SURGICAL IRRIGATION APPARATUS AND METHOD OF USING SAME

• US 3,677,248 A
• Filed: 08/27/1970
• Issued: 07/18/1972
• Est. Priority Date: 08/27/1970
• Status: Expired due to Term

• Current Assignee: Kendall Mcgraw Laboratories Incorporated
• Original Assignee: Charles J. Mcphee
• Inventors: McPhee, Charles J.
• Primary Examiner(s): Gaudet, Richard A.
• Assistant Examiner(s): Yasko, J.
• Application Number:
  US05/067,375
• Time in Patent Office: 691 Days
• Field of Search: 128/227,228,213,214,272,275,DIG.12,DIG.13 137/123-127,602-607 222/129,145,416 141/311,319-323,285
• US Class Current: 604/500
• CPC Class Codes: A61M 2205/7536 allowing gas passage, but preventing liquid passage, e.g. liquophobic, hydrophobic, water-repellent membranes
• CPC Class Codes: A61M 2210/1078 Urinary tract
• CPC Class Codes: A61M 3/0216 Pressure
• CPC Class Codes: A61M 3/022 Volume; Flow rate
• CPC Class Codes: A61M 3/0241 the liquid being supplied by gravity
• CPC Class Codes: A61M 5/36 with means for eliminating or preventing injection or infusion of air into body dialysis systems, blood oxygenators A61M1/14; haemofiltration equipment A61M1/34; automatic tube cut-off A61M39/281
• CPC Class Codes: Y10T 137/274 From plural tanks

Abstract

Apparatus for delivering large quantities of sterile medical liquid at both a fast flow rate and a low pressure to a resectoscope used by a physician in performing prostate surgery. Each of several 2-liter bottles suspended above the patient has an outlet tube providing for simultaneous concurrent flow of liquid and air between the bottle and an air trap chamber of the apparatus. In the process of maintaining a constant supply of bubble-free liquid to the resectoscope for flushing out blood and tissue, any randomly selected bottle of the apparatus that becomes empty can be disconnected from its outlet tube and replaced with a full bottle without disrupting the liquid supply to the air trap chamber from any other bottle of the apparatus.

Claims

1. A substantially free-fall, gravity-feed surgical irrigation apparatus comprising:

a plurality of liquid-containing bottles with outlet ports adapted to be randomly-selected and supported above an irrigation site or discharged and replaced without interferring with irrigation procedures;

a flexible outlet tube for each bottle with upper ends of these outlet tubes connected to the respective outlet ports, each of the outlet tubes including means defining a passage sufficiently large in cross sectional area from its upper end to its lower end for permitting substantially simultaneous counter-current flow of liquid and air at approximately atmospheric pressure during free-fall of liquid therethrough during a surgical irrigation procedure;

an enlarged air trap chamber having an inlet structure at its top in directflow communication with lower ends of the outlet tubes and having an outlet port at its bottom, said air trap chamber having a size and capacity and free communication between the inlet structure and outlet port permitting free discharge of a randomly selected filled bottle to be inverted and the entire contents to be freely discharged thereinto at the hydrostatic head developed at the outlet port of the inverted bottle;

means operatively connected to said air trap chamber and said bottles for permitting a liquid-air interface to form in said air trap chamber as liquid is permitted to freely discharge from said said outlet port while liquid and air are flowing counter-currently in said flexible outlet tube; and

a flexible drain tube connected to the drain port and which includes a longitudinal passage therethrough to a lower end of the drain tube, said drain tube having a cross sectional area for permitting free-fall liquid to be directed at a low pressure and high volume without entrapped air bubbles to the irrigation site, each bottle through its outlet tube having means providing its own independently operating liquid-air interchange system with the air trap chamber, and any bottle being operable to Continue to supply liquid to the air trap chamber while any other randomly selected bottle of the apparatus that becomes empty is replaced by a filled bottle.

2. Surgical irrigation apparatus as set forth in claim 1, wherein the apparatus has a separate valve for opening and closing the passage of each outlet tube, and has a valve for opening and closing the passage of the drain tube.

3. Surgical irrigation apparatus as set forth in claim 1, wherein the drain tube'"'"''"'"'s passage is approximately the same size as each outlet tube passage and has a constriction adjacent its lower end, whereby the drain tube can run full of liquid to deliver large volumes of liquid at low pressure to the irrigation site without intermittant slugs of air.

4. Surgical irrigation apparatus as set forth in claim 1, wherein the drain tube has an elastic sleeve at its lower end adapted to stretch over and grip a medical instrument.

