WO2014084769A1

WO2014084769A1 - Forceps

Info

Publication number: WO2014084769A1
Application number: PCT/SE2013/000181
Authority: WO
Inventors: Zoltan SZABÓ
Original assignee: Zoltan SZABÓ
Priority date: 2012-11-28
Filing date: 2013-11-22
Publication date: 2014-06-05
Also published as: SE1200730A1; SE537073C2

Abstract

Forceps for intubation and other manipulation in the throat with a grip part that includes two grip legs (1 and 2), that in their other ends are ended with an oval or round grip section, (3 and 4 respectively). The grip legs transcend backwards from the grip parts into bent parts (5 and 6) that in their rear ends in turn transcends into short straight parts (7 and 8), which then transcend in the opposite direction bent maneuvering legs (9 and 10 respectively), in the maneuvering end, and that in their outer ends are less bent and provided with rings (11 and 12 respectively), for thumb and one or several fingers. The joint (14) of the forceps is arranged in the short straight parts, (7 and 8), that at the use of the forceps are located in the oral cavity.

Description

Angled forceps for intubation

In order to secure breathing of people that are not breathing spontaneously, for instance at accidents, operation or unconsciousness, a tube (endotracheal tube) is inserted through the mouth, down into the windpipe and passed the vocal folds in the larynx, so called intubation. In order to guide the tube it is necessary to obtain sight to see the entrance (glottis) into the trachea. In order to provide free sight the tongue is held away with a laryngoscope, so called laryngoscopy. The inner end of the tube can when needed be guided by means of a Magill forceps. This is shaped so that it leaves a free field of vision and therefore extends along the side of the windpipe.

Modern technique with small cameras and/or fiber optics has made it possible to obtain on a viewing screen a considerably improved picture of glottis and to hold the tongue up at the same time, so called videolaryngoscopy. Videolaryngoscopes that shall also be able to guide the tube has already been constructed but become considerably space requiring and therefor get a comparatively small freedom of movement and little adaptability. At certain occasions when deviating anatomic conditions are present these instruments become impractical or even insufficient. Magills forceps is intended to be used at classical direct laryngoscopy, said forceps requiring good training and experience due to its special design. The new technique for videolaryngoscopy has a different field of vision were the optics of the video camera is close to the tip of the instrument. If you should use Magills forceps together with the videolaryngoscope there is a risk for unwanted contact with the rear wall of the throat, since the instrument is used in the dead angle of the video camera. This is due to the shape of the instrument that is not adapted to the view field of the videolaryngoscope. Today at videolaryngoscopy you have to use Magills forceps, which is not suited for the purpose.

In order to facilitate the inserting of the tube in the trachea, at difficult air ways, it is known to use a stiff or shapeable guide as an internal guide. Due to its smaller diameter, less than the inner diameter of the tube, the guide is easier to insert and to get in place and when this has been done it can serve as an internal guide. The guides, that to their shape are, more or less, adjustable and flexible, are before use bent to a suitable shape. Since the guides are comparatively long and weak due to their small diameter they can easily become bent at contact with oral cavity and throat so that they lose their adjusted curvature at the insertion. To sum up view point and field of sight at videolaryngoscopy change, so that you can see further down into and a larger part of the throat than at classical laryngoscopy. The problem with manipulating the intubation tube or an a shapable guide through the larynx, between the vocal folds, remain at difficult airways. These problems are also present when removing alien objects from the throat.

The intubation should furthermore take place quickly without injuring the patient. Preferably the instrument should also be easy to understand and handle.

In view of the above indicated problems an instrument is needed that is adapted to the field of sight and view point of the videolaryngoscope, and that is simple to handle and learn to use. The object of the invention is to provide such an instrument. This is achieved by means of a forceps in accordance with claim 1. Advantageous further developments of the inventive thought are apparent from the subclaims as well as the following description of a preferred embodiment of the invention, which is also shown in enclosed drawings. In the drawings fig. 1 depicts a forceps in accordance with the invention in a vertical longitudinal section in place in a patient, fig. 2 similar forceps in accordance of the invention seen from the side, fig. 3 the forceps in fig. 2 seen from above and fig. 4 the forceps in fig. 2 and 3 in perspective.

