Medical catheter assembly including multi-piece connector
Abstract
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Expired 17 May 2024, 2.4 years ago.
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45 claims: 9 independent, 36 dependent
- 1医療用カテーテル・アセンブリであって、(a)医療用カテーテルと、(b)第1の管状部材とを含んでおり、前記第1の管状部材が前記医療用カテーテル内に固定されており、前記アセンブリがさらに、(c)フィッティングを含んでおり、前記フィッティングが後側部分及びショルダを含んでおり、前記後側部分が、前記第1の管状部材内に位置決めされてそれに固定され、前記ショルダが前記後側部分の前に位置決めされ、前記医療用カテーテルが前記ショルダを包囲 し 、前記アセンブリがさらに、(d) 硬質材料製の 第2の管状部材を含んでおり、前記第2の管状部材が前記医療用カテーテルに被せて挿入され、且つ前記ショルダと前記第1の管状部材との間に位置決めされ、前記第2の管状部材は、前記医療用カテーテルを前記第2の管状部材と前記第1の管状部材との間で強固に保持し、且つ前記医療用カテーテルを前記第2の管状部材と前記ショルダとの間で強固に保持するように適切にサイズ設定されるアセンブリ。
- 2前記第1の管状部材に内ねじ山が設けられており、前記フィッティングに外ねじ山が設けられており、前記第1の管状部材と前記フィッティングとが、前記内ねじ山と前記外ねじ山との螺合式係合によって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 3前記第1の管状部材に横開口部が設けられており、前記フィッティングに弾性脚部が設けられており、前記弾性脚部が、前記横開口部に挿通されるように適合された足部を有しており、前記第1の管状部材と前記フィッティングとが、前記足部を前記横開口部に挿通することによって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 4前記第1の管状部材に1対の横開口部が設けられており、前記フィッティングに1対の弾性脚部が設けられており、前記弾性脚部それぞれが、前記横開口部の1つに挿通されるように適合された足部を有しており、前記第1の管状部材と前記フィッティングとが、前記足部を前記横開口部に挿通することによって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 5前記第1の管状部材に、径方向内側に延びる突出部が設けられており、前記フィッティングに、前記突出部を受けるように適合された陥凹部が設けられており、前記第1の管状部材と前記フィッティングとが、前記突出部を前記陥凹部に挿入することによって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 6前記第1の管状部材に、径方向内側に延びる、対向する1対の突出部が設けられており、前記フィッティングに、スロットと、1対のL字形陥凹部とが設けられており、前記スロットが、前記フィッティングの後端から長手方向に延び、前記対向する1対の突出部をその中に挿通させるように適合されており、前記L字形陥凹部の一方が、前記対向する1対の突出部の一方を受けるように適合されており、前記L字形陥凹部の他方が、前記対向する1対の突出部の他方を受けるように適合されており、前記L字形陥凹部それぞれが、前記スロットと連通する、周方向に延びる部分と、前記 フィッティングの後端 に向かって延びる、長手方向に延びる部分とを有しており、前記第1の管状部材と前記フィッティングとが、前記突出部を前記スロットに挿通し、前記L字形陥凹部の前記周方向に延びる部分を通過させ、且つ前記L字形陥凹部の前記長手方向に延びる部分に到達させることによって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 7前記第1の管状部材と前記フィッティングとが、スピン溶接によって互いに固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 8前記第1の管状部材が摩擦嵌めによって前記医療用カテーテル内で固定される、請求項1に記載の医療用カテーテル・アセンブリ。
- 9前記医療用カテーテルがシリコーン・チューブである、請求項8に記載の医療用カテーテル・アセンブリ。
- 10前記フィッティングが前側部分をさらに有しており、前記前側部分が前記医療用カテーテルを越えたところまで延びており、前記前側部分が円錐形で、前記フィッティングの前端のところで頂点となる、請求項1に記載の医療用カテーテル・アセンブリ。
- 11ワイヤ・ループをさらに含んでおり、前記ワイヤ・ループが前記フィッティングの前記前端から前方に延びる、請求項10に記載の医療用カテーテル・アセンブリ。
- 12前記フィッティングが前側部分をさらに有しており、前記前側部分が前記医療用カテーテルを越えたところまで延びており、前記前側部分が少なくとも1つのバーブを含むように成形される、請求項1に記載の医療用カテーテル・アセンブリ。
- 13前記フィッティングの前記前側部分が、複数のバーブを含むように成形される、請求項12に記載の医療用カテーテル・アセンブリ。
- 14前記フィッティングに長手方向ボアが設けられている、請求項12に記載の医療用カテーテル・アセンブリ。
- 15前記フィッティングに長手方向ボアが設けられている、請求項1に記載の医療用カテーテル・アセンブリ。
- 16前記医療用カテーテルが前端と後端とを有しており、前記医療用カテーテル・アセンブリが、ある長さのチュービングをさらに含んでおり、前記ある長さのチュービングが前端と後端とを含んでおり、前記ある長さのチュービングの前記後端が、前記フィッティングによって前記医療用カテーテルの前記前端に結合される、請求項1に記載の医療用カテーテル・アセンブリ。
- 17前記フィッティングが前側部分をさらに含んでおり、前記フィッティングの前記前側部分が、前記ある長さのチュービングに挿入されてそれに固定される、請求項16に記載の医療用カテーテル・アセンブリ。
- 18前記フィッティングの前記前側部分が、前記フィッティングの前記前側部分を前記ある長さのチュービングに固定する少なくとも1つのバーブを含むように成形される、請求項17に記載の医療用カテーテル・アセンブリ。
- 19前記フィッティングの前記前側部分が、前記フィッティングの前記前側部分を前記ある長さのチュービングに固定する複数のバーブを含むように成形される、請求項18に記載の医療用カテーテル・アセンブリ。
- 20前記フィッティングの前記前側部分が、スピン溶接によって前記ある長さのチュービングに固定される、請求項17に記載の医療用カテーテル・アセンブリ。
- 21前記医療用カテーテルが栄養チューブであり、前記ある長さのチュービングが拡張器である、請求項16に記載の医療用カテーテル・アセンブリ。
- 22内部ボルスタをさらに含んでおり、前記内部ボルスタが前記栄養チューブの前記後端に配置される、請求項21に記載の医療用カテーテル・アセンブリ。
- 23医療用カテーテル・アセンブリであって、(a)医療用カテーテルを含んでおり、前記医療用カテーテルが、弾性材料製で、前端と、後端と、内径とを有しており、前記アセンブリがさらに、(b)第1の管状部材を含んでおり、前記第1の管状部材が前記医療用カテーテルの内径よりも大きい外径を有しており、前記第1の管状部材が、前記医療用カテーテル内に同軸的に配置され、摩擦嵌めによって前記医療用カテーテルに固定されており、前記アセンブリがさらに、(c)フィッティングを含んでおり、前記フィッティングがショルダと後側部分とを含んでおり、前記ショルダが、前記後側部分の前に位置決めされ、前記医療用カテーテルの内径よりも大きい外径を有しており、前記後側部分が前記第1の管状部材に挿入されてそれに固定された状態で、前記ショルダ及び前記後側部分が、前記医療用カテーテルの前端を通って前記医療用カテーテルに挿入され、前記アセンブリがさらに、(d) 硬質材料製の 第2の管状部材を含んでおり、前記第2の管状部材が、前記医療用カテーテルに被せて挿入され、前記ショルダと前記第1の管状部材との間に位置決めされており、前記第2の管状部材が、前記第2の管状部材と前記第1の管状部材との間において前記医療用カテーテルに第1の挟持点を形成し、且つ前記第2の管状部材と前記ショルダとの間において前記医療用カテーテルに第2の挟持点を形成するアセンブリ。
