US3680562A - Surgical drainage apparatus for bladder - Google Patents

Surgical drainage apparatus for bladder Download PDF

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US3680562A
US3680562A US137550A US3680562DA US3680562A US 3680562 A US3680562 A US 3680562A US 137550 A US137550 A US 137550A US 3680562D A US3680562D A US 3680562DA US 3680562 A US3680562 A US 3680562A
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catheter
bladder
tube
distal end
assembly
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US137550A
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James M Wittes
Peter J Bonanno
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Becton Dickinson and Co
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Becton Dickinson and Co
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    • 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
    • A61M25/0606—"Over-the-needle" catheter assemblies, e.g. I.V. catheters
    • 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
    • A61M25/02—Holding devices, e.g. on the body

Definitions

  • a surgical apparatus for delivering fluids to or withdrawing fluids from the bladder includes a catheter having an inwardly curved, tapered blunt-tip with a series of longitudinally aligned ports spaced on the inside of the curve.
  • a removable piercing element is disposed within the catheter having a beveled point extending beyond the end of the plastic tube.
  • a pliant sheath is bifurcated at its distal end into half-tube branches which are 5 m- Cited adapted to be bent away from the catheter tube after introduction of the assembly into the body to anchor UNITED STATES PATENTS the apparatus to the skin.
  • the bifurcated anchoring wings are in a mut l l t th t] t t 3,538,913 11/1970 Stolfi ..l28/351X y pe'pen p C e s 5 Claims, 6 Drawing Figures 22 J2 a /z I .31.. 1 V, n 1:! J2 1 1-2- ⁇ Sl' Y l 4 34 Pmmmws Hm 3.680.562
  • the invention relates to a catheter assembly, and in particular, to a catheter assembly which can be introduced into the bladder with minimal trauma.
  • a catheter unit having received acceptance features an assembly including a piercing element, in some instances a conventional hypodermic needle, and a plastic catheter tube engaging the walls of the needle and so arranged with respect thereto that both are adapted to be introduced into the skin.
  • the needle and catheter tube are respectively shiftable whereby the needle is withdrawn with respect to the catheter tube which, under such circumstance, will remain situated for the intended catheterization purpose.
  • Catheter needles accorded a high degree of commercial acceptance for this purpose are disclosed in US. Pat. No. 3,406,685 and U.S. Pat. No. 3,469,579.
  • Other indwelling catheters are illustrated in US. Pat. No. 3,419,010 and US. Pat. No. 3,312,220.
  • a suprapubic catheter for bladder drainage must be provided with anchoring means for the indwelling period, wherein the anchoring means does not create a germ trap and concomitant source of infection.
  • the distal end of the catheter inserted into the bladder must resist expulsion through the urethra.
  • Outlet ports on the distal end of the catheter must resist occlusion by the bladder mucosa during the indwelling period.
  • Indexing means must be provided to determine orientation of the distal end of the catheter within the bladder and to indicate satisfactory penetration of the catheter needle in the bladder during introduction.
  • a hollow piercing element having a beveled point which extends beyond the distal end of the tube, wherein the tapered blunt tip of the tube provides a close fit with the piercing element.
  • a pliant sheath, bifurcated at its distal end into half-tube branches, is tightly fitted over the proximal end of the plastic tube.
  • the proximal ends of the piercing element and tube are each affixed to a rigid hub, the hubs adapted to interlock. At least a portion of the hub of the piercing element is pervious to light.
  • the above assembly is inserted through the skin into the bladder and, when properly positioned, the piercing element is removed as the catheter tubing is inserted into the bladder.
  • the bifurcated wings of the sheath provide the anchoring means for the indwelling catheter.
  • the tightly fitted sheath precludes the formation of a germ trap.
  • As the piercing element is withdrawn from the catheter tubing its distal end as sumes a preformed coil or curve.
  • the springiness of the coil prevents the catheter from injuring the body cavity walls as the catheter changes shape. Since the catheter tip is located within the coil, it is prevented from working itself into any natural passages or orifices leading from the cavity.
  • the catheter can uncoil or coil to adapt to changes in the distance from the skin to which the catheter is anchored and the cavity wallthrough which it passes.
  • the spacing of the catheter ports on the inside of the coil permits unimpeded introduction of the piercing element into the catheter lumen and avoids occlusion by the bladder mucosa.
  • the light-pervious element hub allows identification of fluids passing through the element as the assembly is introduced into the body.
  • FIG. I is an exploded elevational view of the piercing element and indwelling catheter with a gripping shield over the catheter for insertion of the piercing element and a ribbed vent plug for the hub of the piercing element;
  • FIG. 2 is an elevational view of the catheter assembly of the invention including the gripping shield and vent P g;
  • FIG. 3 is an enlarged sectional view of the catheter assembly including a vent plug
  • FIG. 4 is an enlarged view, partially in section, of the distal end of the catheter tubing
  • FIG. 5 is an enlarged elevational view of a catheter tubing in the coiled position after removal of the piercing element
  • FIG. 6 is a schematic diagram of the indwelling catheter with the piercing element removed representing the position of the catheter within the bladder.
  • the catheter needle assembly of the invention includes a piercing element such as a hollow puncture needle 10 having a beveled point 12 at the distal end and a light-pervious hub 14 at the proximal end.
  • the tubular shank l6 of the needle' is of a selected gauge, for example, 18 gauge, to facilitate ready insertion through the skin into the bladder.
  • An air dent surface 20 is provided to indicate the depth of penetration of the needle into the body.
  • the hub 14 of the puncture needle or cannula 10- is fabricated from translucent and, preferably, transparent rigid material, such as a polycarbonate plastic. As the catheter assembly is inserted into the bladder, proper penetration may be insured by observing the presence of fluids in the hub. During insertion vent plug 22 engages hub 14 to prevent escape of contaminated body fluids into the sterile catheterization field. As illustrated in FIG. '3, shank 16 is securely bonded to the bore 18 of hub 14 with epoxy resin. If desired, the shank may be swedged within the hub according to conventional techniques. I
  • proximal end 24 of hub 14 have a Luer-Lok type fitting.
