US1899781A - Stomach tube or the like - Google Patents

Description

Feb. 28, 1933. J R w ss 1,899,781

STOMACH TUBE OR THE LIKE Filed April 27, 1932 John Ewell Patented Feb. 28, 1933 Jo n; RUSSELL 'rwIss, or New YORK, N. .Y.

. s'romacn TUBE on THE Application med an 27,

The invention concerns an appliancefor drawing fluids from, or introducing the same into the duodenumstomach,- or the like, and

relates particularly to the employment in such appliance of a'bucket with the conduit tube, and also ofa'ball or weight connected with-thebucket in such manner as to act as a leader, having freedom of movement in various directions relative thereto. Y r 1 I a The invention consists in the features,-and

arrangement I and combination of parts hereinafter described and outin the claims.

Inthedrawing: Figure 1 is a sectionalview of the invention in one form. i Fig. 2-is a lengthwise sectional view of the .bucket member. v 3 Fig. 3 is a transverse sectional view-of the bucket member. 7

particularly pointed Fig. 4 is a view of another forinof the invention. l l

Fig. 5 is a lengthwise section of the bucket memberof Fig.4.

Fig. 6'is a transversesectiona'lview of the bucket member of Fig 4. 1 I 4 The flexible duodenal tube is shown in part at'l, This is formed of rubber and 'isof about in diameter, and approximately four and a half feet long. This tube carries at its end a hollow member 2 generally known as a bucket. It'is formed of metal and is intended to provide the means for furnishing the proper arrangementof inlet openings tothe tube,*or in case fiuidsa're to be introduced into'the patient" these open ings form'the' outlet from the tube. This metal memberis provided with end portions or shoulders 3 ofslightly larger diameter 7 than the rubber tube which may be attached thereto by a wrapping of silk thread. The

rubber tube fits upon a hollow nipple 2a extending from the end face of this metal tip or bucket. The bucket intermediate "of. the

end portions or shoulders 3'is provided with perforations in the form of slots 4 in its wall and these are of a length toextend substantially from one end portion to the other. These slots form the inlet openings to-the in connection position of 'ders or end di'ate part of the bucket reduced diameter in respect to the end porshown it is of spherical shape.

19: 2. Serial recovers. V v p v x I bucket and hence to the tube when the device these openings form the outlets from the tu when used for introducing. fluids into the patient. p

There are preferably four of these, slots -90 apart. Leading to' the ends of certain.

of these slots are groovesor' channels. 5; in the shoulders or endportions 3. The'ldisthe slots 4 and the channels 5- relative'to the shoulder or-endjportionsof the bucket is such that a free communication :is afforded to and from the tube 2 when'the' appliance is in operation, because the .s houl; I

portions 'of the bucket will pre-/ Vent the wall of the stomach or duodenum when in-collapsed condition from closing these slots and channels by afl'ording stops or bearing surfaces for the said collapsed, wall, thus acting to hold itofl' from the 'slots'70 and channels sufficiently to maintain 1 them in open condition. Preferably the intermeis of considerably tions or shoulders, andthe slots are formed fa *in this reduced portion, and the channels 5 lead to these slots. Furthermore this reduced intermediate portion; of the bucket may be of generally concaved formation, its smallest diameter being its length, and gradually ameter towards the end portions orshoul- "ders, though about midway" of '80 increasing -in d-ithe invention is not limited in this respect. I f This concave formationavoids the exist-' ence of abrupt shoulders or edges on -the bucket. Beyond this terminal tip or bucket is located a weight or leader member- 6.