- 24前記第1の管状部材に内ねじ山が設けられており、前記フィッティングの前記後側部分に外ねじ山が設けられており、前記第1の管状部材と前記フィッティングの前記後側部分とが、前記内ねじ山と前記外ねじ山との螺合式係合によって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 25前記第1の管状部材に横開口部が設けられており、前記フィッティングの前記後側部分に弾性脚部が設けられており、前記弾性脚部が、前記横開口部に挿通されるように適合された足部を有しており、前記第1の管状部材と前記フィッティングの前記後側部分とが、前記足部を前記横開口部に挿通することによって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 26前記第1の管状部材に1対の横開口部が設けられており、前記フィッティングの前記後側部分に1対の弾性脚部が設けられており、前記弾性脚部それぞれが、前記横開口部の1つに挿通されるように適合された足部を有しており、前記第1の管状部材と前記フィッティングの前記後側部分とが、前記足部を前記横開口部に挿通することによって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 27前記第1の管状部材に、径方向内側に延びる突出部が設けられており、前記フィッティングの前記後側部分に、前記突出部を受けるように適合された陥凹部が設けられており、前記第1の管状部材と前記フィッティングの前記後側部分とが、前記突出部を前記陥凹部に挿入することによって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 28前記第1の管状部材に、径方向内側に延びる、対向する1対の突出部が設けられており、前記フィッティングの前記後側部分に、スロットと、1対のL字形陥凹部とが設けられており、前記スロットが、前記フィッティングの前記後側部分の後端から長手方向に延び、前記対向する1対の突出部をその中に挿通させるように適合されており、前記L字形陥凹部の一方が、前記対向する1対の突出部の一方を受けるように適合されており、前記L字形陥凹部の他方が、前記対向する1対の突出部の他方を受けるように適合されており、前記L字形陥凹部それぞれが、前記スロットと連通する、周方向に延びる部分と、前記 フィッティングの前記後側部分の後端 に向かって延びる、長手方向に延びる部分とを有しており、前記第1の管状部材と前記フィッティングの前記後側部分とが、前記突出部を前記スロットに挿通し、前記L字形陥凹部の前記周方向に延びる部分を通過させ、且つ前記L字形陥凹部の前記長手方向に延びる部分に到達させることによって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 29前記第1の管状部材と前記フィッティングの前記後側部分とが、スピン溶接によって互いに固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 30前記医療用カテーテルがシリコーン・チューブである、請求項23に記載の医療用カテーテル・アセンブリ。
- 31前記フィッティングが前記ショルダの前に前側部分をさらに有しており、前記前側部分が前記医療用カテーテルの前記前端を越えたところまで延びており、前記フィッティングの前記前側部分が円錐形で、前記フィッティングの前端のところで頂点となる、請求項23に記載の医療用カテーテル・アセンブリ。
- 32ワイヤ・ループをさらに含んでおり、前記ワイヤ・ループが前記フィッティングの前記前端から前方に延びる、請求項31に記載の医療用カテーテル・アセンブリ。
- 33前記フィッティングが前記ショルダの前に前側部分をさらに有しており、前記フィッティングの前記前側部分が、前記医療用カテーテルを越えたところまで延び、少なくとも1つのバーブを含むように成形される、請求項23に記載の医療用カテーテル・アセンブリ。
- 34前記フィッティングの前記前側部分が、複数のバーブを含むように成形される、請求項33に記載の医療用カテーテル・アセンブリ。
- 35前記フィッティングに長手方向ボアが設けられている、請求項33に記載の医療用カテーテル・アセンブリ。
- 36前記フィッティングが前記ショルダの前に前側部分をさらに含んでおり、前記医療用カテーテル・アセンブリが、ある長さのチュービングをさらに含んでおり、前記ある長さのチュービングが前端と後端とを含んでおり、前記フィッティングの前記前側部分が、前記ある長さのチュービングの前記後端を通って前記ある長さのチュービングに挿入され、前記ある長さのチュービング内で固定される、請求項23に記載の医療用カテーテル・アセンブリ。
- 37前記フィッティングの前記前側部分が、前記フィッティングの前記前側部分を前記ある長さのチュービング内で固定する少なくとも1つのバーブを含むように成形される、請求項36に記載の医療用カテーテル・アセンブリ。
- 38前記医療用カテーテルが栄養チューブであり、前記ある長さのチュービングが拡張器である、請求項36に記載の医療用カテーテル・アセンブリ。
- 39前記拡張器が外側に広がった後端を有する、請求項38に記載の医療用カテーテル・アセンブリ。
- 40内部ボルスタをさらに含んでおり、前記内部ボルスタが前記栄養チューブの前記後端に配置される、請求項38に記載の医療用カテーテル・アセンブリ。
- 41医療用カテーテル・アセンブリであって、(a)医療用カテーテルを含んでおり、前記医療用カテーテルが、弾性材料製で、前端と、後端と、内径とを有しており、前記アセンブリがさらに、(b)第1の管状部材を含んでおり、前記第1の管状部材が前記医療用カテーテルの内径よりも大きい外径を有しており、前記第1の管状部材が、前記医療用カテーテル内に同軸的に配置され、摩擦嵌めによって前記医療用カテーテルに固定されており、前記アセンブリがさらに、(c)フィッティングを含んでおり、前記フィッティングが、前側部分と、ショルダと、後側部分とを含んでおり、前記ショルダが、前記前側部分と前記後側部分との間に位置決めされ、前記医療用カテーテルの内径よりも大きい外径を有しており、前記後側部分が前記第1の管状部材に挿入されてそれに固定された状態で、前記ショルダ及び前記後側部分が、前記医療用カテーテルの前端を通って前記医療用カテーテルに挿入され、前記アセンブリがさらに、(d) 硬質材料製の 第2の管状部材を含んでおり、前記第2の管状部材が、前記医療用カテーテルに被せて挿入され、前記ショルダと前記第1の管状部材との間に位置決めされており、前記第2の管状部材が、前記第2の管状部材と前記第1の管状部材との間において前記医療用カテーテルに第1の挟持点を形成し、且つ前記第2の管状部材と前記ショルダとの間において前記医療用カテーテルに第2の挟持点を形成する、前記アセンブリがさらに、(e)ある長さのチュービングを含んでおり、前記ある長さのチュービングが前端と後端とを有しており、前記フィッティングの前記前 側部分 が、前記ある長さのチュービングの前記後端を通って前記ある長さのチュービングに挿入され、前記ある長さのチュービング内で固定されるアセンブリ。
- 42前記フィッティングの前記前側部分が、前記フィッティングの前記前側部分を前記ある長さのチュービング内で固定する少なくとも1つのバーブを含むように成形される、請求項41に記載の医療用カテーテル・アセンブリ。
- 43前記医療用カテーテルが栄養チューブであり、前記ある長さのチュービングが拡張器である、請求項41に記載の医療用カテーテル・アセンブリ。
- 44内部ボルスタをさらに含んでおり、前記内部ボルスタが前記栄養チューブの前記後端に配置される、請求項43に記載の医療用カテーテル・アセンブリ。
- 45前記フィッティングが長手方向ボアをさらに含む、請求項41に記載の医療用カテーテル・アセンブリ。
Independent claims45
68 paragraphs, as filed
The present invention generally relates to medical catheters such as gastrostomy feeding tubes, and more particularly to medical catheter assemblies such as percutaneous endoscopic gastrostomy (PEG) implantable assemblies.