  • Distal end 26 of hub 14 is tapered and adapted to frictionally engage hub 30 of catheter 32.
  • Indwelling catheter 32 comprises hollow, smooth, flexible plastic tubing 28 and hub 30.
  • the tubing is preferably fabricated from a transparent polymerized olefin resin, such as tetrafluoroethylene (Teflon) resin, or, more preferably, a fluorinated ethylene propylene resin.
  • Teflon tetrafluoroethylene
  • the catheter tubing has a penetrating tip, tapered onto penetrating needle shank 16 to prevent collapse of the tubing during insertion into the bladder. As illustrated in FIG. 3, a portion of the shank l6 and beveled point 12 of the piercing needle extends beyond the blunt end 34 of the catheter tubing to facilitate insertion.
  • the catheter tubing 28 terminates in an inward pigtail curve.
  • the distal end of the tubing is pre-formed to have a coil memory.
  • the end of the unobstructed coiled tip 34 of the tubing forms an angle a of preferably from about 30 to 45 with the adjacent straight portion of the catheter tubing.
  • a series of longitudinally aligned ports 36 are spaced on the inner portion of the pigtail curve. Such placement prevents kinking of the tubing and permits unimpeded introduction of the cannula into the catheter lumen. Further, the placement avoids occlusion of the ports by bladder mucosa.
  • the proximal end of the catheter tubing is affixed in permanent fluid communication to hub 30.
  • a leakproof, permanent and strong connection is formed between catheter tubing 28 and hub 30.
  • a satisfactory method for forming the connection is disclosed in US. Pat. No. 3,469,579.
  • the tubing can be affixed to the hub by conventional riveting or swedging techniques.
  • the catheter hub is fabricated from a rigid plastic material, such as polypropylene. For drainage pruposes,- it is particularly preferred that the catheter hub have a Luer-Lok type fitting.
  • the bifurcated wings are bent away from the catheter tube and affixed. to the skin to anchor the indwelling catheter.
  • the wings may be anchored to the skin with silk sutures.
  • the bifurcated wings are aligned in a plane perpendicular to the plane passing through outlet ports 36.
  • the orientation of the coil and outlet ports within the bladder can be determined merely by observing the bifurcated wings afiixed to the skin, since the plane passing through the coil and outlet ports will be oriented from the plane in which the wings are spaced.
  • the pliant sheath is preferably fabricated from a flexible, heat-shrinkable, plastic resin such as the aforementioned tetrafluoroethylene resin, or, more preferably, a polyolefin material, such as Penntube' V vinyl resin.
  • the length of the sheath and the extent of bifurcation are preselected such that the precoiled catheter tubing is fully implanted within the bladder.
  • a workable catheter for this purpose has an eleven inch catheter tube with a 4 inch sheath shrunk fit about the proximal end of the catheter tubing, said sheath having a 1 inch bifurcation at the distal end.
  • the tight fit between the sheath and catheter tubing prevents fluid and/or blood seepage therebetween. Undesired blood or fluid seepage results in the formation of a germ trap between the sheath and catheter tubing, thereby promoting infection at the catheter insertion site.
  • the sheath is slipped over the distal end of the tubing and onto the lower portion 42 of hub 30. Thereafter the sheath is shrunk fit about the tubing and hub by suitable heating means such as an autoclave or an oven.
  • a tubular shield 44 is introduced over the catheter tubing.
  • the shield provides a gripping surface during insertion of the piercing needle 10 into the catheter 32 and prevents contamination of the catheter tubing through handling.
  • the shield is of slightly greater diameter than the catheter tubing and forms a slidable friction fit with the tubing.
  • piercing needle 10 is inserted into catheter 32 until needle hub 14 is firmly seated in catheter hub 30 and beveled point 12 of needle 10 protrudes from the distal end 34 of catheter tubing 28.
  • vent plug 22 is provided.
  • Plug 22 has a series of spaced ribs 23 which are adapted to be force-fit into needle hub 14. The ribs allow air to pass through the cannula 10 during insertion, but prevent the passage of fluids.
  • the bladder is initially distended with sterile saline or other suitable fluid.
  • the catheter assembly is thrust through the abdominal wall about half the distance between the needle point 12 and the bifurcated wings 40, 40, as indicated by air dent surface 20.
  • the preferred clear, fluorinated ethylene propylene catheter tubing allows the operator to follow the movement of air dent 20 at all times.
  • the presence of clear fluid in light pervious hub 14 verifies the presence of the catheter tip in the bladder. Occasionally it may be necessary to aspirate the apparatus with a syringe.
  • the cannula When the catheter is within the bladder, the cannula is disengaged and gradually withdrawn, while the catheter is simultaneously introduced up to the point of bifurcation in the sheath. Thereafter, the bifurcated wings are anchored to the skin with sutures or the like as illustrated in FIG. 6.
  • catheter hub 30 is interengaged in fluid communication with an adapter (not shown) having a male luer fitting and a female luer fitting.
  • the adapter is connected to a plastic drainage bag or the like by conventional tubing having clamping means.
  • a trocar with a light-pervious hub may be employed in combination with a fitted, pointed stylet for piercing element and vent plug 22, with less satisfactory results, however.
  • Such an assembly would be more awkward to use and more expensive to fabricate than the catheter assembly hereinbefore described.
  • a LONGDWEL obturator may be inserted into the catheter tubing to plug the lumen during manipulation of the adapter.
  • a surgical catheter assembly for draining or delivering fluids to the bladder comprising:
  • a hollow, flexible plastic tube of suitable diameter for insertion into the bladder said tube having a tapered blunt tip at the distal end thereof, said tube being inwardly curved at the distal end when unobstructed, said tube having a series of longitudinally aligned ports spaced on the inside of said curve;
  • a rigid hub in open communication with the lumen of the plastic tube in sealing engagement with the proximal end of the tube;
  • a hollow, piercing element removably disposed within said plastic tube, said element having a beveled point extending beyond the distal end of said plastic tube, wherein the tapered blunt tip of said tube is in close friction fit with the piercing element;
  • a pliant sheath sealingly fitted about the proximal end of the catheter tubing, said sheath bifurcated at its distal end into anchoring wings adapted to be bent away from the catheter tube after introduction of the assembly into the bladder to form an anchor for the assembly.