The forceps shown in the figs. 2 to 4 have a grip part that includes two grip legs, 1 and 2, that in their outer ends are ended with an oval or round gripping portion 3 and 4 respectively. The grip legs transcends rearward from the grip portions into bent parts 5 and 6, that in their rear ends in turn transcends into short straight parts 7 and 8 respectively, which then transcends into in the opposite direction bent manoeuver legs, 9 and 10 respectively, in the manoeuver end and that in their outer ends are less bent and provided with rings, 11 and 12 respectively, for thumb and one or several fingers. The joint 14 of the forceps is arranged in the shorter straight parts, 7 and 8, that at use of the forceps are located in the oral cavity. The short straight parts may possibly be restricted to what is needed for the joint so that the bent gripping legs and the manoeuver legs principally transcends into each other.

In the outer ends of the manoeuvering legs these are provided with towards each other protruding parts 13, 15 that are provided with towards each other protruding sawtooth-like protrusions that at a mutual movement can grip into each other so that the forceps are locked against opening in order to grip a guide, intubation tube or other gripped object. The forceps can be opened by a flexing apart of the legs by means of the rings so that the protrusions no longer grip each other. Due to the S-bending and/or -angleing the forceps can advantageously be griped in the same way as tweezers and this in a comfortable position for the manoeuvering hand. A good precision can then be achieved in an intuitively correct handling of the forceps for entering of an incubation tube or a guide for this past the vocal folds. It is also possible to consider that the manoeuvering legs 9 and 10 in front of the rings 11 and 12 are provided with grip portions with a half-circular cross section so that the forceps at manoeuvering can not only be moved in four directions but also easily be rotated with the fingers. This portion can also extend a distance over the bent parts of the manoeuvering legs so that by gripping the forceps differently far forwards one can chose the rotational center of the turning movement in the throat. At an advantageous bending and finger placing the rotation center can be placed in the end of the forceps or in the end of a tube or a guide. It will be felt as if the forceps are straight.

At use of the instrument at intubation by means of a guide that can be shaped you grip with the instrument the front end of the guide a distance from the tip. The tip is bent in an appropriate direction before or after the gripping. Then the forceps with a curved movement is brought around the tongue (that is held up with a laryngoscope 16 (fig. 1) and down into the throat to a desired distance from glottis. At the insertion the forceps can slide on the outer side of the laryngoscope. The manoeuver end of the forceps ends at this up in front of the face of the patient and slightly angled up from this. For precise adjustments the forceps can be gripped with the inside or the hand facing upwards or downwards between the thumb and at least two fingers. A stable and comfortable grip is obtained were you when needed can move the fingers along the instrument or roll it between the fingers respectively. With small movements you can with precision move the forceps and the guide easily and intuitively so that a minimum of time will be required for the insertion of the front end of the guide in glottis, whereafter the intubation tube can be entered and the guide be removed. If the guide does not reach all the way to glottis the forceps can be released and drawn back for a renewed gripping. After the freeing of the forceps from the guide the forceps may remain for a possible helping with the insertion of the tube, alternatively the forceps can be inserted again when needed.

Claims

C L A I M S

1. Forceps for intubation and other manipulation in the throat comprising a grip part for insertion into the throat and a maneuvering end, characterized in that the grip part is angled or bent in a plane that is perpendicular to the movement plane of the forceps at its opening and closing.

2. Forceps according to claim 1 , characterized in that the forceps in its maneuvering end is angled or bent in the same plane as the first angleing or bending, in the opposite direction relative the first angling or bending so that the forceps in its plane perpendicular to the movement plane receive a more or less S-like shape.

3. Forceps according to any of the preceding claims, characterized in that they in the manoeuvering end comprise rings (11 , 12) and a locking device (13, 15) for the fixing of the forceps in one or several gripping positions.

4. Forceps according to any of the preceding claims, characterized in that its joint (14) is placed so that it at use is located above the tongue base.

5. Forceps according to claim 2, characterized in that the angle or bends are essentially of the same magnitude.

6. Forceps according to any of the preceding claims, characterized in that they in the maneuvering end has a grip or grip areas shaped to facilitate a turning between the thumb and one or several fingers.

7. Forceps according to claim 6, characterized in that the grip or the gripping areas extends over a part of the bend in the maneuvering end in accordance with claim 2.

8. Forceps according to any of the preceding claims, characterized in that the grip part is sufficiently long to be able to reach the vocal folds.