Some patients are unable to take food and / or medicines orally due to difficulty swallowing. Such dysphagia is due to a variety of causes, including esophageal cancer and neuropathy. Intravenous administration of food and / or medicines to such patients is a feasible technique in the short term, but is not well suited in the long term. Therefore, the most common method of long-term feeding of such patients is gastrostomy, i.e. forming a feeding tube or stoma between the stomach and the upper abdominal wall. This is usually inserted into the feeding tube with the distal end of the feeding tube extending into the stomach and held in the stomach by an internal anchor or bolster, and the proximal end of the feeding tube extending through the abdominal wall. Nourishment is provided by administering food through a catheter or feeding tube.
Early gastrostomy was performed surgically, but today most gastrostomy is performed using a percutaneous endoscope and catheter / bolster assembly (generally percutaneous endoscopy) is performed on the patient. Mirror gastrostomy (PEG) device) will be implanted. Two of the more common techniques for implanting PEG devices in patients are the "push method" (also known as the "Sacks-Vine method") and the "pull method" ("Gauderer-". Also known as the "Ponsky method"). Information on the above two methods can be found in the following patents: Inventor Hirsch et al., U.S. Pat. No. 5,391159, issued February 21, 1995, Inventor Clegg et al., U.S. Pat. No. 5167627, Inventor Grobe's U.S. Patent No. 5112310 issued on May 12, 1992, Inventor Quinn et al.'S U.S. Patent No. 4900306 issued on February 13, 1990, and August 1989. It can be found in US Pat. No. 4,861334 of the inventor Nawaz issued on the 29th, all of which are incorporated herein by reference.
According to the push method, the distal end of the endoscope is inserted into the patient's mouth and reaches the stomach through the esophagus. After dilating the stomach by swelling, the entry site on the abdomen is identified and an incision is made by penetrating the abdominal wall with a needle (eg, a Seldinger needle) with the outer cannula to reach the stomach. Be done. The needle is then removed with the cannula in place. The snare is then inserted into the stomach through the endoscope and wrapped in a loop around the distal end of the cannula. The first end of the flexible guide wire is then passed through the cannula, reaches the stomach and is gripped by the snare. The second end of the guide wire remains outside the patient's body. The endoscope and snare are then pulled out of the patient's mouth to deliver the first end of the guide wire.
The push catheter implantation assembly is then inserted over the first end of the guide wire and pushed over the guide wire towards the second end of the guide wire. Push-type catheter-embedded assemblies typically include a gastrostomy feeding tube, which has a dome-shaped internal bolster located at its trailing end and is connected in series with its leading end. It has a tubular dilator. The gastrostomy feeding tube and internal bolster are usually made of a soft biocompatible material such as silicone rubber and may form an integral structure. The dilator is made of polyethylene or a similar material, which has a gradual decrease in outer diameter from its trailing end to its leading end, but is usually stiffer than silicone and still has some flexibility. Advancement of the push-type catheter implantation assembly on the guidewire continues until the anterior end of the dilator reaches the cannula and pushes the cannula through the patient's abdominal wall. The anterior end of the gastrostomy feeding tube then emerges from the abdomen, after which the anterior end of the dilator is pulled through the abdominal wall until the internal bolster at the posterior end of the gastrostomy feeding tube engages the stomach wall.
Once the internal bolster was in place against the stomach wall, the proximal portion of the implanted gastrostomy feeding tube was usually cut and implanted to reduce the extracorporeal portion of the implanted gastrostomy feeding tube to the desired length. Removed from the tube. (Removing the proximal portion of the gastrostomy feeding tube will also remove the dilator attached to it.) Normally, the external bolster would impede the longitudinal movement of the feeding tube within the fistula tube. It is fixed to the embedded part of the remaining feeding tube so that it engages with the abdomen in a flexible manner. In addition, a "Y-port" adapter is typically attached to the proximal end of the implanted feeding tube, so that this Y-port adapter receives a pair of connector tips through which food and / or medicine can be distributed. It is adapted. In addition, there is usually a removable locking clip between the external bolster and the Y-port adapter to prevent gastric juice from leaking from the proximal end of the feeding tube when the feeding tube is not in use. At the point, it is anchored to an embedded feeding tube.
As is easily understood, pulling the dilator pulls the leading end of the gastrostomy feeding tube through the abdomen, so the connection between the dilator and the gastrostomy feeding tube withstands the tensile forces applied therein. Must be strong enough to be. Otherwise, the feeding tube may separate from the dilator before the gastrostomy feeding tube appears from the patient, resulting in the need to retrieve the feeding tube from the patient, which can be an unwanted hassle. It can be imitated. For connections such as the connection between the gastrostomy feeding tube and the dilator of the push catheter implantation assembly described above, the industry standard minimum tensile strength is approximately 7.7 kg (17 lbs) (see BS EN 1615: 2000). Is.
However, to date, this criterion has not been met by the conventional ligation normally used to attach the dilator to the gastrostomy feeding tube. An example of such a connection usually includes a properly sized tubular fitting having multiple barbs at both ends thereof. One end of the tubular fitting is inserted into the trailing end of the dilator, and the other end of the fitting is inserted into the leading end of the gastrostomy feeding tube. The connection is also shrink-wrapped around the trailing end of the dilator and the leading end of the feeding tube (as well as around the fitting placed inside the trailing end of the dilator and the leading end of the feeding tube), short length. Also includes plastic tubing.
In addition to often not meeting the minimum tensile strength required for the connection between the dilator and the feeding tube, the other drawbacks of the connection mentioned above are (i) shrink-wrapped tubing of some length into the assembly. It takes time and effort to apply, (ii) shrink-wrapped tubing undesirably enlarges the cross-sectional outline of the assembly, and (iii) shrink-wrapped tubing ends. It is widely recognized that the ends may get caught in the tissue as the assembly travels in a winding path through the patient's body, not coplanar with the dilator or feeding tube.
According to the pull method, the distal end of the endoscope is inserted into the patient's mouth and reaches the stomach through the esophagus. After dilating the stomach by swelling, the site of entry on the abdomen is identified and an incision is made by penetrating the abdominal wall with a needle (eg, a Serzinger needle) with an outer cannula to reach the stomach. The needle is then removed with the cannula in place. The snare is then inserted into the stomach through the endoscope and wrapped in a loop around the distal end of the cannula. The first end of the suture is then threaded through the cannula, reaches the stomach and is gripped by the snare. The second end of the suture remains outside the patient's body. The endoscope and snare are then pulled out of the patient's mouth to deliver the first end of the suture. The first end of the suture is then coupled to the leading end of the pull catheter implantation assembly, which has an internal bolster at its trailing end and a plastic fitting at its leading end. , Includes gastrostomy feeding tube. The plastic fitting has a barbed rear portion that is installed within the leading end of the feeding tube and a conical front portion that acts as an expander, the conical front portion being the feeding tube. The diameter gradually decreases from the leading end to the tip of the. A wire loop is fixed to the tip of the plastic fitting and the first end of the suture is tied to the wire loop.
The second end of the suture is then used to allow the pull catheter implantation assembly to flip back into the patient's body until a gastrostomy feeding tube emerges from the patient's abdomen and the internal bolster engages the patient's stomach wall. Is drawn to. Then, as in the push method, the implanted gastrostomy feeding tube is usually cut to the desired length and the external bolster is usually anchored to the cut embedded tube, "Y port. The adapter is usually attached to the proximal end of the embedded feeding tube, and a removable locking clip is usually attached to the embedded feeding tube at some point between the external bolster and the Y-port adapter. It is fixed.
