PIVOTING LARYNGOSCOPE HAVING A POWER-DRIVEN CURVED SPATULA

Abstract: A pivoting laryngoscope (1) having a power-driven curved spatula, used for performing intubation of patients under anesthesia or in resuscitation, comprising a handle part (2) and a spatula part (3), equipped with power means, power-feeding means and transmission means present in the handle part, which allow the spatula-part (3) to be movable in a radial direction with respect to a fulcrum (33) within a predetermined arc, in order to vary its curvature. The laryngoscope (1) is equipped with a guide (42) through which the operator inserts a cannula (40) for intubation in the patient's mouth, directing it to the desired point through the larynx and trachea, to the lungs, employing means for lighting the path of the cannula.

Description: Pivoting laryngoscope having a power-driven curved spatula. -a 5 The present invention concerns a surgical instrument, specifically a pivoting laryngoscope having a power-driven, curved spatula, used for performing intubation of patients under anesthesia or in resuscitation. As it is known, before performing 10 surgery, it is necessary to anesthesize the patient. Anesthesia is obtained through drugs which work to completely suspend pain sensitivity in a temporary and reversible way; the anesthetic effect, generally obtained by using alcaloid drugs and nuscle relaxants, affects the brain, the cerebellum, the spinal cord 15 and the peripheral nervous system in general , and is furthermore accompanied by a paralysis of the respiratory centers, variable only in intensity and duration exclusively through the use of different drugs. It is well known that prolongued 20 paralysis of respiratory centers, causes brain damage and, in cases where the duration of the drugs' effect has extended itself beyond a given amount of time, death from asfyxia. In surgical practice, when the patient undergoes anesthesia, artificial respiration is given by means 25 of external machinery specifically designed for this purpose, after having connected the patient to the same through cannulae and tubes. Connecting the patient to the machine requires a significant amount of manual maneuvers, generally executed by the anesthesiologist, which in medical practice are known as 30 "intubation", consisting of the introduction of a tube or cannula through the mouth, the larynx and trachea to the lungs, the tube being then connected to the respiratory machinery. In order to understand the problem, it must be taken into account that the above-described maneuver must be executed with means and within a time frame defined by the progressive paralyzing effect upon the respiratory centers generally brought about through alcaloid anesthetics and muscle relaxants or other similar drugs, therefore, the duration of the intubation process cannot extend itself beyond a generally brief and definite time frame, also because of the mechanical difficulties inherent to the introduction of the cannula of tube. Usually, in order to execute the intubation maneuver, the anesthesiologist uses a mechanical instrument, typically a spatula-tube mounted at a right angle on a handle, of the same type as that which is used to execute laryngoscopies, bronchioscopies or esophagoscopies. Said instrument having been introduced in the patient's mouth, the anesthesiologist reaches, by means of the spatula, the base of the toungue and the laryngeal wall of the epiglottis and with a quick pivoting movement straightens the spatula-tube into an almost vertical position, and then, with small, slow motions, introduces the cannula along the laryngeal cavity. The manner of execution of this maneuver, as traditionally executed and with the known instruments, presents some inconveniences. First of all, it must be noted how t maneuver needs to be executed by pivotally moving the cannula- guiding instrument, in order that the lowering of the toungue and the dental arch allows the cannula to travel along the medial line of the trachea in an axis as direct as possible to the point of introduction, that is, the mouth. Such a pivoting movement, is obviously not obtainable by using an instrument having the cannula-guiding spatula placed at a right angle to the handle; similarly, a curved spatula does not resolve the problem since such a curve, being permanently set, could not be adapted to the multiple positions which are produced by the rotation of the head and the neck in various situations. With this purpose it must be taken into account that the intubation maneuver operator frequently operates on patients having acquired pathologies, such as cervical arthrosis or andibular anchylosis, or having congenital deformities such as acroglossis (overdevelopment of the toungue) or "bull neck", which make it extremely difficult, if not impossible, to introduce an intubation cannula guided by an