  • the piercing element comprises a needle extending beyond the blunt tip of the catheter tube at its distal end and having a hollow light-pervious hub in fluid communication with the proximal end of said catheter tube.
  • the invention in accordance with claim 2 including a vent plug removably engaged in said needle hub for blocking the flow of fluid through said needle during insertion of the assembly into the bladder and for permitting the passage of air through said needle during such insertion.
  • a suprapubic method for lnsertmg the catheter assembly of claim 1 into the bladder comprising, in sequence, the steps of:

Abstract

A surgical apparatus for delivering fluids to or withdrawing fluids from the bladder includes a catheter having an inwardly curved, tapered blunt-tip with a series of longitudinally aligned ports spaced on the inside of the curve. A removable piercing element is disposed within the catheter having a beveled point extending beyond the end of the plastic tube. A pliant sheath, tightly fit over the catheter tube, is bifurcated at its distal end into half-tube branches which are adapted to be bent away from the catheter tube after introduction of the assembly into the body to anchor the apparatus to the skin. In order to provide further control over the position of the catheter tubing in the bladder the bifurcated anchoring wings are in a mutually perpendicular plane to the outlet ports.

Description

United States Patent Wittes et al.
1451 Aug. 1,1972
[54] SURGICAL DRAINAGE APPARATUS FOR BLADDER [72] Inventors: James M. Wittes, Linden; Peter J.,
Bonanno, both of Tenafly, NJ.
[73] Assignee: Becton, Dickinson and Company,
East Rutherford, NJ.
[58] Field of Search ..128/214.4, 221, 347, 348, I 349R, 123/350 R,351
FOREIGN PATENTS OR APPLICATIONS 392,687 12/1908 France 128/348 Primary Examiner-Dalton L. Truluck Art0rneyl(ane, Dalsimer, Kane, Sullivan & Kurucz [5 7] ABSTRACT A surgical apparatus for delivering fluids to or withdrawing fluids from the bladder includes a catheter having an inwardly curved, tapered blunt-tip with a series of longitudinally aligned ports spaced on the inside of the curve. A removable piercing element is disposed within the catheter having a beveled point extending beyond the end of the plastic tube. A pliant sheath, tightly fit over the catheter tube, is bifurcated at its distal end into half-tube branches which are 5 m- Cited adapted to be bent away from the catheter tube after introduction of the assembly into the body to anchor UNITED STATES PATENTS the apparatus to the skin. In order to provide further control over the position of the catheter tubing in the g gg bladder the bifurcated anchoring wings are in a mut l l t th t] t t 3,538,913 11/1970 Stolfi ..l28/351X y pe'pen p C e s 5 Claims, 6 Drawing Figures 22 J2 a /z I .31.. 1 V, n 1:! J2 1 1-2- \Sl' Y l 4 34 Pmmmws Hm 3.680.562
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SURGICAL DRAINAGE APPARATUS FOR BLADDER BACKGROUND OF THE INVENTION The invention relates to a catheter assembly, and in particular, to a catheter assembly which can be introduced into the bladder with minimal trauma.
In the past a number of catheter units of one form or another have been introduced commercially. A catheter unit having received acceptance, features an assembly including a piercing element, in some instances a conventional hypodermic needle, and a plastic catheter tube engaging the walls of the needle and so arranged with respect thereto that both are adapted to be introduced into the skin. When the desired degree of penetration has occurred, the needle and catheter tube are respectively shiftable whereby the needle is withdrawn with respect to the catheter tube which, under such circumstance, will remain situated for the intended catheterization purpose. Catheter needles accorded a high degree of commercial acceptance for this purpose are disclosed in US. Pat. No. 3,406,685 and U.S. Pat. No. 3,469,579. Other indwelling catheters are illustrated in US. Pat. No. 3,419,010 and US. Pat. No. 3,312,220.
Recently, the medical profession has recognized the desirability of suprapubic catheterization following gynecological surgery instead of employing the traditional Foley catheter. It has been postulated that traditional bladder catheterization through bacteria-laden exterior reproductive apparatus represents a greater infection hazard than traversing the more easily cleansed abdominal skin and sterile abdominal wall. General and specialized technique catheter needles known to the art as, for example, the needles described in the aboveidentified patents, are not adapted for this function as certain unique problems are presented. A suprapubic catheter for bladder drainage must be provided with anchoring means for the indwelling period, wherein the anchoring means does not create a germ trap and concomitant source of infection. The distal end of the catheter inserted into the bladder must resist expulsion through the urethra. Outlet ports on the distal end of the catheter must resist occlusion by the bladder mucosa during the indwelling period. Indexing means must be provided to determine orientation of the distal end of the catheter within the bladder and to indicate satisfactory penetration of the catheter needle in the bladder during introduction.
SUMMARY OF THE INVENTION series of longitudinally aligned outlet ports spaced on the inside of the curve at the distal end of the tube. Within the tube is disposed a hollow piercing element having a beveled point which extends beyond the distal end of the tube, wherein the tapered blunt tip of the tube provides a close fit with the piercing element. A pliant sheath, bifurcated at its distal end into half-tube branches, is tightly fitted over the proximal end of the plastic tube. The proximal ends of the piercing element and tube are each affixed to a rigid hub, the hubs adapted to interlock. At least a portion of the hub of the piercing element is pervious to light.
The above assembly is inserted through the skin into the bladder and, when properly positioned, the piercing element is removed as the catheter tubing is inserted into the bladder. The bifurcated wings of the sheath provide the anchoring means for the indwelling catheter. The tightly fitted sheath precludes the formation of a germ trap. As the piercing element is withdrawn from the catheter tubing, its distal end as sumes a preformed coil or curve. The springiness of the coil prevents the catheter from injuring the body cavity walls as the catheter changes shape. Since the catheter tip is located within the coil, it is prevented from working itself into any natural passages or orifices leading from the cavity. The catheter can uncoil or coil to adapt to changes in the distance from the skin to which the catheter is anchored and the cavity wallthrough which it passes.