For easy understanding, it is very important that the plastic fitting maintains a bond with the gastrostomy feeding tube, as pulling the suture moves the pull catheter assembly to a position within the patient's body. Is.
<p> An object of the present invention is to provide a new medical catheter assembly.</p><p> Another object of the present invention is to provide the medical catheter assembly that overcomes at least some of the problems described above with respect to existing medical catheter assemblies of the type used for implanting PEG devices. ..</p>
<p> The present invention is based on our recognition that at least one of the existing PEG embedding assemblies cannot withstand the large separation forces applied during embedding. This defect is mainly between the gastrostomy feeding tube, which is usually made of silicone rubber, and the dilator (push or pull), which is usually made of thermoplastic material rather than silicone rubber. Due to the fact that strong connectivity cannot be maintained.</p><p> Therefore, according to one aspect of the invention, a medical catheter assembly comprising (a) a medical catheter, wherein the medical catheter is made of an elastic material and has an anterior end, a rear end and an inner diameter. The assembly further comprises (b) a first tubular member, wherein the first tubular member has an outer diameter greater than the inner diameter of the medical catheter. A first tubular member is coaxially disposed within the medical catheter and secured to the medical catheter by frictional fitting, the assembly further comprises (c) a fitting, the fitting being a shoulder. And a posterior portion, the shoulder is positioned in front of the posterior portion and has an outer diameter larger than the inner diameter of the medical catheter, the posterior portion being the first. With the shoulder and the posterior portion inserted into and secured to the tubular member, the shoulder and the posterior portion are inserted into the medical catheter through the anterior end and the assembly further comprises (d) a second tubular member. The second tubular member is inserted over the medical catheter and positioned between the shoulder and the first tubular member, and the second tubular member is for medical use. Suitable for holding the catheter firmly between the second tubular member and the first tubular member, and holding the medical catheter firmly between the second tubular member and the shoulder. An assembly that is sized to is provided.</p><p> In one embodiment, the medical catheter assembly described above is a pull-type PEG-implanted assembly. In such an embodiment, the fitting preferably further includes an anterior portion in front of the shoulder, the anterior portion extending beyond the anterior end of the medical catheter and also the anterior side. The portion is conical and reaches the apex at the front end of the fitting. The wire loop is preferably fixed to the fitting, for example by insert molding, with the wire loop extending forward from the front end of the fitting.</p><p> In another embodiment, the medical catheter assembly described above is a push-type PEG-implanted assembly. In such an embodiment, the assembly preferably further includes a tubular dilator, and the fitting preferably further includes an anterior portion in front of the shoulder, wherein the anterior portion is said to the medical catheter. It extends beyond the front end and is secured inside the rear end of the tubular dilator, for example by a barb formed on the fitting that engages the inner surface of the dilator. The fitting is further preferably provided with a longitudinal bore through which the guide wire can be passed.</p><p> In the pull-type and push-type PEG-embedded assemblies described above, the rear portion of the fitting can be secured to the first tubular member in a wide variety of ways. For example, the posterior portion of the fitting and the first tubular member can be joined together by paired engagement of threads, one of which is the inner surface of the first tubular member. It is provided on top and the other thread is provided on the outer surface of the rear portion of the fitting. Alternatively, the posterior portion of the fitting can be molded to include a pair of elastic legs with outwardly facing feet located on the opposite side, and a first tubular member can be placed on the opposite side. It can also be molded to include a lateral opening adapted to receive the arranged outward facing foot. Alternatively, the rear portion of the fitting and the first tubular member can be joined together by spin welding. Alternatively, the rear portion of the fitting and the first tubular member can be complementarily molded so that they can be joined in a push-twist-pull manner.</p><p> The present invention is also a medical catheter assembly comprising (a) a medical catheter and (b) a first tubular member, wherein the first tubular member is within the medical catheter. Secured, the assembly further comprises (c) a fitting, the fitting comprises a posterior portion, the posterior portion being positioned and secured within the first tubular member. Assemblies are also included.</p><p> The present invention further relates to a connector for connecting a first length tubing to a second length tubing, wherein the first length tubing is made of an elastic material, and the connector is (a). A first tubular member is included, the first tubular member has an outer diameter larger than the inner diameter of the tubing of the first length, and the first tubular member is the first tubular member. Fitted to be coaxially inserted into the length of the tubing and secured by friction fitting therein, the connector further comprises (b) a fitting, wherein the fitting is with the anterior portion. , The shoulder and the rear portion, the shoulder is positioned between the front portion and the rear portion, and has an outer diameter larger than the inner diameter of the tubing of the first length. The shoulder and the rear portion of the fitting are fitted so as to be coaxially inserted into the tubing of the first length, and the rear portion of the fitting is the first tubular member. Fitted to be coaxially inserted into and secured to it so that the anterior portion of the fitting is coaxially inserted into and anchored into the second length of tubing. The connector further comprises (c) a second tubular member, the second tubular member being inserted over the first length of tubing and with the shoulder. The first tubular member is adapted to be positioned between the first tubular member and the first tubular member, with the fitting and the first tubular member fixed to each other. Also covered are connectors that are appropriately sized to hold the length tubing firmly between the second tubular member and the first tubular member and between the second tubular member and the shoulder. And.</p><p> The present invention further comprises a connector for use with a first length tubing, wherein the first length tubing is made of an elastic material and the connector comprises (a) a first tubular member. The first tubular member has an outer diameter larger than the inner diameter of the tubing of the first length, and the first tubular member is contained in the tubing of the first length. Fitted to be coaxially inserted and secured in it by friction fitting, the connector further comprises (b) fittings, the fittings being the front part, the shoulder and the rear side. The shoulder is positioned between the front portion and the rear portion, and has an outer diameter larger than the inner diameter of the tubing of the first length, and includes the shoulder and the shoulder. The rear portion is adapted to be coaxially inserted into the first length of tubing so that the rear portion of the fitting is coaxial within the first tubular member. Fitted to be inserted and secured to it, the anterior portion of the fitting is conical and ends with an apex at its anterior end, and the connector is further (c) of the fitting. It includes a wire loop extending forward from the front end and (d) a second tubular member, the second tubular member being inserted over the first length of tubing and the shoulder. The first tubular member is adapted to be positioned between the first tubular member and the first tubular member, and the second tubular member is in a state where the fitting and the first tubular member are fixed to each other. Also a connector that is appropriately sized to hold a tubing of this length firmly between the second tubular member and the first tubular member and between the second tubular member and the shoulder. set to target.</p><p> For the purposes of the present specification and claims, various related terms such as "top", "bottom", "upper", "lower", "front", and "rear" are given by the present invention. Used to describe the invention when positioned in the orientation of, or when the invention is viewed from a given orientation. It should be understood that changing the orientation of the present invention may require adjustment of certain related terms accordingly.</p><p> Other objects, features and advantages of the present invention are described in part in the following description, but some are self-evident from the following description or may be understood by practicing the present invention. .. In the following description, reference is made to the accompanying drawings, which form part of the description and show various embodiments of the present invention for the purposes of description. Examples will be described in sufficient detail to allow those skilled in the art to carry out the present invention, but it is understood that other examples can be used and structural modifications can be made without departing from the scope of the present invention. Should. Therefore, the following detailed description should not be taken in a restrictive sense, and the scope of the present invention is best defined by the claims at the beginning.</p><p> The accompanying drawings, which are incorporated herein and form part of this specification, show various embodiments of the invention and serve to explain the principles of the invention in conjunction with the description. In the drawings, similar reference numbers represent similar parts.</p>
Here, with reference to FIGS. 1 and 2, a partial perspective view and a partially disassembled assembly perspective view of a conventional medical catheter assembly adapted for percutaneous endoscopic implantation in a patient using the push method, respectively. Is shown, and the conventional medical catheter assembly is generally represented by reference numeral 11.