instrument which depends on its being pivoted only through the rotation of the patient's head; such rotation being limited or impeded in the aforementioned cases. Another inconvenience is that during the introduction of the cannula, the anesthesiologist does not have means for seeing inside the larynx and generally along the entire path which the cannula travels. In view a what is said above, this invention has been made with the purpose of allowing intubation of a patient before surgery, regardless of the shape of the patient's neck and toungue, or despite the presence of pahologies which impede complete movement of the head and neck. It is significant that, in order to achieve complete success of the anesthesysing action and, as a consequence, the possibility of connecting the patient to external machinery for artificial respiration or for other purposes, by means of the instrument which is the object of this invention, the introduction of the cannula is gretly facilitated and sped-up, giving the possibility of adapting the cannula guiding instrument to the shape of the involved anatomic parts of the patient. An additional purpose is to include in the instrument means for an illuminated laryngoscopy during the intubation maneuvers. These and further purposes are achieved by the invention, by means of a pivoting laryngoscope having a power-driven curved spatula, particularly useful1 for performing intubation of patients under anesthesia or in resuscitation, characterised by comprising: - a grip-handle for holding which houses the power means, operating means and power feeding means, as well as notion transmitting parts from said power means to a curved spatula connected to them, constituting their performing extension. - a curved spatula part, typically flattened, subdivided into a number of adjacent sections, the last of which having at one end a circular section ending, and which sections receive movenent from transmission parts present in the handle, which allow the spatula part to be moveable in a radial direction, with respect to a fulcrum, defined within a pre-determined arc. To achieve a better understanding of the present invention, a description of the preferred embodiment follows , it being understood that it is purely for the purpose of exemplification and is non-limitative to the invention, with reference to the enclosed drawings, in which: fig. 1, shows a schematic view of the laryngoscope in operating position, fig. 2, is a lateral perspective of the laryngoscope indicating the movement of the spatula part and the outline of the path of the sheaf of optical fibers. fig. 3, is a lateral perspective of the laryngoscope as viewed from the side opposite that described above. fig. 4, is a view of the laryngoscope in which the handle part is open to allow viewing of the internal members. fig. 5, is a detailed view of the open spatula part. Referring in particular to figures 2, 3 and 4, it is therein indicated in its whole a pivoting laryngoscope 1 with a curved motorized spatula, specifically for performing intubation in patients under anesthesia or in resuscitation. The device essentially comprises a hollow handle, in its whole indicated with 2, a substantially rectangular section 2A, presenting a central portion 20, serving to permit holding, having an inferior ending with a larger section portion 22 and a superior ending with abnother portion 21 symetrical to 22, from which departs a power-driven curved spatula part 3; the power means 5 of said curved spatula part 3, are housed inside the bottom portion 22 of the handle 2, and, in the embodiment shown as an example, consist of a small electric motor 15 fed by a direct current by means of two rechargeable batteries 14 and 14A, present in the central portion 20, in the inferior portion 22, in a position opposite that of the small motor 15, the operating means 23 and 24 of the same are found. From the group of power means 5, through the central portion 20 of the handle part 2, transmission means generically indicated with 6, transmit the movement to a curved spatula part 3 connected and dependent upon the superior portion 21, of which it constitutes a performing extention. The curved spatula 3, typically flattened, subdivided into " a number of adjacent sections 30, 31, 32 each respectively consisting of a curved blade, carries the performing organs of the rotation respectively indicated by 11, 12, 13, said performing organs receive motion from the power means 5, through the group of transmission means 6 present in the handle part 2, by means of the combined rotation of sections 30, 31, 32 determines a progressive pivoting of the blade portions, so as to enact a radial mobility, with respect to a fulcrum 33, which allows the entire spatula part 3 to be variably positioned at different angles and, simultaneously, allows the ensemble of blade