The spacing of the catheter ports on the inside of the coil permits unimpeded introduction of the piercing element into the catheter lumen and avoids occlusion by the bladder mucosa. The light-pervious element hub allows identification of fluids passing through the element as the assembly is introduced into the body.
It is, therefore, a primary object'of the invention to provide an indwelling catheter apparatus for suprapubic insertion into the urinary bladder. I
It is another object of the invention to provide a catheter apparatus adapted to drain the bladder which resists expulsion from the bladder and occlusion by the bladder mucosa.
It is an additional object of the invention to provide suprapubic catheter apparatus with indexing means to indicate proper insertion and orientation in the bladder.
The above and other objects are obtained in a surgical catheter drainage apparatus for the bladder, the apparatus including a flexible plastic tube inwardly curved at the distal end with a tapered, blunt tip and a BRIEF DESCRIPTION OF THE DRAWINGS Other objects and advantages will become apparent from the following detailed description of the invention which is to be taken in conjunction with the accompanying drawings illustrating several preferred embodiments of the invention and in which:
FIG. I is an exploded elevational view of the piercing element and indwelling catheter with a gripping shield over the catheter for insertion of the piercing element and a ribbed vent plug for the hub of the piercing element;
FIG. 2 is an elevational view of the catheter assembly of the invention including the gripping shield and vent P g;
FIG. 3 is an enlarged sectional view of the catheter assembly including a vent plug;
FIG. 4 is an enlarged view, partially in section, of the distal end of the catheter tubing;
FIG. 5 is an enlarged elevational view of a catheter tubing in the coiled position after removal of the piercing element; and
FIG. 6 is a schematic diagram of the indwelling catheter with the piercing element removed representing the position of the catheter within the bladder.
As illustrated in FIG. 1, the catheter needle assembly of the invention includes a piercing element such as a hollow puncture needle 10 having a beveled point 12 at the distal end and a light-pervious hub 14 at the proximal end. The tubular shank l6 of the needle'is of a selected gauge, for example, 18 gauge, to facilitate ready insertion through the skin into the bladder. An air dent surface 20 is provided to indicate the depth of penetration of the needle into the body.
The hub 14 of the puncture needle or cannula 10- is fabricated from translucent and, preferably, transparent rigid material, such as a polycarbonate plastic. As the catheter assembly is inserted into the bladder, proper penetration may be insured by observing the presence of fluids in the hub. During insertion vent plug 22 engages hub 14 to prevent escape of contaminated body fluids into the sterile catheterization field. As illustrated in FIG. '3, shank 16 is securely bonded to the bore 18 of hub 14 with epoxy resin. If desired, the shank may be swedged within the hub according to conventional techniques. I
For aspiration and other purposes, it is desirable that proximal end 24 of hub 14 have a Luer-Lok type fitting. Distal end 26 of hub 14 is tapered and adapted to frictionally engage hub 30 of catheter 32.
Indwelling catheter 32 comprises hollow, smooth, flexible plastic tubing 28 and hub 30. The tubing is preferably fabricated from a transparent polymerized olefin resin, such as tetrafluoroethylene (Teflon) resin, or, more preferably, a fluorinated ethylene propylene resin. The catheter tubing has a penetrating tip, tapered onto penetrating needle shank 16 to prevent collapse of the tubing during insertion into the bladder. As illustrated in FIG. 3, a portion of the shank l6 and beveled point 12 of the piercing needle extends beyond the blunt end 34 of the catheter tubing to facilitate insertion.
Turning now to FIGS. 4 and it is seen that the catheter tubing 28 terminates in an inward pigtail curve. The distal end of the tubing is pre-formed to have a coil memory. The end of the unobstructed coiled tip 34 of the tubing forms an angle a of preferably from about 30 to 45 with the adjacent straight portion of the catheter tubing.
To facilitate withdrawal or introduction of fluids into the bladder a series of longitudinally aligned ports 36 are spaced on the inner portion of the pigtail curve. Such placement prevents kinking of the tubing and permits unimpeded introduction of the cannula into the catheter lumen. Further, the placement avoids occlusion of the ports by bladder mucosa.
The proximal end of the catheter tubing is affixed in permanent fluid communication to hub 30. A leakproof, permanent and strong connection is formed between catheter tubing 28 and hub 30. A satisfactory method for forming the connection is disclosed in US. Pat. No. 3,469,579. If desired, the tubing can be affixed to the hub by conventional riveting or swedging techniques. The catheter hub is fabricated from a rigid plastic material, such as polypropylene. For drainage pruposes,- it is particularly preferred that the catheter hub have a Luer-Lok type fitting.
Turning now to FIGS. 1 and 2, in order to provide an anchoring means for the indwelling catheter, a pliant sheath 38, bifurcated into half- tube wings 40, 40 at its distal end, is fitted over the catheter tubing. After the catheter tubing is implanted within the bladder, the bifurcated wings are bent away from the catheter tube and affixed. to the skin to anchor the indwelling catheter. The wingsmay be anchored to the skin with silk sutures. In order to provide a means for properly orienting the catheter "coil in the bladder, the bifurcated wings are aligned in a plane perpendicular to the plane passing through outlet ports 36. Thus, the orientation of the coil and outlet ports within the bladder can be determined merely by observing the bifurcated wings afiixed to the skin, since the plane passing through the coil and outlet ports will be oriented from the plane in which the wings are spaced.
The pliant sheath is preferably fabricated from a flexible, heat-shrinkable, plastic resin such as the aforementioned tetrafluoroethylene resin, or, more preferably, a polyolefin material, such as Penntube' V vinyl resin. The length of the sheath and the extent of bifurcation are preselected such that the precoiled catheter tubing is fully implanted within the bladder. A workable catheter for this purpose has an eleven inch catheter tube with a 4 inch sheath shrunk fit about the proximal end of the catheter tubing, said sheath having a 1 inch bifurcation at the distal end.
