Apparatus and methods for minimizing peritoneal injection catheter obstruction

• US 4,559,033 A
• Filed: 08/12/1983
• Issued: 12/17/1985
• Est. Priority Date: 10/27/1980
• Status: Expired due to Fees

• Current Assignee: University of Utah Research Foundation Salt Lake City Utah
• Original Assignee: University of Utah Research Foundation (State of Utah)
• Inventors: Jacobsen, Stephen C., Hanover, Barry K., Stephen, Robert L., Harrow, Jeffrey J., Kablitz, Carl
• Primary Examiner(s): Rosenbaum, C. Fred
• Assistant Examiner(s): Costantino, Mario
• Application Number:
  US06/522,907
• Time in Patent Office: 858 Days
• Field of Search: 604/8-10, 604/29, 604/49, 604/48, 604/50, 604/51, 604/73, 604/93, 604/117, 604/132, 604/174, 604/175, 604/181, 604/185, 604/246, 604/891, 604/265.6, 604/267, 128/1 R
• US Class Current: 604/502
• CPC Class Codes: A61M 39/0208 Subcutaneous access sites for injecting or removing fluids transcutaneous access sites A61M39/0247; implantable infusion devices A61M5/14276

Abstract

The present invention is directed to subcutaneous peritoneal injection catheters and methods which minimize catheter obstruction during use. The apparatus includes a receiving chamber or reservoir having a relatively small internal volume while employing a penetrable membrane and relatively enlarged target surface area. The reservoir is interconnected with the peritoneal cavity by a hollow stem. The penetrable membrane accommodates a hollow needle being inserted into the receiving reservoir and is configurated with a dome-like profile so that the membrane may also be depressed to expel insulin from the receiving reservoir into the peritoneal cavity in a direction generally toward the mesenteric peritoneal membrane.

The distal end of the hollow stem (which is situated inside the peritoneal cavity), is constructed so as to minimize the likelihood of catheter obstruction during use by a patient. For example, in one presently preferred embodiment of the invention, the distal end of the stem is provided with two, parallel, diametrally enlarged flanges. The two flanges are unequal in size, and they are positioned on the stem such that the larger flange resides against the peritoneal membrane and the smaller flange is located immediately adjacent the distal opening of the stem. In addition, an antibacterial agent may be placed within the device, and the device may also be formed of or coated with a substance which inhibits body cell and bacterial growth.

Claims

1. A subcutaneously implantable injection conduit for injecting a drug into a peritoneal cavity, comprising:

a hollow receptacle for receiving the drug, the hollow receptacle having a penetrable portion;

a hollow stem having a proximal end and a distal end, the proximal end of the stem being attached to the receptacle such that the stem forms a passageway extending from the chamber;

a first substantially diametrally enlarged flange attached to the stem such that, when the conduit is implanted under a layer of skin adjacent the peritoneal cavity and the first flange is secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem is positioned within the peritoneal catheter; and

structural means for inhibiting cell growth which would inhibit flow through the hollow stem comprising a second substantially rigid, diametrically enlarged flange attached to the stem within the peritoneal cavity.

2. A subcutaneously implantable injection conduit as defined in claim 1 wherein the structural means for inhibiting cell growth comprises a second diametrally enlarged flange, said second flange being attached to the stem in spaced relationship with the first flange.

3. A subcutaneously implantable injection conduit as defined in claim 2 wherein the second flange is substantially parallel to the first flange.

4. A subcutaneously implantable injection conduit as defined in claim 2 wherein the second flange is attached adjacent the distal end of the hollow stem.

5. A subcutaneously implantable injection conduit as defined in claim 2 wherein the second flange is diametrally smaller than the first flange.

6. A subcutaneously implantable injection conduit as defined in claim 2 wherein the second flange is substantially the same size as the first flange.

7. A subcutaneously implantable injection conduit as defined in claim 1 wherein the structural means for inhibiting cell growth comprises:

a tube having a proximal end and a distal end, said tube being secured within the hollow stem such that the proximal end of the tube lies within the passageway and the distal end of the tube protrudes from the distal end of the hollow stem; and

a second diametrally enlarged flange attached adjacent the distal end of the tube so as to be in spaced relationship with the first flange.

8. A subcutaneously implantable injection conduit as defined in claim 7 wherein the second flange is diametrally smaller than the first flange.

9. A subcutaneously implantable injection conduit as defined in claim 1 wherein the structural means for inhibiting cell growth comprises a diametrally enlarged solid disc having spacing members attached to one side thereof, said spacing members also being attached to the first flange such that the first flange and the disc form a circumferential opening which communicates with the passageway.

10. A subcutaneously implantable injection conduit as defined in claim 9 wherein the spacing members are configurated as narrow strips, each of which is attached along a radius of the disc.