sections 30, 31, 32 to take on an adjustable and reversible curvature which is predetermined within the extreme positions A and B. More specifically, the handle part 2, in its hollow inferior part 22, houses the power means 5, to which is connected one end of a small transmission shaft 16, having at its opposite ending a screw segment 17, which in turn has a projection 36 inside a tubular tang 8, having a lead screw, which is moveable and connected to the group of motion transmission organs 6 to the three blade sections 30, 31, 32. Said small transmission shaft 16, placed inside the central part 20 of the handle part 2, in conjunction with the power-feeding means (4), during operation causes the tubular tang 8, located in the superior portion 21 of the handle part 20, as it travels from C to Cl, to activate the motion of the transmission organs consisting of an elbow plate 9, having its fulcrum in 18 and hinged on 35 and 37, respectively on the tubular tang and on a shaft 19, hinged on 38, said shaft 19 is in turn hinged on a second extension shaft 29 which is hinged on it's opposite end to 39 with the performing part 13, imparting the entire apparatus described above with movement in the direction 34, to elements 11 and 12, directly connected to the blade sections 31 and 32 of the spatula part 3. Referring in particular to fig. 5, it is noted that elements 10, 11 and 12, integral parts of adjacent sections 30, 31 and 32 of spatula part 3, substantially consisting of two pairs of plates 42/42a and 43/43a, having a semicircular shape and each respectively having a radial ring- shaped groove 25 and 27 and a radial ring-shaped ledge 26 and 28, which perfectly fit in each other and, in use, rotate upon each other, thereby allowing the respective adjacent sections 31 and 32 of the spatula part ot take on various positions contained within the arc A-B, thus varying the pivoting of the spatula part group, said group having its fulcrum at point 33, without needing to adjust the curvature of the spatula, unless the operator desires to do so. Element 12, placed upon blade section 32, has a terminal end in which are present illumination means 13 cc aisting of one or more illuminated elements of a known type s. ivated thr- ' "-. a switch 23 found in the inferior potion of the handle 2 an --d by rechargeable batteries 14 and 14a, and in addition in ._ ' . terminal end are located the openings 44 of a channel 41 carrying a system of optical fibers for transmitting analog or numerical signals, substantially to achieve, by means of a pilot circuit not depicted in the drawing, the emission of corresponding optical impulses to be transformed into electrical signals which can then be amplified, equalized and decoded. In one variation of the construction, a semiconductor laser- sheaf of a known type can be inserted through the channel 41, into which it is entered through a special housing 43, by employing a special type of connection plug as in 45, and can be led through the channel to one or more exit openings 44 of element 13. Another alternative which employs the above-described arrangement, could allow for the use of semiconductor devices which use spontaneous emission of the type known as luminous diodes or LED - Light Emitting Diodes. The laryngoscope which is the object of the invention as described above, during use (see fig. 1), allows the user, for example and generically, an anesthesiologist, once he is holding the instrument by section 20 of handle 2, to introduce the spatula blade 3 in the patient's mouth, to reach the base of the toungue and the laryngeal plate of the epiglottis and to progressively adapt the position of the spatula blade 3 through the motorized pivoting movement that the instrument allows. The range of positions and of curvatures obtainable from the spatula-blade 3, with respect to the handle 2, is, in any case, of an extent large enough to make the use of the instrument effective under any conditions in which mechanical, muscular or articular difficulties, in the patient's head, mouth or neck are encountered. Such efficiency during use allows, when using the instrument according to the invention, to introduce an intubation cannula 40 for connection to respiratory equipment of for equivalent medical purposes, not shown in the drawings, by making said cannula travel " along a guide which follows a path 42 determined by an area, substantially an L, formed by the group of elements 10, 11,12 with respect to the position of the blade sections 30,31,32, allowing the possibility of guiding the cannula up to the point of arrival, through the larynx, the trachea to the lungs by means of the illumination means 13 or of LEDs, or to carry out an exploration by employing image transmission systems carried by an optical fiber system or, alternatively, by employing the possibilities afforded by a laser sheaf.