Assembly 11, which has been shown before use in the patient, includes a gastrostomy feeding tube 13, an internal bolster 14, a dilator 15, a fitting 17, and a short length tubing 19.
The tube 13 is made of soft biocompatible silicone rubber and is an elongated tubular member having a trailing end 25 and a leading end 27. A series of tick marks (not shown) are printed on the tube 13 to facilitate cutting of the tube to the desired length after the tube 13 has been implanted in the patient, from trailing end 25 to leading end 27. It extends several inches (1 inch = about 2.5 cm) in the direction of.
The internal bolster 14 is also made of soft biocompatible silicone rubber and is firmly placed at the trailing end 25 of the tube 13 to form an integral structure with the tube 13 in this embodiment.
The dilator 15 is a tubular member made of polyethylene with sufficient hardness to open a fistula and sufficient flexibility to bend in the patient's body, with a leading end 31 and a trailing end 33. The dilator 15 goes from a leading end 31 sized to be exactly conformal to the guide wire inserted into it to a trailing end 33 sized to approach the dimensions of the leading end 27 of the tube 13. , Dimensioned to gradually increase in diameter over a length of several inches (1 inch = about 2.5 cm).
The fitting 17 is made of hard plastic and is an integral tubular member having a front side portion 40 and a rear side portion 42, the front side portion 40 starting from the leading end 41 and the rear side portion 42 ending at the trailing end 43. There is. The anterior portion 40 is inserted into the dilator 15 through the trailing end 33 and secured within the dilator 15 by a series of outer barbs 45 extending posteriorly from the leading end 41. The posterior portion 42 is inserted into the gastrostomy feeding tube 13 through the leading end 27 and secured within the tube 13 by a series of lateral barbs 47 extending anteriorly from the trailing end 43.
The tubing 19 is an integral member made of a heat-shrinkable material, and has a leading end 51 inserted over the trailing end 33 of the dilator 15 (and the leading end 41 of the fitting 17) and a leading end 27 of the tube 13 (and the fitting 17). It is formed so as to include the trailing end 53 inserted over the trailing end 43). As can be seen from FIG. 1, the tubing 19 fits snugly over the tube 13, dilator 15, and fitting 17, so the tubing 19 helps to mitigate changes in outer dimensions between the various components.
However, as mentioned above, despite the tubing 19 providing reinforcement of the connection, assembly 11 often cannot withstand tensile forces in the range of about 7.7 kg (about 17 lbs), and therefore BS EN 1615: Does not meet industry standards such as 2000. In addition, applying the tubing 19 to the underlying components requires additional time and effort, thus increasing the manufacturing cost of the assembly 11. In addition, the tubing 19 enlarges the cross-sectional outline of the assembly 11, and in the art, the ends 51 and 53 of the tubing 19 are not coplanar with the dilator 15 or feeding tube 13, and the assembly 11 is the patient. It is widely recognized that the ends 51 and 53 may get caught in the tissue as they wind around the body.
Referring now to FIG. 3, a partial perspective view showing a part of a conventional medical catheter assembly adapted for percutaneous endoscopic implantation in a patient using the pull method is shown as an exploded view. The conventional medical catheter assembly is generally represented by reference number 71.
Assembly 71, shown in its pre-patient condition, includes a gastrostomy feeding tube 73, an internal bolster 74, and a fitting assembly 75.
The tube 73 and bolster 74 are the same size, shape, and configuration as the tube 13 and bolster 14 of assembly 11, respectively.
The fitting assembly 75 includes the fitting 85. The fitting 85 is made of hard plastic and is molded to include a barbed rear portion 87 that is installed within the lead end 81 of the tube 73 and a conical front portion 89 that acts as an expander. The diameter of the anterior portion 89 gradually decreases from the point closest to the leading end 81 of the tube 73 to the tip 91. The wire loop 93 is adapted to be secured to the first end of the suture, but is fixed and installed at the tip 91 (usually by insert molding).
Unfortunately, as mentioned above, the assembly 71 often cannot withstand tensile forces in the range of about 7.7 kg (about 17 lbs) and the fitting 85 is often pulled out of the tube 73.
With reference to FIGS. 4 and 5, a first embodiment of a medical catheter assembly adapted for percutaneous endoscopic implantation in a patient using the push method, constructed according to the teachings of the present invention. A partial cross-sectional view and a partially disassembled assembly perspective view are shown, respectively, and the medical catheter assembly is generally represented by reference numeral 101.
Assembly 101 includes a gastrostomy feeding tube 103 and an internal bolster 104. Tube 103 is an elongated tubular member made of a biocompatible soft elastic material, such as silicone rubber, similar to tube 13 of assembly 11, molded to include a trailing end 105 and a leading end 107. Will be done. Although not intended to be limited to specific dimensions, tube 103 is approximately 61 cm long, 18 Fr., 20 Fr., or 24 Fr. diameter.<u style="single">(6mm, 6.7mm or 8mm)</u>Can be. A series of tick marks (not shown) are printed on the tube 103 to facilitate cutting of the tube to the desired length after the tube 103 has been implanted in the patient, from trailing end 105 to leading end 107. It extends several inches (1 inch = about 2.5 cm) in the direction of.
The internal bolster 104 is made of a soft biocompatible material such as silicone rubber and is firmly placed at the trailing end 105 of the tube 103, forming an integral structure with the tube 103 in this embodiment.
Assembly 101 also includes an expander 108, which is an integral tubular member having a leading end 109 and a trailing end 111. The dilator 108 is made of polyethylene that is hard enough to open a fistula and at the same time flexible enough to bend inside the patient's body. The dilator 108 is several inches (1 inch = about 2.5 cm) long, from the lead end 109, which is sized to be exactly conformal to the guide wire inserted into it, to approximately the diameter of the tube 103. It is sized to gradually increase in diameter over. The leading end 107 of the tube 103 is inserted into the dilator 108 through the trailing end 111, which for example flaring to facilitate receipt of the leading end 107 of the tube 103. It is spread outward by iron).
Assembly 101 further comprises fitting 121 (shown separately in FIGS. 6 (a) to 6 (c)), which is an integral tubular member preferably made of a hard material such as hard molded plastic. Is. The fitting 121 is molded to include a front portion 122-1, an intermediate portion 122-2, and a rear portion 122-3, with the front portion 122-1 ending at the leading end 123 and the rear side. Part 122-3 ends at the trailing end 125. A longitudinal bore 126 extends the length of the fitting 121, which extends outward at its anterior end. The longitudinal bore 126 is appropriately sized to receive the guide wire in it. In this method, the push method can be used to advance the assembly 101 into the patient's body on the guidewire.
The leading end 123 of the fitting 121 is coaxially inserted into the dilator 108 through the trailing end 111 and secured within the dilator 108 by a series of outer barbs 127 formed on the anterior portion 122-1. The trailing end 125 of the fitting 121 is coaxially inserted into the gastrostomy feeding tube 103 through the leading end 107. An outer spiral thread 129 is integrally formed on the rear portion 122-3 and extends from the trailing end 125 to the intermediate portion 122-2, the purpose of which thread will be described later.