5. Surgical irrigation apparatus as set forth in claim 1, wherein the bottles are of rigid glass.

6. Surgical irrigation apparatus as set forth in claim 1, wherein each bottle has semirigid thermoplastic walls capable of storing energy by temporarily bending inwardly as liquid drains from the bottle and thereafter springing outwardly to suck air back into the bottle.

7. Surgical irrigation apparatus as set forth in claim 1, wherein each bottle has a mouth, and the apparatus includes a removable closure fitting across this mouth and having first and second ports through the closure;

the upper end of the bottle'"'"''"'"'s flexible outlet tube being secured to the closure at its first port; and

means secured to the closure at the second port for admitting air into the bottle and preventing liquid exit from the bottle through the second port when the bottle is suspended in a mouth downward position.

8. Surgical irrigation apparatus as set forth in claim 7, wherein the means for admitting air is a hydrophobic filter which establishes a hydrostatic head at approximately the level of the filter so the hydrostatic head is generally constant regardless of the liquid level in the bottle.

9. Surgical irrigation apparatus comprising:

a plurality of liquid-containing bottles with outlet ports adapted to be supported above an irrigation site;

a flexible outlet tube for each bottle with upper ends of these outlet tubes connected to the outlet ports, each of the outlet tubes defining a passage sufficiently large in cross sectional area from its upper end to its lower end for simultaneous concurrent flow of liquid and air at approximately atmospheric pressure;

an enlarged air trap chamber having an inlet structure at its top in flow communication with lower ends of the outlet tubes and having an outlet port at its bottom; and

a flexible drain tube connected to this drain port and which includes a longitudinal passage therethrough to a lower end of the drain tube for directing liquid to the irrigation site, whereby each bottle through its outlet tube has its own independently operating liquid-air interchange system with the air trap chamber, and any bottle can continue to supply liquid to the air trap chamber while any other randomly selected bottle of the apparatus that becomes empty is replaced by a filled bottle, the apparatus having an air opening to the atmosphere in the air trap chamber adjacent its top for assisting in air removal from the air trap chamber, and a check valve closing off the air opening, said check valve permits air but not liquid to flow outwardly through the air opening and prevents both air and liquid from flow into the air trap chamber through the air opening.

10. Surgical irrigation apparatus as set forth in claim 1, wherein the air trap chamber has a top cap with a separate inlet port connected to each outlet tube.

11. Surgical irrigation apparatus as set forth in claim 1, wherein the air trap chamber has a transparent cylindrical wall that is volumetrically calibrated.

12. Surgical irrigation apparatus as set forth in claim 1, wherein each outleT tube has a passage with a diameter between 0.150 and 0.400 inch.

13. Surgical irrigation apparatus as set forth in claim 1, wherein the air trap chamber has an internal pressure that is between 90 and 120 percent of the atmospheric pressure outside the air trap chamber when liquid is being supplied to the air trap chamber.

14. In surgical irrigation apparatus including a plurality of liquid containers each with an outlet connected to a downwardly extending flexible tube that has a lower end, the improvement of:

an enlarged air trap chamber with an inlet structure in flow communication with the lower ends of the outlet tubes, the air trap chamber having an air opening to the atmosphere adjacent a top of the chamber and has a drain port adjacent its bottom; and

a check valve secured across the air opening, which check valve permits air but not liquid to flow outwardly through the air opening, while preventing both air and liquid from flowing inwardly through the air opening.

15. The improvement in surgical irrigation apparatus as set forth in claim 14, wherein the check valve comprises the combination of a flap valve with inner and outer ends, and a hydrophobic filter connected with the inner end of the flap valve.

16. An assembly for use in surgical irrigation apparatus including a plurality of liquid-containing bottles having mouths, which assembly includes:

a plurality of closures with portions for connecting with the bottle mouths, said closures including a liquid outlet port through the closure;

removable sterility protectors fitting over said portions of the closures;

a flexible outlet tube connected at its upper end to the outlet port of each closure, each of the outlet tubes including means defining a passage sufficiently large in cross-sectional area from its upper end to its lower end for simultaneous counter-current flow of liquid and air at approximately atmospheric pressure during free gravity-flow of liquid therethrough;

an enlarged air trap chamber having an inlet structure at its top in direct-flow communication with the lower ends of the outlet tubs and having a drain port at its bottom, said air trap chamber having a size and capacity and free communication between the inlet structure and outlet port for permitting free discharge of a randomly selected filled bottle to be inverted and the en-contents to be freely discharged therein at the hydrostatic head developed at the outlet port of the bottles to which said closures have been attached;