This may be of various forms,=-for instance,

ovoid or globular. In thepartic'ulrr formeo apart'fromthe bucket aconsiderable distance, say two inches,and is connected to the bucket by means which will allowthe ballor weightto have in large degree free 'dom of movement, independently of the bucket both laterally in respect to the axis of the "bucket and flexible tube,- and-also about its own axis, or in other words, about that pole which isattached to-the bucket'filoo is used for evacuation, or, on the-contrarg It is spaced V and ball respectively, and inrespect to the ballor weight The means for attaching this ball or weight to the bucket may assume various forms, but in each form it is desirable that the freedoin of movement of the ball relative to the bucket and main tube be provided for. In Fig. 1 this connection is shown as rubber tubing than the rubber conduit tube. 1 It lends itself to convenient attachment both to the ball and to the bucket, eachof said parts having a projection marked respectively 8 and 9, over which the rubber tube is stretched, and secured by a silk thread. The diameter of these projections is somewhat less than the adjacent parts of the bucket,

the connection is such that the working surface of the ball is available at bycarrying the end of the thread under the all points excepting the comparatively small area covered by the attached end of the rubber tube connection, and the stud surrounded thereby, i being noted that theball is of larger diameterthan the said ball and the connecting tube.

The silk thr'ead windings are held without knotti-ng said thread. This may be done v wrapped strand or strands, so asto be held clamped in position thereby.

, In Fig. 4 is shown a slightly diifere'nt form of bucket. The main difference between it and the form described above is that :take place relative to the bucket which, therefore, will be; relieved in large measure leading weight or member, for example a chain 1( coveredby The chainis' {the intermedlate slotted part is not concaved.

. he slots and channels above described are present in this form also and are so. disposed thestomnotjact as a closure The slots in this form thereto are marked 56;. I

In thisform the connection between the ball is shown as a flexible a tubular rubber sheath 7a. attached to a swivel pin 10 having a head 11 hearing; on awasher 12 within the hollow bucket, the said pin being adapted to turn about its axis; to accommodate any rolling action that the ball may tend to have.- In this swivelling action the movement will :oftendency to turn about its axis and twist the main conduit tube 1. The flexible connecting member or chain is ball by a pin 13 screw threaded into the latattached to the ter. ,Thecovering tube 7a of rubber, which is intended vto protect the. chain, and also to avoid contact of said chain with the wall of r .the cavity in which the device operates, may be made of highly flexible rubber tubing fastened to the pin 13 by a silk thread wrapping. At its other end this rubber sheath is attached bya silkthreadwrapping to. a collar'14 which is mounted rotatively upon 7. Thistube is more highly flexible joint between p position,,forthe purpose of lavage,

have freedom of movement in various directions relative to the bucket.

The-ball in this form of the appliance, like that first described, presents its rounded surface atfront, rear and sides for contact with the wall of he cavity in which it operates, it

being noted that the diameter of the ballis considerably greater than that of the flexible connection, so that all sides of the ball are exposed, as just stated, in large degreeln use, the rounded terminal mass or ball G is inserted into the mouth of the patient followed by the bucket, and the. attached long, narrow, flexible, conduit tube, by means of which the bucket'and mass below it are pro elled through the esophagus and stomach to the distal end of the stomach'known as the pylorus.

the duodenum, assisted by gravity. The terminal mass draws the bucket afterit until the bucket reaches the approximate location ofth'e opening of the pancreatic and common bile ducts into the duodenum,its arrival at 'this pointbeing indicated by the appearance of bile at the upper end of the tube. [The upper end of the tube is then held. in place by the hand, or by some external temporary attachment, during which time the bucket is also maintained in its position by traction from below, exerted by the rounded terminal mass and its flexible couplin n r eera ty or testinal action, OI bOthLf peristaltic in- .The bucket may remain this-position as long as necessary. Thecontents of the duo-. be drained outby gentle suction num may orfsiphonage; Fluids may be injected by means of syringe for the purpose of stimulating the flow" of bile and pancreatic secretions, after which the secretions and stimu- -.lating fluids may be'drained out. Fluids may also beintroduced, with the bucket in this nutrition, or for specific medicinal purposes. After completion of the desired procedure, the bucket isw-ithdrawn by exerting gentle traction on the part of the long narrow tube outside the mouth.