The intermediate portion 122-2 is molded to include an outer annular flange or shoulder 131, the purpose of which shoulder will be described later.
Assembly 101 further includes an inner ring 141 (shown separately in FIGS. 7 (a) -7 (c)), which is an integral type, preferably made of a hard material such as hard molded plastic. It is a tubular member and has a leading end 143, a trailing end 145, and a longitudinal bore 146. The inner ring 141 is coaxially positioned within the tube 103 at a depth, eg, about 3.8 cm (about 1.5 inches) from the lead end 107, and has an outer diameter that is greater than the inner diameter of the tube 103. As a result, the inner ring 141 is fixed in the tube 103 by press fitting.
The longitudinal bore 146 of the inner ring 141 is properly sized to receive the trailing end 125 of the fitting 121 therein and engages the outer spiral thread 129 in a paired manner to ring the fitting 121. An inner spiral thread 147 is formed on the inner surface of the inner ring 141 so as to lock the 141 into one.
Assembly 101 further comprises an outer ring 151 (shown separately in FIGS. 8 (a) and 8 (b)), which is an integral type, preferably made of a hard material such as hard molded plastic. It is a tubular member and has a leading end 153, a trailing end 155, and a longitudinal bore 157. The outer ring 151 coaxially surrounds the tube 103 between the shoulder 131 and the inner ring 141, and has an inner diameter slightly larger than the trailing end 125 of the fitting 121 and smaller than the outer diameter of each of the shoulder 131 and the inner ring 141. Has. In this method, when the fitting 121 and the ring 141 are completely screwed together, the tube 103 is tightly coupled to the fitting 121 through a pair of pinching points, one of which is ringing. It is between the leading end 153 of 151 and the shoulder 131, and the other of such pinching points is between the trailing end 155 of the ring 151 and the leading end 143 of the ring 141. The outer diameter of the outer ring 151 is set to be approximately constant on the outside of the assembly 101 over the area extending from the portion of the tube 103 covering the shoulder 131 to the portion of the tube 103 covering the inner ring 141, respectively. It is preferable not to make it much larger than the outer diameter of.
The inner surface 159 of the outer ring 151 is shown as a straight surface in this embodiment, but to facilitate insertion of the tube 103 into the bore 157, the inner surface 159 at the leading end 153 and / or the trailing end 155. Can be easily understood that the can be chamfered.
The assembly 101 may further include a hypotube 161, which in the bore 126 to reinforce the trailing end 125 of the fitting 121 so that it is not damaged due to bending. It is an integrated tubular member that is coaxially arranged toward. The hypotube 161 is preferably made of stainless steel and the fitting 121 can be insert molded around the hypotube 161.
We tested assembly 101 and found that the connection between the dilator 108 and the tube 103 in it met the industry standard minimum tensile strength of 7.7 kg (17 lbs).
To assemble the assembly 101, the inner ring 141 is inserted into the tube 103 through the lead end 107, preferably to a depth of about 3.8 cm (about 1.5 inches). The leading end 107 of the tube 103 is then inserted through the outer ring 151 until the outer ring 151 is positioned just in front of the inner ring 141. The rear portion 122-3 of the fitting 121 is then inserted through the leading end 107 of the tube 103 into the longitudinal bore 146 of the inner ring 141. The fitting 121 and the inner ring 141 are then tightly screwed together so that the tube 103 is sandwiched between the outer ring 151 and the shoulder 131 and between the outer ring 151 and the inner ring 141. (If desired, apply a small amount of medical adhesive around the central part 122-2 of the posterior portion before inserting the fitting 121 into the tube 103 to strengthen the connection between the fitting 121 and the inner ring 141. It can also be placed.) When the fitting 121 and the inner ring 141 are screwed in this way, the leading end 107 of the tube 103 is pushed into the recessed area between the shoulder 131 and the barb 127. Finally, the anterior portion 122-1 of the fitting 121 is inserted into the dilator 108 through the trailing end 111, whereby the barb 127 of the fitting 121 engages the inner surface of the dilator 108 in it. Hold fitting 121. The assembled assembly 101 can be used in the same manner as the assembly 11.
As will be readily appreciated, the assembly steps described above can be performed manually or can be automated to varying degrees.
In this embodiment, it is preferable that the fitting 121, the inner ring 141, and the outer ring 151 are each made of the same material, that is, a molded plastic such as acetal. However, it can be easily understood that the fitting 121, the inner ring 141, and the outer ring 151 do not have to be made of the same material and, in fact, do not have to be made of molded plastic. For example, in stainless steel, one or more of the fitting 121, inner ring 141, and outer ring 151 are made of stainless steel, although material costs and / or manufacturing costs (eg, machining) are probably higher than for molded plastics. Can be made of.
It should also be noted that if the fitting 121 and the expander 108 are to be made of the same material, such as polyethylene, the barb 127 can be omitted from the fitting 121 and the fitting 121 can be joined to the expander 108 by spin welding. (In such cases, the leading portion of the fitting 121 is preferably conical or trapezoidal to accommodate spin welding.)
Similarly, if the fitting 121 and the inner ring 141 are made of the same material, the fitting 121 and the inner ring 141 can be joined together by spin welding. (In such a case, it is preferable to omit the threads 129 and 147 from the fitting 121 and the inner ring 141, respectively, and it is preferable that the rear portion 122-3 of the fitting 121 is conical or trapezoidal.)
It should also be noted that although the fitting 121 is disclosed as an integral structure in this embodiment, the fitting 121 can be assembled from two or more separate parts.
With reference to FIG. 9, a partial cross-sectional view of a second embodiment of a medical catheter assembly constructed according to the teachings of the present invention is shown, wherein the medical catheter assembly uses the push method. It is adapted for percutaneous endoscopic use in patients and is generally represented by reference number 201.
Assembly 201 is similar to assembly 101 in some respects, with the main difference between the two assemblies being that assembly 201 does not include fitting 121 and inner ring 141, but instead includes fitting 203 and inner ring 205, respectively. Is to be done. In addition, the assembly 201 isTheA in that the assembly 201 does not include hypotube 161, differs from the assembly 101.
Although the fitting 203 is shown separately in FIGS. 10 (a) and 10 (b), it is similar to the fitting 121 in many respects, and the main difference between the two fittings is in the fitting 203, The posterior portion 207 is to be included in place of the posterior portion 122-3. The rear portion 207 includes a pair of parallel legs 209-1 and 209-2, the front ends 211-1 in which the legs 209-1 and 209-2 are fixedly installed on the shoulder 131, respectively. And 211-2, and rear ends 213-1 and 213-2, respectively, adapted to be elastically bent towards each other. The rear ends 213-1 and 231-2 are molded to include the foot parts 215-1 and 215-2 located on opposite sides facing outward, respectively, and the purpose of the foot parts is as follows. To clarify.
The inner ring 205, shown separately in FIGS. 11 (a) and 11 (b), is in many respects similar to the inner ring 141, with the main difference between the two rings being the inner ring. The 205 is to include a pair of lateral openings 217-1 and 217-2 rather than an inner spiral thread 147, the openings 217-1 and 217-2, respectively, foot 215-1. And properly sized to receive 215-2 and positioned on the ring 205.
