Percutaneous access device having removable turret assembly

• US 5,833,655 A
• Filed: 05/15/1997
• Issued: 11/10/1998
• Est. Priority Date: 05/15/1997
• Status: Expired due to Term

• Current Assignee: L3 Technologies, Inc. (L3Harris Technologies, Inc.)
• Original Assignee: L3 Technologies, Inc. (L3Harris Technologies, Inc.)
• Inventors: Kantrowitz, Adrian, Freed, Paul S., Taro, George
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US08/856,905
• Time in Patent Office: 544 Days
• Field of Search: 604/93, 604/174, 604/175, 128/DIG. 26
• US Class Current: 604/93.01
• CPC Class Codes: A61M 2039/0267 comprising sensors or electrical contacts
• CPC Class Codes: A61M 2039/0282 with implanted tubes connected to the port
• CPC Class Codes: A61M 2039/0294 having a specific shape matching the shape of a tool to be inserted therein, e.g. for easy introduction, for sealing purposes, guide
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053
• CPC Class Codes: A61M 60/139 inside the aorta, e.g. intra-aortic balloon pumps
• CPC Class Codes: A61M 60/295 Balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/497 for balloon pumps for circulatory assistance
• CPC Class Codes: A61M 60/88 Percutaneous cables

Abstract

A percutaneous access device implantable beneath the skin of a patient which includes a housing having a flange positionable beneath the skin and neck projecting outward through the skin. The percutaneous access device includes electrical communication through the flange and fluid access through the flange. The components providing fluid access and electrical communication are removable through the neck portion of the implant for testing and service as required without the need for further surgery on the patient. A turret body is received within the hollow interior of the neck having a fluid channel extending therethrough and containing current limiting devices securely disposed within the turret body.

Claims

1. A percutaneous access device for implantation within a patient having at least a portion projecting outwardly through a skin of the patient comprising:

housing means for defining at least one chamber, the housing means having a flange portion positionable beneath the skin of the patient and an outwardly extending neck portion disposable passing through the skin of the patient;

at least one fluid conduit means and at least one electrical conduit means, each conduit means for communicating from an external position with respect to the patient to an internal position with respect to the patient, each of the conduit means passing through the neck portion and flange portion of the housing and in communication with the at least one chamber defined by the housing means; and

means for externally removing at least a portion of each of the conduit means through the neck portion of the housing means.

2. The percutaneous access device of claim 1 wherein the means for externally removing further comprises:

a turret engageable through the neck to complementarily seat with respect to the chamber defined by the housing means.

3. The percutaneous access device of claim 2 wherein the turret further comprises:

means disposed within the turret for limiting current passing from the external position with respect to the patient to the internal position with respect to the patient.

18. The percutaneous access device of claim 3 wherein the current limiting means further comprises:

at least one current limiter operably disposed in electrical communication with current passing through the electrical conduit means, the current limiter removable with the turret for maintenance and testing.

4. A percutaneous access device for implantation within a patient having at least a portion projecting outwardly though a skin of the patient comprising:

housing means for defining at least one chamber, the housing means including a flange body having an upper wall orientatable toward the skin of the patient and a lower wall opposed to the upper wall, the upper and lower wall defining the at least one chamber in a central interior region, the flange body further having a first passage in communication between the at least one chamber in the central interior region and the exterior of the flange body, and a second passage extending external to the housing from the at least one chamber, a neck integrally formed with the upper wall of the flange body and projecting outward therefrom, the neck defining at least in part the chamber within the central interior region, the chamber having an internal surface, the neck terminating in an end region projectable above the outer surface of the skin of the patient, the end region having an outer end opening opposed to the lower wall of the flange body;

means for electrically communicating from a position external with respect to the patient to a position internal with respect to the patient, the electrical communicating means passing through the flange body and having at least one electrically conductive conduit associated therewith;

means for fluidly communicating from the position external with respect to the patient to the position internal with respect to the patient, the fluid communicating means passing through the interior region in the flange body and having at least one fluid conduit associated therewith; and

means for removably positioning at least one of the fluid communicating means and the electrical communicating means within the housing means.