. An advantageof this improved type of"ap-,

plian'ce is that it is composed of twov units,

a small, light, metal bucket and a rounded or ovoid terminalmassin which the weight of the unit is localized. This arrangement allows great ease ofentrance intothe duodenum and provides assurance of keeping the bucket in positionfollow'ing the u eef ti g Here, the rounded terminal mass becomes .engagedin the pyloric orificeand is drawn downward by theperistaltic action of g, which is held-j flating fluids, because of the following 'fea- 3 ing intestinal wall may be.

tures a flexible coupling is introduced through the tube.

The terminal rounded mass is highly mobile, easily seized upon and propelled through the stomach and duodenum towards;

its destination at the opening of the bile and pancreatic ducts by the peristaltic waves of the stomach and duodenum. This action is aided by the long, light, and flexible characterof the connecting coupling, which is of a lesser diameter than that, of the terminal I tion bycollapse or constrictlon of the intes- IIIHSS.

short, and of small diameter, is easily drawn after the rounded mass, carrying Wltli 1t the attached tube, to the duodenum, where the secretions of the are obtained. 7

The metal bucket collecting these scoretions isretained at the proper place by holding the long, narrow, flexible tube externally, which preventsthe further progress of the bucket, and by the traction exerted by the pancreas and'biliary tract rounded mass or weight and its elongated,'-

flexible coupling, which prevents'the regurgitation of the tube fromthe duodenum back into the stomach. 7 1

It will be seen from the abovethat the feature of separating the light, metal bucket from the mass weight of'the tip, is an important one, as well as the feature of connecting these parts by a highlyflexible connection allowing for substantially complete freedom of the weight to assume different positions.

Further advantages are found in the cone struction of the metal bucket itself. The shoulders make the total diameter of the bucket at its ends slightly larger than that of the long flexible rubber tube or the diameter of the elongated flexible coupling with the terminal mass. This difference in diameter is not enough to impede the progress of the bucket in either direction in the ga strointestinal canal; it is, however,suflicient to prevent the walls of the stomach or duodenum from collapsing down upon the four slots in the bucket. This collapsing would make impossible the flow of fluidsthrough the slots into the long, flexible tubing and create a vacuum which would prevent movement of the bucket. These shoulders or en: largements constitute guards to protect the slots against closure. I

The grooves in the shoulders provide for the free in-flow and outflow of fluids from above or below the bucket through the slots, into or out from the long,

The terminal rounded mass at theend of.

The metal bucket, being light in weight;

.spirit of the invention. V. V It will be understood that Where parts in 1 shown in Fig.

ing from being flexible tube, re-

gardless' of how constricting the surround,

A further advantage of these grooves is that they prevent the formation of avacuum between thetwo shoulders,-in cases of a constricted intestinal wall, with the subsequent necessary immobility of the bucket.

' An advantage in the construction of the slots is that they are long enough, and have a width almost as great as the'lumen of the tinal wall. v

' The coupling connection for the ball consistinof a thin, narrow, flexible member of greater flexibility thanthat of the long, flexi eil ex ending to the mouth, is an advantage in the adaptation of th t i L,

mass toirregular or roundedsurfaoes and to-theopening of the pyloric orifice.

i Except as maybe interpreted from the apqpen'ded claims, the

not limited to the forms or characteristicsv of the elements described and scopetofi the invention is shown herein, certain ofthe-- features being susceptible to modification without one form'can be used in the other form, they are to be regarded as existing in said other form. Thus the swivel connection in Fig. 4

may be substituted for the'coupling member lfor holding the ball weight.

I claim: I 1. An appliance of the class described, comprising a flexible conduit tubeand anattached bucket mcmbenprovided with'an openingin its wall, and with means at opposite ends of the opening to guard said open- 1ng against closure from the wall of the cavity in which, the bucket is located- 2. In anappliance of the class described, a flexible conduit tube,a bucket member attached thereto having anopening through its wall and an enlarged portionat each side of said opening to guard the same against closure from the collapsed wall of the cavity in I which the bucket is located.

