Abstract:
A hybrid introducer and its use are provided. In one form, a method includes one or more of the following steps: feeding a guidewire through a hybrid introducer into a scope, the hybrid introducer including a proximal thumb advance portion and a distal tapered portion coupled to the proximal thumb advance portion; removing the proximal thumb advance portion; and feeding an accessory instrument through the distal tapered portion into the scope.

Description:
FIELD 
       [0001]    The present disclosure relates to a medical device. More specifically, the present disclosure relates to the use of a hybrid introducer for inserting a guidewire into an endoscope. 
       BACKGROUND 
       [0002]    The statements in this section merely provide background information related to the present disclosure and may or may not constitute prior art. 
         [0003]    In certain medical procedures, a guidewire is inserted into an endoscope, and the tip of the guidewire is advanced to a particular location of interest in a patient&#39;s body. A sheath or catheter is slid over the guidewire, and the guidewire is subsequently withdrawn. After the guidewire is withdrawn, an accessory instrument is inserted through the sheath or catheter and advanced to the location of interest so that a physician can perform a desired medical procedure. 
         [0004]    Among the literature that can pertain to this technology include the following patent documents and published patent applications: US 2007/0270892, U.S. Pat. No. 5,282,479, U.S. Pat. No. 5,263,938, and U.S. Pat. No. 5,980,492, all incorporated by reference for all purposes. 
         [0005]    The guidewire is typically advanced or retracted with the use of a guidewire introducer. With certain introducers, there is a risk of the guidewire touching the ground and becoming contaminated before it is inserted into the patient. With other types of introducers, the advancement mechanism makes it difficult to feed other devices through the endoscope. 
         [0006]    Accordingly, there is a need for effective and improved guidewire introducers. 
       SUMMARY 
       [0007]    The present disclosure provides an improved hybrid introducer and a method of using the hybrid introducer. In one aspect, the present disclosure provides a method including one or more of the following steps: feeding a guidewire through a hybrid introducer into a scope, the hybrid introducer including a proximal thumb advance portion and a distal tapered portion coupled to the proximal thumb advance portion; removing the proximal thumb advance portion; and feeding an accessory instrument through the distal tapered portion into the scope. 
         [0008]    The invention may be further characterized by one or any combination of the features described herein, such as: removing the proximal thumb advance portion includes decoupling the proximal thumb advance portion from the distal tapered portion; the distal tapered portion is coupled to the proximal thumb advance portion with a snap fit mechanism or a screw mechanism; the scope is an endoscope; advancing a distal end of the guidewire to a desired location in a patient&#39;s body as the guidewire is being fed through the hybrid introducer; imaging the guidewire in the patient&#39;s body to determine if the distal end of the guidewire is at the desired location; imaging the guidewire includes generating an x-ray image of the guidewire in the patient&#39;s body; feeding a second endoscope over the guidewire; removing the proximal thumb advance portion of the hybrid introducer and feeding an accessory instrument through the distal tapered portion of the hybrid introducer into the second endoscope; removing the guidewire prior to feeding the accessory instrument through the distal tapered portion; the accessory instrument is an optical fiber; the accessory instrument is a retrieval basket; a distal end of the guidewire is a J-shaped end and the hybrid introducer has a passageway that straightens the J-shaped end. 
         [0009]    Accordingly, pursuant to another aspect of the invention, there is contemplated a method including one or more of the following steps: feeding a guidewire through a hybrid introducer into a first endoscope, the hybrid introducer including a proximal thumb advance portion and a distal tapered portion coupled to the proximal thumb advance portion; advancing a distal end of the guidewire to a desired location in a patient&#39;s body and exchanging the first endoscope with a second endoscope; removing the proximal thumb advance portion from the hybrid introducer; attaching the distal tapered portion to the second endoscope; removing the guidewire; feeding an accessory instrument through the distal tapered portion into the endoscope; and advancing the accessory instrument through the second endoscope to the desired location. 
         [0010]    Further features, advantages, and areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. 
     
    
     
       DRAWINGS 
         [0011]    The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way. The components in the figures are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention. Moreover, in the figures, like reference numerals designate corresponding parts throughout the views. In the drawings: 
           [0012]      FIG. 1  is a side view of a hybrid introducer in accordance with the principles of the present invention; 
           [0013]      FIG. 2  is an perspective view of the hybrid introducer with a guidewire contained in a protective tube; 
           [0014]      FIG. 3  is a partial top view of the hybrid introducer; 
           [0015]      FIG. 4  is a close-up expanded view of the hybrid introducer with a tapered portion that couples to a thumb advance portion with a screw mechanism in accordance with the principles of the present invention; 
           [0016]      FIG. 5  is a close-up expand view of the hybrid introducer with the tapered portion that couples to the thumb advance portion with a snap fit mechanism in accordance with the principles of the present invention; 
           [0017]      FIG. 6  is a flow diagram showing a process of using the hybrid introducer in accordance with the principles of the present invention; and 
           [0018]      FIG. 7  is a close-up view of the hybrid introducer employed with an endoscope. 
       