11. A subcutaneously implantable injection conduit as defined in claim 9 wherein a portion of the disc which is in direct line with the passageway is frangible, such that said frangible portion may be broken out of the disc by means of a rigid instrument inserted through the passageway.

12. A subcutaneously implantable injection conduit as defined in claim 11 wherein the frangible portion is substantially circular in shape.

19. A subcutaneously implantable injection conduit as defined in claim 1 further comprising a cellulicidal material for suppressing cell growth covering at least a part of the hollow receptacle and the hollow stem.

20. A subcutaneously implantable injection conduit as defined in claim 19 wherein the cellulicidal material covers at least a portion of the interior surface of the hollow receptacle and the hollow stem.

21. A subcutaneously implantable injection conduit as defined in claim 20 wherein the cellulicidal material is silver.

22. A subcutaneously implantable injection conduit as defined in claim 20 wherein the cellulicidal material is platinum-silver.

23. A subcutaneously implantable injection conduit as defined in claim 20 wherein the cellulicidal material is copper.

24. A subcutaneously implantable injection conduit as defined in claim 19 wherein the conduit is formed of a plastic material and wherein the cellulicidal material is dispersed within the plastic.

25. A subcutaneously implantable injection conduit as defined in claim 24 wherein the cellulicidal material is silver.

13. A subcutaneously implantable injection conduit for injecting a drug into a peritoneal cavity, comprising:

a hollow receptacle for receiving the drug, the hollow receptacle having a penetrable portion;

a hollow stem having a proximal end and a distal end, the proximal end of the stem being attached to the receptacle such that the stem forms a passageway extending from the chamber;

a first diametrally enlarged flange attached to the stem such that, when the conduit is implanted under a layer of skin adjacent the peritoneal cavity and the first flange is secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem is positioned within the peritoneal cavity; and

a cellulicidal material covering at least a portion of the injection conduit for inhibiting cell growth which would inhibit flow through the hollow stem.

14. A subcutaneously implantable injection conduit as defined in claim 13 wherein the cellulicidal material is silver.

15. A subcutaneously implantable injection conduit as defined in claim 13 wherein the cellulicidal material is platinum-silver.

16. A subcutaneously implantable injection conduit as defined in claim 13 wherein the cellulicidal material is copper.

17. A subcutaneously implantable injection conduit as defined in claim 13 wherein the conduit is formed of a plastic material and wherein the cellulicidal material is dispersed within the plastic.

18. A subcutaneously implantable injection conduit as defined in claim 17 wherein the cellulicidal material is silver.

26. A subcutaneously implantable injection conduit for injecting a drug into a peritoneal cavity, comprising:

a hollow receptacle for receiving the drug, the hollow receptacle having a penetrable portion;

a hollow stem having a proximal end and a distal end, the proximal end of the stem being attached to the receptacle such that the stem forms a passageway extending from the chamber;

a first diametrally enlarged flange attached to the stem such that, when the conduit is implanted under a layer of skin adjacent the peritoneal cavity and the first flange is secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem is directed toward the mesenteric peritoneal membrane; and

a cellulicidal material for inhibiting cell growth covering at least a part of the hollow receptacle and the hollow stem.

27. A subcutaneously implantable injection conduit as defined in claim 26 wherein the cellulicidal material covers at least a portion of the interior surface of the hollow receptacle and the hollow stem.

28. A subcutaneously implantable injection conduit as defined in claim 27 wherein the cellulicidal material is silver.

29. A subcutaneously implantable injection conduit as defined in claim 27 wherein the cellulicidal material is platinum-silver.

30. A subcutaneously implantable injection conduit as defined in claim 27 wherein the cellulicidal material is copper.

31. A subcutaneously implantable injection conduit as defined in claim 26 wherein the conduit is formed of a plastic material and wherein the cellulicidal material is dispersed within the plastic.

32. A subcutaneously implantable injection conduit as defined in claim 31 wherein the cellulicidal material is silver.

33. A subcutaneously implantable injection conduit for injecting a drug into a peritoneal cavity, comprising:

an injection receiver having a diametrally enlarged, convergent receiving surface and an opening in the receiving surface;

a diametrally enlarged, penetrable cover across the receiving surface in spaced relationship therewith, the cover forming a receiving reservoir in combination with the receiving surface;

a hollow stem having a proximal end and a distal end, the proximal end of the stem being attached to the injection receiver such that the stem forms a passageway extending from the opening in the receiving surface, the stem having a length sufficient that the stem penetrates the parietal peritoneal membrane and extends into the peritoneal cavity;

a first substantially rigid diametrally enlarged flange attached to the stem such that, when the conduit is implanted under a layer of skin adjacent the peritoneal cavity and the first flange is secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem is directed toward the mesenteric peritoneal membrane; and

structural means adjacent the distal end of the hollow stem for preventing obstruction of the passageway comprising a second substantially rigid, diametrically enlarged flange attached to the stem within the peritoneal cavity.