3. An appliance of the class described, comprising a flexible conduit tube and an atdeparting; from" the tached bucket member provided with an 7 opening in its wall, and with means to guard saidopening against closure from the wall of the cavity in which the bucket is located, said guard means having a channel or space leading to the said opening, to prevent said openplaced out of service. i

J 4i. An appliance of the class described'comprising a flexible conduit tube and a bucket ends of said bucket, which ends provide bearings to prevent closure of said opening by 'a collapsed wall of the cavityin which said bucket is located.

5. An appliance of the class described com- I prising a flexible conduit tube and a bucket "attached thereto, substantially circular in.

member attached thereto having an opening in its wall for the passage o'f fiuid, said open comprising a flexlble condu1t tube, a bucket ing being depressed in relation to the end portions of the bucket, whereby saidends guard the opening'against closure from a collapsed wall of the cavity in which the bucketis located.

6. An appliance of the class described, comprising a flexible conduit tube and a bucket attached thereto, said bucket having its wall intermediate its relatively larger end portions depressed relative to said end portions and perforated, and a channel extending through said relatively larger end portions and communicating with the perforation for the passage of fluid between said channeland the interior of the bucket and conduit tube, said channel opening to the outside of the bucket and guarded by the end portion against closure by a collapsed wall of the' cavity in which the bucket is located.

7. An appliance according to claim 6 in which the slot and channel extend longitudinally of the bucket;

' 8. An appliance of the class described comprising a flexible conduit tube, and a bucket cross section and concaved on its exterior lengthwise with a slot intermediate its end portions, and with achannel through the end portion connecting with the slot and communicating with the outside to prevent closure of communication through the slot to the interior ofthe bucket and the tube, substantially as described.

'9'. An appliance of the class described comprising a flexible conduit tube with a passage associated tlierewitliioi' the flow of fluid to or from the outside oi said tube at or near one end thereof, and a leader weight member spaced apart from that end of said tube with which said passage is associated, and'a flexible connection between said weight member and the said end portion of said tube, substantially as described.

10. An appliance according to claim 9'in which said weight member is rounded on its outer surface. I

11. An appliance according to claim 9 in which the leader weight is of larger transverse dimension than the thickness of the flexible connection.

12. An appliance accordingto claim 9 in whichthe leader weight is substantially in the form of a ball, substantially as described. 13. An appliance according to claim 9 in which the flexible connection allows the weight member to have movement about its.

axis.

1 4. An appliance according to claim 9 in which the. flexible connection includes a swivel joint for allowing the weight member to turn about its axis. 7

15. An appliance according to claim 9 in which the flexible connection has a swivel joint between itself and the tubular conduit.

16.'An appliance of the class described comprisin a flexible conduit tube, and an attached bucket member having an opening in its wall, said'bucket member being pros vided with wall portions in outstanding relation in respect to said opening to guard it against closure by which the bucket is located.

18. An appliance of the class described comprising a bucket member having an end wall provided Wltll a pro1ectionfor the attachment ofa flexible memberg the end wall being of greater diameter than the flexible member tobe attached to the projection, said endwall at one side of the projection having an opening communicating with the interior of the bucket. f v

19. An appliance of the class described,

the wall of the cavity in comprising a flexible conduit tube and anattached bucket member having an opening in its wall to one side of the flexible conduit tube and av second openlng in its end communicating with the first named opening to prevent complete closure of the first named opening in the event that a portion of the wall of the cavity in whlch the bucket is located overlies the first named opening.

-20. An appliance of the class-described,

comprising a flexible conduit-tube and anat:

tached bucket member PIOViClGClQ with a lateral opening and with guard means to prevent closure oi said opening by the wall of the cavity in which the bucket is located, said guard means having an aperture which opens. at the endjof the bucket and communicates with said lateral opening to provide access to thelateral opening in the event that a portion of the wall of the cavity in which the bucket is located overliesthe lateral opening.

In testimony whereof, I affix my signature.

JOHN RUSSELL TWISS.

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