means operatively connected to said closures and said air trap chamber for permitting a liquid air interface to form in said air trap chamber as liquid is permitted to freely discharge from said outlet port while liquid and air are flowing counter-courently in said flexible outlet tube;

a flexible drain tube connected to this drain port and having a passage of sufficient capacity for permitting liquid to freely fall therethrough at low pressure and high volume without entrapped air bubbles for directing liquid from its lower end to an irrigation site; and

a removable protector housing fitted over a lower end of the drain tube, each outlet tube is adapted to provide an independent air-liquid interchange system between a bottle and the air trap chamber.

17. Surgical irrigation apparatus comprising:

a plurality of liquid-containing bottles, each with a mouth and adapted to be suspended in a mouth-downward position above an irrigation site with the liquid freely flowing therefrom under the force of gravity;

a removable closure fitting across the mouth of each bottle and having first and second ports therethrough;

through;

a flexible outlet tube with an upper end connected to the first port of each respective closure, each outlet tube including means having a lower end and a passage between its ends sufficiently large in cross-sectional area for simultaneous counter-current flow of liquid and air at approximately atmospheric pressure;

a pinch clamp on each outlet tube for opening and closing its passaGe;

a hydrophobic filter fitting across the second port of the closure to admit air into the bottle and to prevent liquid exit from the bottle through the second port when the bottle is suspended in a mouth downward position, said bottles developing a hydrostatic head substantially at said filter when liquid is permitted to freely fall from the bottles;

an enlarged air trap chamber including a transparent cylinderical housing, an upper cap secured to a top of the housing and having a separate inlet port in communication in communication with each outlet tube'"'"''"'"'s lower end, and a lower cap secured secured to a bottom of the housing and having a drain port therethrough;

means operatively connected to said air trap chamber developing a liquid-air interface therein when liquid in permitted to freely drain from the air trap chamber, each bottle through its tube forming an independent liquid-air interchange system with the air trap chamber, and any randomly-selected bottle and its system continuing to function after any other bottle of the apparatus becomes empty and is replaced by a filled bottle;

a flexible drain tube connected at its upper end to the drain port of the air trap chamber'"'"''"'"'s bottom cap, and having a passage between its upper and lower ends that is approximately the same size as each outlet tube passage for permitting liquid to freely flow therethrough at a low pressure and high volume without entrapped bubbles; and

adaptor with a constricted opening connected to the drain tubes lower end, said adapter having a cross section so the drain tube can run full of liquid to deliver large volumes of liquid at low pressure to the irrigation site without intermittant slugs of air;

an elastic sleeve secured to the adapter for stretching over and gripping to a medical instrument; and

a removable protector housing fitting over the elastic sleeve.

18. A method of surgical irrigation for continuously supplying a substantially air-free liquid to an irrigation site when effecting a '"'"''"'"''"'"''"'"'Transurethral Resection'"'"''"'"''"'"''"'"' or similar surgical procedure at a low pressure and large volume, comprising the steps of:

A. filling a plurality of containers with an irrigation liquid;

B. independently connecting each of the filled bottles to an an enlarged air chamber through independent outlet tubes and permitting air and liquid flowing therethrough to have counter-current flow therethrough as a filled bottle is emptied into air chamber;

C. connecting the air trap chamber to a drain tube for permitting liquid to drain therethrough at a low pressure and high volume without entrapped air bubbles therein;

D. randomly selecting two or more of the filled bottles, suspending the same in a discharge attitude above an irrigation site;

E. emptying one of the suspended bottles into the air trap chamber while starting to empty another of the suspended bottles into the chamber before the first is completely empty so that liquid for irrigation is uninterrupted;

F. continuing to discharge liquid into the air trap chamber at a hydrostatic head developed at the bottle being discharged while replacing the emptied bottle with one that is filled; and

G. effecting the discharge of liquid through the air trap chamber while maintaining an air liquid interface in said air trap chamber during free gravity flow of liquid therethrough.

19. A method of surgical irrigation as set forth in claim 18 wherein there are four liquid containing bottles and four outlet tubes leading between the bottles and the air trap chamber, and the method includes the step of completely emptying any two randomly selected bottles and then disconnecting and replacing them with filled bottles while liquid is supplied to the air trap chamber by at least one of the other two bottles.