Claims: CLAIMS 1 - Pivoting laryngoscope having a power- driven curved spatula, particularly used for performing intubation in patients under anesthesia or in resuscitation, characterised by comprising: - a handle for gripping (2) which houses the power means (5), power feeding means (4) and operating means (24) for the motorization, as well as motion transmitting organs (6) of said motorization to acurved spatula (3) therewith connected and of which it constitutes the performing extension. - a curved spatula part (3), typically flattened, subdivided into a number of adjacent sections (30), (31), (32) the last of which (32) presenting a circular section at its terminal ending, said spatula part (3) receiving motion from transmission parts (6) present in the handle (2), allowing the spatula part (3) in itself to be moveable in a radial direction with respect to a fulcrum (33), said mobility defined within a predetermined arc. 2 - A pivoting laryngoscope having a power-driven curved spatula, according to claim 1, characterised in that the handle (2) is hollow, with a rectangular section and presenting a central portion (20) which permit its being held or gripped; having in kits inferior end a larger section portion (22) and in its superior end a symmetrical section portion (21) . 3 - A pivoting laryngoscope having a power-driven curved spatula, according to claim 1, characterised in that its power means (5) consist of a small electric motor of a known type, fed by a direct current by means of two rechargeable batteries (14) and (14A). 4 - A pivoting laryngoscope having a power-driven curved spatula, according to claims 1 and 2 characterised within the handle (2) there are present operating means (24) of the small motor (15) which allow the transmission parts (6) to transmit motion to the spatula-part (3) assembly. 5 - A pivoting laryngoscope having a power-driven curved spatula, according to claim 1 characterised in that the combined rotation of sections (11) (12), determines a progressive pivoting of the blade portions (30) (31) (32) as an ensemble, thereby obtaining a combined curvature, adjustable and reversible, which can be made to take on a range of positions comprised between A and B. 6 - A pivoting laryngoscope having a power-driven curved spatula, according to claims 1, 3 and 4, characterised in that the motor means are connected to an ending of a screw segment (15), having a projection (36) inside a tubular tang (8) stroking from C to Cl and setting in motion trasmission members. 7 - A pivoting laryngoscope having a power-driven curved spatula, according to claims 1, 3, 4, 6, characterised in that the motion transmitting means (6) acting between the power means (5) and the blade sections (31) (32) consist of an elbow plate (9) connected to a first shaft (19) which is in turn connected to a second extension shaft (29) in order that the assembly (5, 6, 9, 19, 29) imparts motion in the direction (34), by means of elements (11) and (12). 8 - A pivoting laryngoscope having a power-driven curved spatula, according to claims 1, 3, 4, 6, 7 characterised in that parts (10) (11) (12) are integral parts of the adjacent blade sections (30) (31) (32) and consist of two pairs of plates (42, 42A) and (43, 43A) having a semicircular shape, which respectively present a radial ring-shaped groove (25, 27) and a radial ring-shaped ledge (26, 28), each groove perfectly fitting into its respective ledge; the entire assembly as described and claimed above being able to adjust the pivoting of the spatula part (3) into a range of positions comprised within the arc A-B. 9 - A pivoting laryngoscope having a power-driven curved spatula, according to claims 1 to 8 characterised in that the performing part (12) placed upon blade section (32) is provided with a terminal ending in which illumination means (13) and the openings (4) for an optical fiber system or laser sheaf are present. 10 - A pivoting laryngoscope having a power- driven curved spatula, according to claim 9, characterised in that illumination means (13) present at the terminal end of the performing part (12) consisting of a number of illuminated parts of a known type fed by rechargeable batteries (14 and ' 14A) present in the handle (2) and activated by a switch (23) also present in the handle. 11 - A pivoting laryngoscope having a power- driven curved spatula, according to claim 9, characterised in that the illumination means (13) present in the terminal end of the performing part (12) consist of semiconductor devices which employ spontaneous light emission of the type known as luminous diodes or LEDs - Light Emitting Devices. 12 - A pivoting laryngoscope having a power- driven curved spatula, according to claims 1 to 11 characterised in that along a channel (41), into which it is entered through a special housing (43), by means of a common type of connection plug (45), a semiconductor laser sheaf of a known tyupe is led towards the exit openings (44) present in elelment 13. 13 - A pivoting laryngoscope having a power-driven curved spatula, according to any of the foregoing claims, characterised in that the same is provided with a guide following a path (42) which is substantially L-shaped, whch derives from the assembly of elements (10) (11) (12) orthogonal to blade sections (30) (31) (32) the later having a greater width and therefore having a section lenght - in a figurative sense the base of the L-figure - through which a cannula (40) for intubation of patients can be drived, said cannula being connected to respiration machines or for equivalent medical uses. 14 - A pivoting laryngoscope having a power- driven curved spatula.,, according to any of the foregoing claims characterised in that the cannula (40) introduced along the L- shaped guide into the patient's mouth, can be directed up to the point of arrival through the larynx, the trachea, up to the lungs with the illumination means (13) or by LEDs and with the possibility of carrying out an exploration by employing optical fiber image transmission systems.

Inventors: VALENTI ELIO, VALENTI, ELIO
Applicants: VALENTI ELIO, VALENTI, ELIO
Application year: 1992
Main classification: A61B1
IPC codes: A61B1, A61B17