Assembly 201 is assembled in much the same way as assembly 101, the main difference between the two assemblies is that in assembly 201, the fitting 203 and the inner ring 205 have their feet 215-1 and 215-2. They are joined together by snap fitting by inserting the fitting 203 into the inner ring 205 until it is received in the openings 217-1 and 217-2, respectively. The assembled assembly 201 is used in the same manner as the assembly 101.
Here, referring to FIGS. 12 (a) and 12 (b), a longitudinal partial cross section and a lateral partial cross section of a third embodiment of a medical catheter assembly constructed according to the teachings of the present invention, respectively. The figure is shown and the medical catheter assembly is adapted for percutaneous endoscopic use in patients using the push method and is generally represented by reference number 301.
Assembly 301 is similar to assembly 101 in some respects, with the main difference between the two assemblies being that assembly 301 does not include fitting 121 and inner ring 141, but instead includes fitting 303 and inner ring 305, respectively. Is to be done. In addition, the assembly 301 differs from the assembly 101 in that the assembly 301 does not include the hypotube 161.
Although the fitting 303 is shown separately in FIGS. 13 (a) and 13 (b), it is similar to the fitting 121 in many respects, and the main difference between the two fittings is in the fitting 303, The posterior portion 307 is to be included in place of the posterior portion 122-3. The posterior portion 307 is generally tubular and molded to include slot 311 which extends longitudinally forward from the posterior end of the posterior portion 307 by a short distance to a pair of trailing end portions. Define 312-1 and 312-2. The trailing end portion 312-1 is provided with a first L-shaped recess, and the trailing end portion 312-2 is provided with a second L-shaped recess. These L-shaped recesses are 180 degrees apart along the perimeter of the posterior portion 307, with portions 315-1 and 315-2 extending in the circumferential direction and portions 317-1 extending in the longitudinal direction, respectively. Including 317-2. Circumferential portions 315-1 and 315-2 communicate with the anterior end of slot 311 at one end thereof, respectively, and longitudinal portions 317-1 and 317.2 are short posteriorly, respectively. It extends by a distance.
The inner ring 305, shown separately in FIG. 14, is in many respects similar to the inner ring 141, the main difference between the two rings being the inner ring 305, the inner spiral thread 147. Rather, it includes a pair of rectangular blocks 321-1 and 321-2 that project radially inward from the inner surface of the ring at the leading end 323 of the inner ring 305 by a short distance. Blocks 321-1 and 321-2 are properly sized and separated on the ring 305 so that they can be inserted through slots 311 into recesses 313-1 and 313-2, respectively.
Assembly 301 is assembled in much the same way as assembly 101, and the main difference between the two assemblies is that in assembly 301, fitting 303 until blocks 321-1 and 321-2 are advanced to the front end of slot 311. Is inserted into the inner ring 305, then the fitting 303 is twisted as much as possible with respect to the inner ring 305 to pull in blocks 321-1 and 321-2 and extend in the circumferential direction of the recesses 313-1 and 313-2, respectively. Completely pass parts 315-1 and 315-2, then pull the fitting 303 away from the inner ring 305 as much as possible to pull in blocks 321-1 and 321-2, recesses 313-1 and 313- The fitting 303 and the inner ring 305 are joined together through a U-shaped lock by completely passing through the longitudinally extending portions 317-1 and 317.2 of 2, respectively. The assembled assembly 301 is used in the same manner as the assembly 101.
With reference to FIGS. 15 and 16, a partial cross-sectional view and a partially disassembled assembly perspective view of a fourth embodiment of the medical catheter assembly constructed according to the teachings of the present invention are shown, respectively. The medical catheter assembly is adapted for percutaneous endoscopic use in patients using the pull method and is generally represented by reference number 401.
Assembly 401 includes a gastrostomy feeding tube 403 and an internal bolster 404, which tube 403 and bolster 404 are identical to tube 103 and bolster 104 of assembly 101.
Assembly 401 further includes fitting assembly 405, which fitting assembly 405 includes fitting 407. The fitting 407 is made of hard plastic and is molded to include a front side portion 409, an intermediate portion 411, and a rear side portion 413. The anterior portion 409 acts as a dilator, but is conical and gradually decreases in diameter from the trailing end 415 to the tip 417. The wire loop 419 is adapted to be secured to the first end of the suture, but is preferably fixed to the tip 417 by insert molding.
The middle portion 411 is cylindrical and co-axis with the front portion 409, but with a press fit so that the leading end 421 of the tube 403 is snugly received on it and at the same time coplanar with the rear end 415 of the front portion 409. Is properly sized to hold the leading end 421 of the tube 403.
The rear portion 413 is cylindrical and co-axis with the intermediate portion 411, but has a smaller diameter than the intermediate portion 411. An outer spiral thread 423 is formed along the length of the rear portion 413, the purpose of which thread will be clarified below.
Assembly 401 further comprises an inner ring 441, which inner ring 441 is similar to the inner ring 141 of assembly 101. Therefore, the inner ring 441 is an integral tubular member, preferably made of a hard material such as hard molded plastic, and has a leading end 443, a trailing end 445, and a longitudinal bore 446. The inner ring 441 is coaxially positioned within the tube 403 at a depth, eg, about 3.8 cm (about 1.5 inches) from the lead end 421, and has an outer diameter that is greater than the inner diameter of the tube 403. As a result, the inner ring 441 is fixed within the tube 403 by press fitting.
The longitudinal bore 446 of the inner ring 441 is properly sized to receive the posterior portion 413 of the fitting 407 in it and engages the outer spiral thread 423 in a pair with the fitting 407. An inner spiral thread 447 is formed on the inner surface of the inner ring 441 so as to lock the ring 441 into one.
Assembly 401 further includes an outer ring 451 which is similar to the outer ring 151 of assembly 101. Therefore, the outer ring 451 is an integral tubular member, preferably made of a hard material such as hard molded plastic, and has a leading end 453, a trailing end 455, and a longitudinal bore 457. The outer ring 451 coaxially surrounds the tube 403 between the middle portion 411 and the inner ring 441 of the fitting 407, slightly larger than the rear portion 413 of the fitting 407, and the middle portion 411 and the inner ring 441, respectively. It has an inner diameter smaller than the outer diameter. In this method, when the fitting 407 and the ring 441 are fully screwed together, the tube 403 is firmly attached to the fitting 407 through a pair of pinching points, and one of such pinching points is the ring. Between the leading end 453 of the 451 and the rear end of the intermediate portion 411 (the rear end of the intermediate portion 411 acts similarly to the shoulder 131 of the assembly 101), the other of such pinching points is the ring 451. It is between the leading end 455 of the ring 441 and the leading end 443 of the ring 441. The outer diameter of the outer ring 451 is set to the intermediate portion 411 and so that the outer diameter of the assembly 401 is approximately constant over the area extending from the portion of the tube 403 covering the intermediate portion 411 to the portion of the tube 403 covering the inner ring 441. It is preferable not to make it much larger than the outer diameter of each of the inner rings 441.
To assemble the assembly 401, the inner ring 441 is inserted into the tube 403 through the lead end 421, preferably to a depth of about 3.8 cm (about 1.5 inches). The leading end 421 of the tube 403 is then inserted through the outer ring 451 until the outer ring 451 is positioned just in front of the inner ring 441. The rear portion 413 of the fitting 407 is then inserted into the longitudinal bore 446 of the inner ring 441 through the leading end 421 of the tube 403. The fitting 407 and the inner ring 441 are then tightly screwed together so that the leading end 421 of the tube 403 is pulled over the intermediate portion 411 and the tube 403 is between the outer ring 451 and the intermediate portion 411. , And is sandwiched between the outer ring 451 and the inner ring 441. (If desired, place a small amount of medical adhesive around the center of the posterior portion 413 before inserting the fitting 407 into the tube 403 to strengthen the connection between the fitting 407 and the inner ring 441. You can also). The assembled assembly 401 can be used in the same manner as the assembly 71.