5. The percutaneous access device of claim 4 wherein the removable positioning means further comprises:

an elongated turret body matingly receivable within the neck, the turret body having an outer side surface, a central bore extending longitudinally therethrough, and a lateral bore extending from the outer side surface and terminating in communication with the central bore, the lateral bore positioned in the turret body in an orientation sufficient to provide fluid communication between the central bore and the fluid conduit located in the flange; and

means for removably securing the turret body within the housing.

6. The percutaneous access device of claim 5 wherein the securing means further comprises:

a threaded screw sealingly engageable through an aperture located in an end of the turret body opposing the lower wall of the housing means; and

a replaceable mounting flange locatable on the lower wall of the housing means, the mounting flange having an internally threaded aperture for matingly receiving the threaded screw therein.

7. The percutaneous access device of claim 4 wherein the electrical communicating means further comprises:

at least one wire terminal fitting maintained in position in the flange body of the housing means, the wire terminal fitting accessible through the outer end opening of the neck;

at least one means for limiting electrical current to the wire terminal fitting;

means for removably maintaining the current limiting means in position within the neck of the housing means; and

at least one ring contact in removable contact with the current limiting means.

8. The percutaneous access device of claim 7 wherein the removable maintaining means further comprises:

a turret body constructed of an electrically insulating material, the turret body matingly received with respect to the internal surface of the neck, the turret body having an outer side surface engageable with the internal surface of the neck and having an end surface opposing the lower wall of the flange body of the housing means, the turret body further defining a sleeve having pockets to removably receive the current limiting means therein; and

a threaded screw engageable through the end wall of the turret body and releasably connectible with the lower wall of the housing means.

9. The percutaneous access device of claim 7 further comprising:

a spring contact interposed between the wire terminating fitting and flexibly contacting the current limiting means;

a replaceable mounting flange connectible to the lower wall of the flange body of the housing means, the mounting flange having a internally threaded aperture adapted to matingly receive the threaded screw therein; and

a gasket disposed between the lower wall of the flange body of the housing means and the turret body to seal the fluid communicating means, the gasket generally coplanar with and extending outward from the mounting flange, the gasket having an opening conforming to allow electrical connection of said electrical current limiting means to the wire terminating fitting.

10. The percutaneous access device of claim 7 wherein the electrical communicating means further comprises:

a resilient insulator having a central aperture, the resilient insulator in overlying contact with the ring contact, the aperture of the resilient insulator essentially coaxial with respect to the aperture of the ring contact;

an electrically conductive contact washer having a central aperture, the contact washer overlying the resilient insulator with the respective apertures coaxially disposed;

an electrically conductive ball contact disposed within and projecting outward from the respective apertures in the ring contact, resilient insulator and the contact washer; and

an insulative ball cap disposed over the electrically conductive ball contact, the insulative ball cap having at least one opening providing access to the ball contact.

11. A percutaneous access device for implantation within a patient having at least a portion projecting outwardly through a skin of the patient comprising:

a housing for implantation beneath the skin of the patient such that a portion of the housing projects outwardly though the skin, the outwardly projecting portion defining an interior region and an opening providing access thereto, the opening located in the outwardly projecting portion of the housing;

a turret subassembly removably contained in the housing, the turret subassembly removable through the opening in the outwardly projecting portion of the housing subassembly; and

at least one fluid conduit means and at least one electrical conduit means, each conduit means for communicating from an external position with respect to the patient to an internal position with respect to the patient, each of the conduit means passing through the turret subassembly and the housing.

19. The percutaneous access device of claim 11 wherein the turret subassembly further comprises:

means disposed within the turret subassembly for limiting current passing through the electrical conduit means from the external position with respect to the patient to the internal position with respect to the patient.