The tight fit between the sheath and catheter tubing prevents fluid and/or blood seepage therebetween. Undesired blood or fluid seepage results in the formation of a germ trap between the sheath and catheter tubing, thereby promoting infection at the catheter insertion site. To assemble the sheath over the catheter tubing, the sheath is slipped over the distal end of the tubing and onto the lower portion 42 of hub 30. Thereafter the sheath is shrunk fit about the tubing and hub by suitable heating means such as an autoclave or an oven.
In order to assemble the catheter apparatus prior to insertion into the bladder, a tubular shield 44 is introduced over the catheter tubing. The shield provides a gripping surface during insertion of the piercing needle 10 into the catheter 32 and prevents contamination of the catheter tubing through handling. The shield is of slightly greater diameter than the catheter tubing and forms a slidable friction fit with the tubing. As shown in FIG. 3 piercing needle 10 is inserted into catheter 32 until needle hub 14 is firmly seated in catheter hub 30 and beveled point 12 of needle 10 protrudes from the distal end 34 of catheter tubing 28.
In order to prevent fluids from escaping from the proximal end 24 of hub 14 during insertion of the catheter assembly into the body, vent plug 22 is provided. Plug 22 has a series of spaced ribs 23 which are adapted to be force-fit into needle hub 14. The ribs allow air to pass through the cannula 10 during insertion, but prevent the passage of fluids.
In order to insert the catheter apparatus into the bladder, the bladder is initially distended with sterile saline or other suitable fluid. Next, with the gripping shield removed, the catheter assembly is thrust through the abdominal wall about half the distance between the needle point 12 and the bifurcated wings 40, 40, as indicated by air dent surface 20. The preferred clear, fluorinated ethylene propylene catheter tubing allows the operator to follow the movement of air dent 20 at all times. The presence of clear fluid in light pervious hub 14 verifies the presence of the catheter tip in the bladder. Occasionally it may be necessary to aspirate the apparatus with a syringe.
When the catheter is within the bladder, the cannula is disengaged and gradually withdrawn, while the catheter is simultaneously introduced up to the point of bifurcation in the sheath. Thereafter, the bifurcated wings are anchored to the skin with sutures or the like as illustrated in FIG. 6.
To drain the bladder, catheter hub 30 is interengaged in fluid communication with an adapter (not shown) having a male luer fitting and a female luer fitting. The adapter is connected to a plastic drainage bag or the like by conventional tubing having clamping means.
Various embodiments of the invention will be obvious to those skilled in the art. A trocar with a light-pervious hub may be employed in combination with a fitted, pointed stylet for piercing element and vent plug 22, with less satisfactory results, however. Such an assembly would be more awkward to use and more expensive to fabricate than the catheter assembly hereinbefore described. If desired, a LONGDWEL obturator may be inserted into the catheter tubing to plug the lumen during manipulation of the adapter.
Having thus described the preferred embodiment of the invention, it is not intended to be limited except as set forth in the following claims:
I claim:
1. A surgical catheter assembly for draining or delivering fluids to the bladder comprising:
a. a hollow, flexible plastic tube of suitable diameter for insertion into the bladder, said tube having a tapered blunt tip at the distal end thereof, said tube being inwardly curved at the distal end when unobstructed, said tube having a series of longitudinally aligned ports spaced on the inside of said curve;
. a rigid hub in open communication with the lumen of the plastic tube in sealing engagement with the proximal end of the tube;
. a hollow, piercing element removably disposed within said plastic tube, said element having a beveled point extending beyond the distal end of said plastic tube, wherein the tapered blunt tip of said tube is in close friction fit with the piercing element;
d. means for indicating the presence of fluid in the piercing element after insertion into the bladder; and
. a pliant sheath sealingly fitted about the proximal end of the catheter tubing, said sheath bifurcated at its distal end into anchoring wings adapted to be bent away from the catheter tube after introduction of the assembly into the bladder to form an anchor for the assembly.
2. The invention in accordance with claim 1 in which the piercing element comprises a needle extending beyond the blunt tip of the catheter tube at its distal end and having a hollow light-pervious hub in fluid communication with the proximal end of said catheter tube.
3. The invention in accordance with claim 2 including a vent plug removably engaged in said needle hub for blocking the flow of fluid through said needle during insertion of the assembly into the bladder and for permitting the passage of air through said needle during such insertion.
4. The invention in accordance with claim 1 in which said bifurcated wings are in preselected alignment with said outlet ports for proper orientation of the distal end of the catheter tubing in the bladder.
5. A suprapubic method for lnsertmg the catheter assembly of claim 1 into the bladder comprising, in sequence, the steps of:
a. distending the bladder with nontoxic fluid,
b. inserting the catheter assembly through the abdominal wall into the bladder for approximately one half the distance between the distal end of the catheter tubing and the bifurcation point of the sheath,
c. verifying the presence of said assembly in the bladder,
d. withdrawing the piercing element while introducing the catheter tubing into the bladder until the bifurcation point on the sheath is reached, and
e. affixing each of said wings to the skin.

Claims (5)

1. A surgical catheter assembly for draining or delivering fluids to the bladder comprising: a. a hollow, flexible plastic tube of suitAble diameter for insertion into the bladder, said tube having a tapered blunt tip at the distal end thereof, said tube being inwardly curved at the distal end when unobstructed, said tube having a series of longitudinally aligned ports spaced on the inside of said curve; b. a rigid hub in open communication with the lumen of the plastic tube in sealing engagement with the proximal end of the tube; c. a hollow, piercing element removably disposed within said plastic tube, said element having a beveled point extending beyond the distal end of said plastic tube, wherein the tapered blunt tip of said tube is in close friction fit with the piercing element; d. means for indicating the presence of fluid in the piercing element after insertion into the bladder; and e. a pliant sheath sealingly fitted about the proximal end of the catheter tubing, said sheath bifurcated at its distal end into anchoring wings adapted to be bent away from the catheter tube after introduction of the assembly into the bladder to form an anchor for the assembly.