The assembly of the present invention has been described in the context of implanting a tube as part of a percutaneous endoscopic gastrostomy, but similarly, using the assembly of the present invention, but not limited to this, intradermally. It should be noted that catheters can also be implanted as part of a number of other medical procedures, including endoscopic jejunostomy. In addition, the connectors used in the push-type medical catheter assemblies described herein are not limited to use in catheter implantation assemblies, but combine different types of tubing into one for a wide variety of applications. Can be used for.
The above-described embodiments of the present invention are merely for the purpose of exemplification, and those skilled in the art shall make numerous changes and modifications to these embodiments without departing from the spirit of the present invention. Can be done. For example, the present specification discloses a particular mechanical arrangement for joining the fitting and the inner ring component of the connector into one, but other arrangements can be readily devised. All such changes and amendments shall fall within the scope of the invention as defined in the claims at the outset.
<figref num="1">FIG. 3 is a partial perspective view of a conventional medical catheter assembly adapted for percutaneous endoscopic implantation in a patient using the push method.</figref><figref num="2">It is a partial decomposition assembly perspective view of the conventional medical catheter assembly of FIG. 1 showing the state of a short plastic tubing before heat shrinkage.</figref><figref num="3">FIG. 3 is a partial perspective view showing a part of a conventional medical catheter assembly adapted for percutaneous endoscopic implantation in a patient using the pull method in an exploded view.</figref><figref num="4">FIG. 5 is a longitudinal partial cross-sectional view of a first embodiment of a medical catheter assembly constructed according to the teachings of the present invention, wherein the medical catheter assembly is percutaneous endoscopic in a patient using the push method. It is a figure adapted for use.</figref><figref num="5">It is a partial decomposition assembly perspective view of the medical catheter assembly of FIG.</figref><figref num="6(a)">It is an enlarged perspective view of the fitting shown in FIG.</figref><figref num="6(b)">It is an enlarged sectional view of the fitting shown in FIG.</figref><figref num="6(c)">It is an enlarged side view of the fitting shown in FIG.</figref><figref num="7(a)">It is an enlarged side view of the inner ring member shown in FIG.</figref><figref num="7(b)">It is an enlarged end view of the inner ring member shown in FIG.</figref><figref num="7(c)">It is an enlarged cross-sectional view of the inner ring member shown in FIG.</figref><figref num="8(a)">It is an enlarged end view of the outer ring member shown in FIG.</figref><figref num="8(b)">It is an enlarged sectional view of the outer ring member shown in FIG.</figref><figref num="9">FIG. 5 is a longitudinal partial cross-sectional view of a second embodiment of a medical catheter assembly constructed according to the teachings of the present invention, wherein the medical catheter assembly is percutaneous endoscopic in a patient using the push method. It is a figure adapted for use.</figref><figref num="10(a)">It is a perspective view of the fitting shown in FIG.</figref><figref num="10(b)">It is a side view of the fitting shown in FIG.</figref><figref num="11(a)">It is a perspective view of the inner ring shown in FIG.</figref><figref num="11(b)">It is a side view of the inner ring shown in FIG.</figref><figref num="12(a)">FIG. 3 is a longitudinal partial cross-sectional view of a third embodiment of a medical catheter assembly constructed according to the teachings of the present invention, wherein the medical catheter assembly is percutaneous endoscopic in a patient using the push method. It is a figure adapted for use.</figref><figref num="12(b)">It is a cross-sectional view of the medical catheter assembly of FIG. 12 (a) showing how the fitting and the inner ring are locked together.</figref><figref num="13(a)">It is a perspective view of the fitting shown in FIG. 12 (a).</figref><figref num="13(b)">It is a side view of the fitting shown in FIG. 12 (a).</figref><figref num="14">It is a perspective view of the inner ring shown in FIG. 12 (a).</figref><figref num="15">FIG. 6 is a longitudinal partial cross-sectional view of a fourth embodiment of a medical catheter assembly constructed according to the teachings of the present invention, wherein the medical catheter assembly is percutaneous endoscopic in a patient using the pull method. It is a figure adapted for use.</figref><figref num="16">It is a partial decomposition assembly perspective view of the medical catheter assembly shown in FIG.</figref>
Every citation, both ways
| Document | Relation | Office |
|---|---|---|
| JP09508542A | Cites | Japan |
| JP33018463Y1 | Cites | Japan |
| JP51072816U | Cites | Japan |
22 members in 6 offices
Priority claims9
| Document | Office | Kind | Date |
|---|---|---|---|
| 10440009 | United States of America | – | |
| 44000903 | United States of America | A | |
| 44000903 | United States of America | A | |
| 2004015541 | United States of America | W | |
| 2004015541 | United States of America | W | |
| 2003440009 | – | – | – |
| 2004015541 | – | – | – |
| US20030440009 | – | – | – |
| WO2004US15541 | – | – | – |
Members22
| Document | Office | Kind | |
|---|---|---|---|
| US2003158539A1 | United States of America | A1 | |
| CA2476931A1 | Canada | A1 | |
| WO03070151A2 | World Intellectual Property Organization (WIPO) | A2 | |
| AU2003205762A1 | Australia | A1 | |
| US2004044330A1 | United States of America | A1 | |
| WO03070151A3 | World Intellectual Property Organization (WIPO) | A3 | |
| US6802836B2 | United States of America | B2 | |
| EP1476119A2 | European Patent Office (EPO) | A2 | |
| WO2004103259A2 | World Intellectual Property Organization (WIPO) | A2 | |
| US2005010195A1 | United States of America | A1 | |
| WO2004103259A3 | World Intellectual Property Organization (WIPO) | A3 | |
| JP2005528135A | Japan | A | |
| EP1631232A2 | European Patent Office (EPO) | A2 | |
| JP2006528910A | Japan | A | |
| US7507230B2 | United States of America | B2 | |
| US2009182272A1 | United States of America | A1 | |
| US7641648B2 | United States of America | B2 | |
| US2010076383A1 | United States of America | A1 | |
| JP4628677B2 | Japan | B2 | |
| JP4782012B2This record | Japan | B2 | |
| US8187253B2 | United States of America | B2 | |
| US8308713B2 | United States of America | B2 |
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Numbers
- Publication
- 4782012
- Publication, DOCDB
- 4782012
- Publication, EPODOC
- JP4782012B
- Application
- 2006533180
- Application, DOCDB
- 2006533180
- Application, EPODOC
- JP20060533180
Titles2
- Japanese
- マルチピース・コネクタを含む医療用カテーテル・アセンブリ
- English
- Medical catheter assembly including multi-piece connector
Classification
- CPC, 12
- A61J15/0026
- A61J15/0034
- A61M25/0014
- A61M39/0247
- A61M39/10
- A61M39/1011
- A61M39/12
- A61M2039/1027
- A61M2039/1033
- A61M2039/1077
- F16L33/225
- A61J15/0019
- IPC, 10
- A61M25 02
- A61M39 00
- A61J15 00
- A61M1 00
- A61M25 00
- A61M25 16
- A61M25 18
- A61M39 10
- A61M39 12
- F16L33 22