20. The percutaneous access device of claim 19 wherein the current limiting means further comprises:

at least one current limiter operably disposed in electrical communication with current passing through the electrical conduit means, the current limiter removable with the turret subassembly for maintenance and testing.

12. A percutaneous access device for implantation within a patient having at least a portion projecting outwardly through a skin of the patient comprising:

a housing for implantation beneath the skin of the patient such that a portion of the housing projects outwardly though the skin, the outwardly protecting portion defining an interior region and an opening providing access thereto, the opening located in the outwardly projecting portion of the housing; and

a turret subassembly removably contained in the housing, the turret subassembly removable through the opening in the outwardly projecting portion of the housing subassembly, wherein the turret subassembly further comprises;

a turret body constructed of an electrically insulative material, the turret body having an upper face, a lower face, an internally threaded central shaft extending inward from the upper face, and at least one current limiter compartment;

means for limiting electrical current passing through the percutaneous access device from a position external with respect to the patient to a position internal with respect to the patient, the current limiting means contained within the current limiter compartment, the current limiting means having at least one lead extending outward from the current limiter compartment; and

an electrically conductive ball contact having an outwardly threaded extension, the outwardly threaded extension threadingly receivable within the internally threaded central shaft in the turret body.

13. The percutaneous access device of claim 12 wherein the turret subassembly further comprises:

an electrically conductive contact ring overlying the upper face of the turret body and interposed between the turret body and the ball contact, the contact ring having a central opening, the central opening coaxially positioned relative to the threaded central shaft in the turret body;

a resilient insulator having a central opening, the central opening coaxially positioned relative to the threaded central shaft in the turret body;

an electrically conductive contact washer interposed between the ball contact and the resilient insulator, the electrically conductive contact washer coaxially positioned relative to the contact ring and insulator.

14. The percutaneous access device of claim 13 further comprising:

the turret body having a laterally extending bore positioned in the turret body in an orientation sufficient to provide gaseous fluid communication between the threaded central bore and an aperture located in the housing means; and

means for removably securing the turret body in the housing means.

15. The percutaneous access device of claim 14 wherein the removable securing means further comprises:

a threaded screw engageable through the lower face of the turret body and removably secured to an inner surface of the housing means.

16. A percutaneous access for implantation within a patient having at least a portion projecting outwardly through a skin of the patient comprising:

a housing for implantation beneath the skin of the patient such that a portion of the housing projects outwardly though the skin, the outwardly projecting portion defining an interior region and an opening providing access thereto, the opening located in the outwardly projecting portion of the housing wherein the housing means further comprises;

a flange body implantable beneath the skin of a patient, the flange body having an upper wall adapted to be oriented toward the skin of the patient and a lower wall opposed to the upper wall, the upper and lower wall defining a chamber in a central interior region, the flange body further having a first passage communicating between the chamber and a position internal with respect to the patient, and a second passage communicating between the chamber and a position external with respect to the patient;

a neck integrally formed with the upper wall of the flange body and projecting outward therefrom, the neck having an essentially hollow interior with an essentially uniform inner diameter, the neck terminating in an end region, the neck having sufficient height to project the end region above the outer surface of the skin of the patient when the housing means is implanted therein, the end region having an outer end opening opposed to the lower wall of the flange body; and

a turret subassembly removably contained in the housing, the turret subassembly removable through the opening in the outwardly projecting portion of the housing subassembly.

17. The percutaneous access device of claim 16 wherein the housing means further comprises:

at least one wire terminal fitting maintained in position in the flange body of the housing, the wire terminal fitting accessible through the outer end opening of the neck;

an interior flange mounted on the lower wall of the flange body of the implantable housing means, the interior flange including means for removably securing the turret subassembly thereto; and

a gasket in contact with the lower wall of the flange body of the housing subassembly, the gasket coplanar with and extending outward from the interior flange, the gasket having an opening conforming to the lower wall and receiving the wire terminal fitting.