2. The invention in accordance with claim 1 in which the piercing element comprises a needle extending beyond the blunt tip of the catheter tube at its distal end and having a hollow light-pervious hub in fluid communication with the proximal end of said catheter tube.
3. The invention in accordance with claim 2 including a vent plug removably engaged in said needle hub for blocking the flow of fluid through said needle during insertion of the assembly into the bladder and for permitting the passage of air through said needle during such insertion.
4. The invention in accordance with claim 1 in which said bifurcated wings are in preselected alignment with said outlet ports for proper orientation of the distal end of the catheter tubing in the bladder.
5. A suprapubic method for inserting the catheter assembly of claim 1 into the bladder comprising, in sequence, the steps of: a. distending the bladder with nontoxic fluid, b. inserting the catheter assembly through the abdominal wall into the bladder for approximately one half the distance between the distal end of the catheter tubing and the bifurcation point of the sheath, c. verifying the presence of said assembly in the bladder, d. withdrawing the piercing element while introducing the catheter tubing into the bladder until the bifurcation point on the sheath is reached, and e. affixing each of said wings to the skin.
US137550A 1971-04-26 1971-04-26 Surgical drainage apparatus for bladder Expired - Lifetime US3680562A (en)

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US3788326A (en) * 1970-07-29 1974-01-29 H Jacobs Distally perforated catheter for use in ventilating system
US3856009A (en) * 1971-11-26 1974-12-24 Johnson & Johnson Catheter placement unit
US3860006A (en) * 1973-06-25 1975-01-14 Kendall & Co Suprapubic catheter system using an internal stylet
US3859998A (en) * 1972-06-05 1975-01-14 Johnson & Johnson Intravenous needle assembly
US3924633A (en) * 1974-01-31 1975-12-09 Cook Inc Apparatus and method for suprapubic catheterization
US4102258A (en) * 1974-08-01 1978-07-25 Swift & Company Apparatus for injecting a liquid additive into poultry flesh
US4308875A (en) * 1981-03-11 1982-01-05 Universal Medical Instrument Corporation Amniocentesis needle
EP0044688A1 (en) * 1980-07-14 1982-01-27 Philip O.(deceased) legally represented by Bates H. Richard Littleford Electrode for endocardial insertion
US4317445A (en) * 1980-03-31 1982-03-02 Baxter Travenol Laboratories, Inc. Catheter insertion unit with separate flashback indication for the cannula
US4341212A (en) * 1980-07-18 1982-07-27 Albert Medwid Serous fluid drain kit
US4362156A (en) * 1979-04-18 1982-12-07 Riverain Corporation Intravenous infusion assembly
US4411654A (en) * 1981-04-30 1983-10-25 Baxter Travenol Laboratories, Inc. Peelable catheter with securing ring and suture sleeve
EP0092389A1 (en) * 1982-04-19 1983-10-26 Cook Incorporated Apparatus for catheterization permitting use of a smaller gage needle
US4412832A (en) * 1981-04-30 1983-11-01 Baxter Travenol Laboratories, Inc. Peelable catheter introduction device
US4568338A (en) * 1983-09-22 1986-02-04 C. R. Bard, Inc. Preformed catheter
US4586921A (en) * 1983-08-17 1986-05-06 Daniel Berson Method of applying a local anesthetic agent to a wound
FR2585578A1 (en) * 1985-07-30 1987-02-06 Mckenzie Buchanan John CANNULA, IN PARTICULAR FOR CHOLANGIOGRAM
US4643716A (en) * 1984-09-26 1987-02-17 The Kendall Company Multi-size ureteral stent
US4661093A (en) * 1983-06-11 1987-04-28 Walter Beck Method for aspirating secreted fluids from a wound
US4705502A (en) * 1985-11-06 1987-11-10 The Kendall Company Suprapubic catheter with dual balloons
US4738667A (en) * 1986-11-04 1988-04-19 Galloway Niall T M Preformed catheter assembly
US4834725A (en) * 1986-03-27 1989-05-30 Pfrimmer-Viggo Gmbh & Co. Catheter for percutaneous gastrostomy
US4904237A (en) * 1988-05-16 1990-02-27 Janese Woodrow W Apparatus for the exchange of cerebrospinal fluid and a method of treating brain and spinal cord injuries
US4961731A (en) * 1988-06-09 1990-10-09 Sherwood Medical Company Angiographic catheter with balanced dye injection openings
US5019039A (en) * 1989-11-15 1991-05-28 Anderson Ronald W Fluid drainage needle method of use
US5109830A (en) * 1990-04-10 1992-05-05 Candela Laser Corporation Apparatus for navigation of body cavities
WO1994012233A1 (en) * 1992-11-24 1994-06-09 B. Braun Melsungen Ag Catheterisation set
US5336177A (en) * 1993-04-29 1994-08-09 Marcus William Y Integral penetrating surgical drain device
US5336176A (en) * 1991-12-06 1994-08-09 Inbae Yoon Automatic retractable safety penetrating instrument
US5509909A (en) * 1994-10-06 1996-04-23 Moy; Grant G. Bent chest tube assembly
US5707362A (en) * 1992-04-15 1998-01-13 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5727555A (en) * 1996-06-18 1998-03-17 Cook Incorporated Indwelling catheter
US6223070B1 (en) 1998-03-16 2001-04-24 Cook, Inc. Indwelling catheter
US20020091352A1 (en) * 2001-01-09 2002-07-11 Rex Medical Peritoneal dialysis catheter and insertion method
US6546280B2 (en) 1996-06-18 2003-04-08 Cook Incorporated Indwelling catheter
US20030093027A1 (en) * 2001-01-09 2003-05-15 Mcguckin James F. Dialysis catheter
