Colonic overtube

• US 6,793,621 B2
• Filed: 03/08/2002
• Issued: 09/21/2004
• Est. Priority Date: 03/08/2001
• Status: Expired due to Fees

• Current Assignee: Atropos Limited
• Original Assignee: Atropos Limited
• Inventors: Gill, Aoibheann, Brennan, Edmund, Bonadio, Frank, Butler, John
• Primary Examiner(s): Leubecker, John P.
• Application Number:
  US10/092,528
• Publication Number:
  US 20020147385A1
• Time in Patent Office: 928 Days
• Field of Search: 600/114, 600/121, 600/101, 600/115, 604/524, 604/526, 604/527
• US Class Current: 600/114
• CPC Class Codes: A61B 1/00078 with stiffening means
• CPC Class Codes: A61B 1/00137 End pieces at either end of the endoscope, e.g. caps, seals or forceps plugs
• CPC Class Codes: A61B 1/00154 using guiding arrangements for insertion
• CPC Class Codes: A61B 1/31 for the rectum, e.g. proctoscopes, sigmoidoscopes , colonoscopes
• CPC Class Codes: A61M 2210/1064 Large intestine
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence

Abstract

A colonic overtube 1 for maintaining a sigmoid colon in a straightened configuration has a proximal end 2 for location externally of a colon, and a distal end 3 for insertion into a colon. A colonoscope lumen 4 extends through the overtube 1 to facilitate passing the overtube 1 over a colonoscope. The overtube 1 has a convoluted corrugation 5 which extends along the entire length of the overtube 1 from the proximal end 2 to the distal end 3. The corrugated configuration of the overtube 1 provides the overtube 1 with laterally flexibility so that the overtube 1 may flex substantially without kinking during advancement of the overtube 1 through a colon. A flexible seal, in the form of a tubular silicone sheath 6 of film material, is provided at the distal end 3 of the overtube 1 for sealing between the overtube 1 and a colonoscope extending through the colonoscope lumen 4. The flexible nature of the seal 6 enables the seal 6 to adapt itself to the size of the colonoscope extending through the colonoscope lumen 4 to achieve a secure, effective seal between the overtube 1 and a colonoscope regardless of the colonoscope size.

Claims

1. A colonic overtube for maintaining a section of a colon in a straightened configuration, the overtube having a proximal end for location externally of a colon, and a distal end for insertion into a colon, and a colonoscope lumen extending therethrough for passing the overtube over a colonoscope;

the overtube comprising a flexible seal at the distal end for sealing between the overtube and a colonoscope extending through the colonoscope lumen;

the seal being mounted to an exterior surface of the overtube, and the seal extending inwardly to seal between the overtube and a colonoscope extending through the colonoscope lumen.

2. An overtube as claimed in claim 1 wherein;

at least portion of the overtube is laterally flexible to facilitate flexing of the overtube substantially without kinking during advancement of the overtube through a colon.

3. An overtube as claimed in claim 1 wherein the laterally flexible portion of the overtube extends along the entire length of the overtube.

4. An overtube as claimed in claim 1 wherein the overtube has more than one laterally flexible portion spaced along the overtube.

5. An overtube as claimed in claim 1 wherein the laterally flexible portion is provided by at least one corrugation.

6. An overtube as claimed in claim 5 wherein the corrugation extends along the overtube in a convoluted manner.

7. An overtube as claimed in claim 5 wherein the corrugation extends at least partially circumferentially around the overtube.

8. An overtube as claimed in claim 5 wherein the overtube comprises a plurality of corrugations.

9. An overtube as claimed in claim 5 wherein the corrugation is provided on an interior surface of the overtube.

10. An overtube as claimed in claim 1 wherein an exterior surface of the overtube is smooth.

11. An overtube as claimed in claim 1 wherein the overtube comprises a coating of a lubricious material.

12. An overtube as claimed in claim 1 wherein the overtube comprises a composite material.

13. An overtube as claimed in claim 12 wherein the overtube is of a layered construction.

14. An overtube as claimed in claim 12 wherein the overtube comprises a reinforcement means element.

15. An overtube as claimed in claim 14 wherein the reinforcement means element is embedded in the overtube.

16. An overtube as claimed in claim 14 wherein the reinforcement means element comprises a coil.

17. An overtube as claimed in claim 14 wherein the reinforcement means element comprises a mesh.

18. An overtube as claimed in claim 14 wherein the reinforcement element is of a braided construction.

19. An overtube as claimed in claim 14 wherein the reinforcement element is of a metallic material.

20. An overtube as claimed in claim 1 wherein the seal comprises a film material.

21. An overtube as claimed in claim 20 wherein the seal comprises a sheath of film material.

22. An overtube as claimed in claim 1 wherein the seal comprises an inner sealing layer and an outer sealing layer around the inner sealing layer.

23. An overtube as claimed in claim 1 wherein the seal extends distally of the distal end of the overtube.

24. An overtube as claimed in claim 1 wherein the overtube is of a material which is thermally stable in use.

25. An overtube as claimed in claim 24 wherein the overtube is of polytetrafluoroethylene.

26. An overtube as claimed in claim 1 wherein the overtube is extendable between a shortened configuration and an elongated configuration for cannulating at least portion of a colon.

27. An overtube as claimed in claim 26 wherein in the shortened configuration at least portion of the overtube is retracted in a concertina-like manner.

28. An overtube as claimed in claim 26 wherein the overtube comprises a plurality of overtube sections which are movable relative to one another to extend the overtube to the elongated configuration.

29. An overtube as claimed in claim 26 wherein the overtube comprises an actuator to extend the overtube in situ to the elongated configuration.