34. A subcutaneously implantable injection conduit as defined in claim 33 wherein the obstruction preventing means comprises a second diametrally enlarged flange, said second flange being attached to the stem in spaced relationship with the first flange.

35. A subcutaneously implantable injection conduit as defined in claim 34 wherein the second flange is substantially parallel to the first flange.

36. A subcutaneously implantable injection conduit as defined in claim 35 wherein the second flange is attached adjacent the distal end of the hollow stem.

37. A subcutaneously implantable injection conduit as defined in claim 36 wherein at least a portion of the injection conduit is formed of a cellulicidal material.

38. A subcutaneously implantable injection conduit as defined in claim 37 wherein the cellulicidal material is silver.

39. A subcutaneously implantable injection conduit as defined in claim 37 wherein the cellulicidal material is platinum-silver.

40. A subcutaneously implantable injection conduit as defined in claim 37 wherein the cellulicidal material is copper.

41. A subcutaneously implantable injection conduit as defined in claim 36 wherein the conduit is formed of a plastic material which has a cellulicidal material dispersed therein.

42. A subcutaneously implantable injection conduit as defined in claim 41 wherein the cellulicidal material is silver.

43. A subcutaneously implantable injection conduit as defined in claim 33 wherein the obstruction preventing means comprises a diametrally enlarged disc having spacing members attached to one side thereof, said spacing members also being attached to the first flange such that the first flange and the disc form a circumferential opening which communicates with the passageway.

44. A subcutaneously implantable injection conduit as defined in claim 43 wherein the spacing members are configurated as narrow strips, each of which is attached along a radius of the disc.

45. A subcutaneously implantable injection conduit as defined in claim 44 wherein a portion of the disc which is in direct line with the passageway is frangible, such that said frangible portion may be broken out of the disc by means of a rigid instrument inserted through the passageway.

46. A subcutaneously implantable injection conduit as defined in claim 45 wherein the frangible portion is substantially circular in shape.

47. A subcutaneously implantable injection conduit as defined in claim 46 wherein at least a portion of the injection conduit is formed of a cellulicidal material.

48. A subcutaneously implantable injection conduit as defined in claim 47 wherein the cellulicidal material is silver.

49. A subcutaneously implantable injection conduit as defined in claim 47 wherein the cellulicidal material is platinum-silver.

50. A subcutaneously implantable injection conduit as defined in claim 47 wherein the cellulicidal material is copper.

51. A subcutaneously implantable injection conduit as defined in claim 46 wherein the conduit is formed of a plastic material which has a cellulicidal material dispersed therein.

52. A subcutaneously implantable injection conduit as defined in claim 51 wherein the cellulicidal material is silver.

53. A method for minimizing peritoneal injection catheter obstruction, the method comprising the steps of:

obtaining an injection conduit, comprising;

a shallow vessel with an open top;

a penetrable membrane covering the open top of the vessel;

a hollow stem having a proximal end and a distal end, the proximal end of the stem being attached to the vessel such that the stem forms a passagweway extending from the vessel; and

a diametrally enlarged flange attached to the stem such that, when the conduit is implanted underneath a layer of skin adjacent the peritoneal cavity and the flange is secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem is directed toward the mesenteric peritoneal membrane;

implanting the injection conduit underneath a layer of skin adjacent the peritoneal cavity with the membrane being generally parallel to the skin, the hollow stem penetrating the parietal peritoneal membrane and extending into the peritoneal cavity, the diametrally enlarged flange being secured adjacent the parietal peritoneal membrane, the distal end of the hollow stem being directed toward the mesenteric peritoneal membrane, and the passageway communicating between the vessel and the peritoneal cavity;

penetrating the layer of skin and the membrane with a rigid instrument such that the rigid instrument moves down the passagweway; and

pushing the rigid instrument through the distal end of the hollow stem so as to force obstructing objects away from the catheter.

54. A method for minimizing peritoneal injection catheter obstruction as defined in claim 53 wherein a portion of the injection conduit adjacent the distal end of the hollow stem is frangible and wherein the instrument pushing step is preceded by an instrument forcing step which comprises:

forcing the rigid instrument against the frangible portion of the injection conduit so as to break said frangible portion.

55. A method for minimizing peritoneal injection catheter obstruction as defined in claim 54 wherein the rigid instrument is a trocar.

56. A method for minimizing peritoneal injection catheter obstruction as defined in claim 53 wherein the injection conduit further comprises:

a diametrally enlarged disc, a portion of said disc being frangible and said disc having spacing members attached to one side thereof, said spacing members also being attached to the first flange such that the frangible portion is in direct line with the passageway and such that the first flange and the disc form a circumferential opening which communicates with the passageway;

and wherein the instrument pushing step is preceded by an instrument forcing step which comprises;

forcing the rigid instrument against the frangible portion of the disc so as to break said frangible portion.