US20030093090A1 (en) * 2001-01-09 2003-05-15 Mcguckin James F. Guidewire retrieval member for catheter insertion
US20030093029A1 (en) * 2001-01-09 2003-05-15 Rex Medical Dialysis catheter
US20030199851A1 (en) * 2001-01-04 2003-10-23 Scimed Life Systems, Inc. Low profile metal/polymer tubes
US20040158211A1 (en) * 2003-02-07 2004-08-12 Rogers Bobby E. Closed system catheterization assembly and related methods
US20040230132A1 (en) * 2003-02-07 2004-11-18 Alfred E. Mann Institute For Biomedical Engineering At The Surgical drain with positioning and protective features
US20050054989A1 (en) * 2001-01-09 2005-03-10 Rex Medical, L.P. Dialysis catheter
US20050260604A1 (en) * 1987-01-07 2005-11-24 Joyce Taylor-Papadimitriou Antigens derived from the core protein of the human mammary epithelial mucin
US20060015089A1 (en) * 2002-04-04 2006-01-19 Meglin Allen J Catheter and method of fluid removal from a body cavity
US20060079853A1 (en) * 2004-10-12 2006-04-13 C. R. Bard, Inc. Corporeal drainage system
US20060122575A1 (en) * 2002-06-11 2006-06-08 Akio Wakabayashi System and efficient drainage of body cavity
WO2006074283A2 (en) * 2005-01-07 2006-07-13 The Catheter Exchange, Inc. Drain with occlusion removing structure
US20060173284A1 (en) * 2002-10-21 2006-08-03 Ackerman Jerome L Radiofrequency coil and catheter for surface nmr imaging and spectroscopy
US20060195069A1 (en) * 2004-09-24 2006-08-31 Opie John C Percutaneous diagnostic and therapeutic hematoma drain
US20070073270A1 (en) * 2005-09-26 2007-03-29 C. R. Bard, Inc. Catheter connection systems
US20090043270A1 (en) * 2007-08-10 2009-02-12 C.R. Bard, Inc. Effusion drainage kits and methods for packaging the same
US20090216202A1 (en) * 2008-02-26 2009-08-27 Medtronic, Inc. Delivery needle apparatus with sleeve
US8500674B2 (en) 2001-01-09 2013-08-06 Rex Medical, L.P. Dialysis catheter
US8591450B2 (en) 2010-06-07 2013-11-26 Rex Medical L.P. Dialysis catheter
US8636721B2 (en) 2003-11-20 2014-01-28 Henry M. Jackson Foundation For The Advancement Of Military Medicine, Inc. Portable hand pump for evacuation of fluids
US8900192B2 (en) 2007-04-18 2014-12-02 Access Scientific, Llc Access device
US9555221B2 (en) * 2014-04-10 2017-01-31 Smiths Medical Asd, Inc. Constant force hold tip protector for a safety catheter
US20180071485A1 (en) * 2016-09-14 2018-03-15 Boston Scientific Scimed, Inc. Catheter hubs
US10010343B2 (en) 2013-03-15 2018-07-03 Access Scientific, Llc Vascular access device
US10136916B2 (en) 2010-02-08 2018-11-27 Access Scientific, Llc Access device
US10569059B2 (en) 2018-03-01 2020-02-25 Asspv, Llc Guidewire retention device
WO2021026641A1 (en) * 2019-08-09 2021-02-18 Safa Behnam Coiled over-the-needle catheter and methods of use thereof for performing continuous nerve block procedures
US10960177B2 (en) 2018-06-29 2021-03-30 Promedica Health System, Inc. Aortic valve no exchange catheter and methods of using the same
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US3788326A (en) * 1970-07-29 1974-01-29 H Jacobs Distally perforated catheter for use in ventilating system
US3782381A (en) * 1971-11-26 1974-01-01 Johnson & Johnson Method for preventing skiving of a catheter
US3856009A (en) * 1971-11-26 1974-12-24 Johnson & Johnson Catheter placement unit
US3859998A (en) * 1972-06-05 1975-01-14 Johnson & Johnson Intravenous needle assembly
US3860006A (en) * 1973-06-25 1975-01-14 Kendall & Co Suprapubic catheter system using an internal stylet
US3924633A (en) * 1974-01-31 1975-12-09 Cook Inc Apparatus and method for suprapubic catheterization
US4102258A (en) * 1974-08-01 1978-07-25 Swift & Company Apparatus for injecting a liquid additive into poultry flesh
US4362156A (en) * 1979-04-18 1982-12-07 Riverain Corporation Intravenous infusion assembly
US4317445A (en) * 1980-03-31 1982-03-02 Baxter Travenol Laboratories, Inc. Catheter insertion unit with separate flashback indication for the cannula
EP0044688A1 (en) * 1980-07-14 1982-01-27 Philip O.(deceased) legally represented by Bates H. Richard Littleford Electrode for endocardial insertion
US4341212A (en) * 1980-07-18 1982-07-27 Albert Medwid Serous fluid drain kit
US4308875A (en) * 1981-03-11 1982-01-05 Universal Medical Instrument Corporation Amniocentesis needle
US4412832A (en) * 1981-04-30 1983-11-01 Baxter Travenol Laboratories, Inc. Peelable catheter introduction device
US4411654A (en) * 1981-04-30 1983-10-25 Baxter Travenol Laboratories, Inc. Peelable catheter with securing ring and suture sleeve
EP0092389A1 (en) * 1982-04-19 1983-10-26 Cook Incorporated Apparatus for catheterization permitting use of a smaller gage needle
US4661093A (en) * 1983-06-11 1987-04-28 Walter Beck Method for aspirating secreted fluids from a wound
US4936834A (en) * 1983-06-11 1990-06-26 Walter Beck Apparatus for aspirating secreted fluids from a wound
US4586921A (en) * 1983-08-17 1986-05-06 Daniel Berson Method of applying a local anesthetic agent to a wound
US4568338A (en) * 1983-09-22 1986-02-04 C. R. Bard, Inc. Preformed catheter
US4643716A (en) * 1984-09-26 1987-02-17 The Kendall Company Multi-size ureteral stent
US4747823A (en) * 1985-07-30 1988-05-31 Buchanan John M Cannulae
FR2585578A1 (en) * 1985-07-30 1987-02-06 Mckenzie Buchanan John CANNULA, IN PARTICULAR FOR CHOLANGIOGRAM