30. An overtube as claimed in claim 29 wherein the actuator may be activated from externally of a colon.

31. An overtube as claimed in claim 30 wherein the actuator comprises a connector for extending from the overtube within a colon to a location externally of the colon.

32. An overtube as claimed in claim 31 wherein the connector extends from the distal end of the overtube.

33. An overtube as claimed in claim 31 wherein the connector is anchored to the overtube.

34. An overtube as claimed in claim 31 wherein the connector comprises a drawstring.

35. An overtube as claimed in claim 34 wherein the drawstring is configured to be looped through a working channel of a colonoscope to a location externally of a colonoscope.

36. An overtube as claimed in claim 1 wherein the overtube comprises a rounded tip at the distal end for atraumatic advancement of the overtube through a colon.

37. An overtube as claimed in claim 36 wherein the tip is mounted to the overtube.

38. An overtube as claimed in claim 37 wherein the tip is mounted to an exterior surface of the overtube.

39. An overtube as claimed in claim 38 wherein the tip extends around the distal end of the overtube at least partially into the colonoscope lumen.

40. An overtube as claimed in claim 1 wherein the overtube comprises at least one exchange lumen for exchange of fluid and/or a medical device through the lumen.

41. An overtube as claimed in claim 40 wherein the overtube comprises means to view a colon distally of the overtube, the viewing means being at least partially provided in the exchange lumen.

42. An overtube as claimed in claim 40 wherein the overtube comprises means to insufflate a colon, the exchange lumen providing an insufflation channel.

43. An overtube as claimed in claim 40 wherein the overtube comprises means to flush a colon, the exchange lumen providing a flushing channel.

44. An overtube as claimed in claim 40 wherein the overtube comprises means to illuminate a colon, the illumination means being at least partially provided in the exchange lumen.

45. An overtube as claimed in claim 1 wherein the overtube comprises a limiting element to prevent complete insertion of the overtube into a colon.

46. An overtube as claimed in claim 45 wherein the position of the limiting element on the overtube is adjustable.

47. An overtube as claimed in claim 45 wherein the limiting element is releasably mounted to the overtube.

48. An overtube as claimed in claim 47 wherein the limiting element is threadably mounted to the overtube.

49. An overtube as claimed in claim 45 wherein the limiting element comprises a flange.

50. An overtube as claimed in claim 1 wherein the overtube has a discontinuous interior surface for ease of passage of the overtube over a colonoscope.

51. An overtube as claimed in claim 50 wherein the overtube comprises one or more inwardly projecting elements on the interior surface for contacting a colonoscope.

52. An overtube as claimed in claim 51 wherein the projecting element comprises a corrugation.

53. An overtube as claimed in claim 52 wherein the projecting element extends longitudinally along the overtube.

54. An overtube as claimed in claim 52 wherein the projecting element extends at least partially circumferentially around the overtube.

55. An overtube as claimed in claim 52 wherein the projecting element extends along the overtube in a convoluted manner.

56. An overtube as claimed in claim 51 wherein the projecting element comprises a protruding strip.

57. An overtube as claimed in claim 51 wherein the projecting element comprises a plurality of discrete protrusions.

58. A method of performing a colonoscopy procedure, the method comprising the steps of:

inserting a colonoscope into a colon and advancing the colonoscope through at least part of the colon;

straightening a section of the colon;

advancing a colonic overtube over the colonoscope to maintain the section of the colon in a straightened configuration;

advancing the colonoscope to a point distally of the straightened section of colon; and

advancing the overtube over the colonoscope to a point distally of the straightened section of colon by extending the overtube from a shortened configuration to an elongated configuration.

59. A method as claimed in claim 58 wherein the method comprises the step of withdrawing the colonoscope from the colon while the overtube remains in place in the colon.

60. A method as claimed in claim 59 wherein the method comprises the step of advancing a medical device through the overtube to access a point in the colon distally of the straightened section of colon.

62. A method as claimed in claim 58 wherein the overtube is advanced by pushing the overtube from externally of the colon.

63. A method as claimed in claim 58 wherein the section of colon being straightened is the sigmoid colon.

64. A method as claimed in claim 58 wherein the overtube is advanced to a point distally of the descending colon.

61. A method as claimed in 58 wherein the method comprises the step of mounting the overtube to the colonoscope before inserting the colonoscope into the colon.

65. A colonic overtube for maintaining a section of a colon in a straightened configuration, the overtube having a proximal end for location externally of a colon, and a distal end for insertion into a colon, and a colonoscope lumen extending therethrough for passing the overtube over a colonoscope;

the overtube comprising a flexible seal at the distal end for sealing between the overtube and a colonoscope extending through the colonoscope lumen;

the seal comprising an inner sealing layer and an outer sealing layer around the inner sealing layer.

66. A colonic overtube having a proximal end for location externally of a colon, a distal end for insertion into a colon, and a colonoscope lumen extending therethrough for passing the overtube over a colonoscope:

the overtube being extendable between a shortened configuration and an elongated configuration for cannulating at least portion of a colon;

the overtube comprising an actuator to extend the overtube in situ to the elongated configuration;

the actuator being activatable from externally of a colon;

the actuator comprising a connector for extending from the overtube within a colon to a location externally of the colon;

the connector comprising a drawstring.

67. An overtube as claimed in claim 66 wherein in the shortened configuration at least portion of the overtube is retracted in a concertina-like manner.

68. An overtube as claimed in claim 66 wherein the overtube comprises a plurality of overtube sections which are movable relative to one another to extend the overtube to the elongated configuration.

69. An overtube as claimed in claim 66 wherein the connector extends from the distal end of the overtube.

70. An overtube as claimed in claim 66 wherein the connector is anchored to the overtube.

71. An overtube as claimed in claim 66 wherein the drawstring is configured to be looped through a working channel of a colonoscope to a location externally of a colonoscope.