    
    
     DETAILED DESCRIPTION 
       [0019]    The following description is merely exemplary in nature and is not intended to limit the present disclosure, application, or uses. 
         [0020]    Referring now to the drawings, a hybrid introducer embodying the principles of the present invention is illustrated in  FIG. 1  and designated at  10 . The hybrid introducer  10  includes a proximal thumb advance portion  12  coupled to a distal tapered portion  14 . The proximal advance portion  12  includes an extension  17  and a top region  18  that facilitates a user, such as, a physician, to hold and manipulate the hybrid introducer  10 . Specifically, the user would typically wrap his/her index finger partially around the extension  17  while placing his/her digit, such as, a thumb, on the top region  18 . 
         [0021]    Referring further to  FIG. 3 , the top region  18  includes an opening  26  to provide access to a guidewire  22 . Hence, the opening  26  allows the physician to use his/her thumb to advance or retract the guidewire in the hybrid introducer  10 . 
         [0022]    As shown in  FIG. 2 , a proximal region  16  of the hybrid introducer is affixed or coupled to a distal end of a protective tube  20 , made of, for example, plastic. The guidewire  22  extends through the tube  20 , the thumb advance portion  12  and the tapered portion  14 . The distal end of the guidewire  22  may have a J-shaped distal end  24 . As such, as the guidewire  22  is passed through the tube  20  and the tube advance portion  12 , the guidewire  22  is straightened through the thumb advance portion  12 . As the guidewire  22  is further advanced through the thumb advance portion  12 , the guidewire  22  exits the tapered portion  14 . As the guidewire  22  exits the tapered portion  14 , the distal end of the guidewire  22  returns back to its preformed J-shaped end  24 . 
         [0023]    The distal tapered portion  14  can be coupled and de-coupled from the thumb advance portion  12  with any suitable mechanism. For example, as shown in  FIG. 4 , the thumb advance portion  12  can include a proximal region  30  with threads  32 , and the tapered portion  14  can include matting threads  34 . With such a configuration, the threads  32  and the matting threads  34  form a screw mechanism  100  that facilitates screwing and unscrewing the tapered potion  14  onto and from the thumb advance portion  12 . 
         [0024]    In another arrangement, the proximal region  30  includes a flared region  36  that couples to a bore region  38  of the tapered portion  14  to a form a snap fit mechanism  200  that facilitates coupling and de-coupling the tapered portion  14  to and from the thumb advance portion  12 . 
         [0025]    When the hybrid introducer  10  is in use, the hybrid introducer is typically employed in conjunction with a scope  400 , as shown in  FIG. 7 . The scope can be, for example, an endoscope, such as a cystoscope, a colonoscope, or an ureteroscope. In the arrangement shown in  FIG. 7 , the scope  400  includes a raised portion  401  with a connector  402 . The connector  402  may have outer threads that thread into inner threads of an adapter  404  to a seal  406  to the endoscope  400 . Both the adapter  404  and the connector  402  have inner passageways so that the guidewire  22  can pass through the adapter  404  and the connector  402  into the endoscope  400  when the tapered portion  14  of the hybrid introducer  10  is inserted into the seal  406 . 
         [0026]    A further aspect of the disclosure provides a method  300  of using the hybrid introducer  10  in conjunction with the endoscope  400 , as illustrated in the block diagram shown in  FIG. 6 . The method  300  includes a step  302  of feeding the guidewire  22  through the hybrid introducer  10  into the endoscope  400 . The thumb advance portion  12  may be de-coupled from the tapered portion  14 , with the screw mechanism  100  ( FIG. 4 ) or the snap fit mechanism  200  ( FIG. 5 ) described earlier, and removed in a step  304 , and an accessory instrument may be fed through the tapered portion  14  into the endoscope  400 . 
         [0027]    In various arrangements, the physician can advance the distal end, for example, the J-shape end  24 , of the guidewire  22  to a desired location in a patient&#39;s body as the guidewire  22  is being fed through the hybrid introducer  10 . Imaging, such as, x-ray imaging, can be employed to determine if the distal end  24  of the guidewire  22  is at the desired location. The initial endoscope can be removed and a second endoscope, such as, for example, a cystoscope, a colonoscope, or an ureteroscope, can be fed over the guidewire  22 . The thumb advance portion  12  can then be removed and an accessory instrument can be fed through the distal tapered portion  14  into the second endoscope. 
         [0028]    With either the first or the second endoscope, the guidewire  22  may be removed prior to feeding the accessory instrument through the distal tapered portion  14 . In various arrangements, the accessory instrument is an optical fiber or a retrieval basket. 
         [0029]    The description of the invention is merely exemplary in nature and variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.