GB2178321A (en) * 1985-07-30 1987-02-11 Buchanan John Mckenzie Cannula with reinforcement sleeve
US4705502A (en) * 1985-11-06 1987-11-10 The Kendall Company Suprapubic catheter with dual balloons
US4834725A (en) * 1986-03-27 1989-05-30 Pfrimmer-Viggo Gmbh & Co. Catheter for percutaneous gastrostomy
US4738667A (en) * 1986-11-04 1988-04-19 Galloway Niall T M Preformed catheter assembly
US20050260604A1 (en) * 1987-01-07 2005-11-24 Joyce Taylor-Papadimitriou Antigens derived from the core protein of the human mammary epithelial mucin
US4904237A (en) * 1988-05-16 1990-02-27 Janese Woodrow W Apparatus for the exchange of cerebrospinal fluid and a method of treating brain and spinal cord injuries
US4961731A (en) * 1988-06-09 1990-10-09 Sherwood Medical Company Angiographic catheter with balanced dye injection openings
US5019039A (en) * 1989-11-15 1991-05-28 Anderson Ronald W Fluid drainage needle method of use
US5109830A (en) * 1990-04-10 1992-05-05 Candela Laser Corporation Apparatus for navigation of body cavities
US5423770A (en) * 1991-12-06 1995-06-13 Yoon; Inbae Automatic retractable safety penetrating instrument
US5336176A (en) * 1991-12-06 1994-08-09 Inbae Yoon Automatic retractable safety penetrating instrument
US5707362A (en) * 1992-04-15 1998-01-13 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5882340A (en) * 1992-04-15 1999-03-16 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
WO1994012233A1 (en) * 1992-11-24 1994-06-09 B. Braun Melsungen Ag Catheterisation set
US5512052A (en) * 1992-11-24 1996-04-30 B. Braun Melsungen Ag Catheterization set
EP0763370A3 (en) * 1992-11-24 1997-04-16 Braun Melsungen Ag
US5858002A (en) * 1992-11-24 1999-01-12 B. Braun Melsungen Ag Catheterization set
US5336177A (en) * 1993-04-29 1994-08-09 Marcus William Y Integral penetrating surgical drain device
US5509909A (en) * 1994-10-06 1996-04-23 Moy; Grant G. Bent chest tube assembly
US5727555A (en) * 1996-06-18 1998-03-17 Cook Incorporated Indwelling catheter
US5941823A (en) * 1996-06-18 1999-08-24 Cook Incorporated Indwelling catheter
US6546280B2 (en) 1996-06-18 2003-04-08 Cook Incorporated Indwelling catheter
US6223070B1 (en) 1998-03-16 2001-04-24 Cook, Inc. Indwelling catheter
US20030199851A1 (en) * 2001-01-04 2003-10-23 Scimed Life Systems, Inc. Low profile metal/polymer tubes
US6719748B2 (en) * 2001-01-04 2004-04-13 Scimed Life Systems, Inc. Low profile metal/polymer tubes
US20050090776A1 (en) * 2001-01-09 2005-04-28 Rex Medical, L.P. Dialysis catheter and methods of insertion
US7097635B2 (en) 2001-01-09 2006-08-29 Rex Medical, L.P. Guidewire retrieval member for catheter insertion
US20050054989A1 (en) * 2001-01-09 2005-03-10 Rex Medical, L.P. Dialysis catheter
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US20030093029A1 (en) * 2001-01-09 2003-05-15 Rex Medical Dialysis catheter
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US6986752B2 (en) * 2001-01-09 2006-01-17 Rex Medical, Lp Peritoneal dialysis catheter and insertion method
US20030093090A1 (en) * 2001-01-09 2003-05-15 Mcguckin James F. Guidewire retrieval member for catheter insertion
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US20060015089A1 (en) * 2002-04-04 2006-01-19 Meglin Allen J Catheter and method of fluid removal from a body cavity
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US20060173284A1 (en) * 2002-10-21 2006-08-03 Ackerman Jerome L Radiofrequency coil and catheter for surface nmr imaging and spectroscopy
US20040158211A1 (en) * 2003-02-07 2004-08-12 Rogers Bobby E. Closed system catheterization assembly and related methods
US7244251B2 (en) 2003-02-07 2007-07-17 Alfred E. Mann Institute For Biomedical Engineering Implanted surgical drain with multiple sensing elements for monitoring internal tissue condition
US20040254431A1 (en) * 2003-02-07 2004-12-16 Alfred E. Mann Institute For Biomedical Engineering At The University Of Southern Ca Surgical drain with sensors for monitoring internal tissue condition by transmittance
US20060217684A1 (en) * 2003-02-07 2006-09-28 Alfred E. Mann Institute For Biomedical Engineering Surgical Drain with Sensors for Monitoring Internal Tissue Condition
US20060217685A1 (en) * 2003-02-07 2006-09-28 Alfred E. Mann Institute For Biomedical Engineering Surgical Drain with Sensors for Monitoring Internal Tissue Condition
US20040230132A1 (en) * 2003-02-07 2004-11-18 Alfred E. Mann Institute For Biomedical Engineering At The Surgical drain with positioning and protective features
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US6979323B2 (en) * 2003-02-07 2005-12-27 Aragon Medical Corporation Closed system catheterization assembly and related methods
US7241287B2 (en) 2003-02-07 2007-07-10 Alfred E. Mann Institute For Biomedical Engineering At The University Of Southern California Implanted surgical drain with drain holes for monitoring internal tissue condition
US20060155258A1 (en) * 2003-02-07 2006-07-13 Aragon Medical Corporation Closed system catheterization assembly and related methods
US7252659B2 (en) 2003-02-07 2007-08-07 Alfred E. Mann Institute For Biomedical Engineering At The University Of Southern California Implanted surgical drain with sensing and transmitting elements for monitoring internal tissue condition
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