20 is an electrode and serves as a conductor for high frequency currents. High frequency electrical energy between the electrode 41 and the tip 22 of the obturator 20 cuts or divides tissue of the body at the tip 22. This action results in the formation ofa passageway in the body tissue for the advancement of the catheter tube 15. The catheter tube is capable of advancing in the passageway with a reduced application of force. The catheter tube 15 follows behind the tip 22 of the obturator in advancing into the passageway. Further, the high frequency energy at the tip 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.
US813543A 1969-04-04 1969-04-04 Catheter with electrical cutting means Expired - Lifetime US3595239A (en)

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