IMPROVEMENTS IN A PROBE ADAPTED TO PROVIDE AN ISOLATED OPERATING ROOM AT THE DISTAL END OF THE OESOPHAGUS

Abstract: In a probe adapted to provide an isolated operating room at the distal end of the oesophagus for facilitating the execution, via endoscopy, of a haemostatsis and consisting of a tubular member of flexible material which connects at its distal end two bladders that are inflated to isolate the operating field from the gastric cavity and the proximal portion of the oesophagus, an improvement consisting in that, in order to avoid that the endoscope is squeezed against the walls of the oesophagus when the proximal bladder is inflated, the endoscope probe is passed inside the proximal bladder into a suitable tubular duct which is competely apart from and independent of both said bladder and the main tubular duct. Sealing means are provided in order to avoid that blood and/or the cleaning liquid can rise from the operating room through such tubular duct up to above the proximal bladder.

Description: Improvements in a probe adapted to provide an isolated operating room at the distal end of the oesophagus The present invention relates to a probe for facilitating the execution, via endoscopy, of a haemostasis (sclerosis or binding of varices) in case of bleeding of the oesophagus varices. A preceding European Patent Application 0 874 657 of the same Applicant discloses a device which can be managed by one person other than the operator using the endoscope. Such device is formed of a tubular member of flexible material which connects at its distal end two bladders that are inflated to isolate the operating field from the gastric cavity and the proximal portion of the oesophagus . According to a peculiar feature, the length of the tubular member between the two bladders is perforated. The inside of such tubular member is suitably divided into three ducts, one aspiration duct with greater diameter being connected directly to the perforated length and two smaller ducts communicating with such bladders independent of each other. In order to help the operators, the two ducts separate from the main duct at the proximal area so as to form corresponding tubular ducts smaller than the main duct, each such duct being connected to inflating or deflating means independent of each other. Such a construction allows the operation to be executed under more favourable circumstances such as : easier cleaning of the operating area from the considerable quantity of blood through the suction channel which the device is provided with; blocking of the reflux of the blood from the stomach to the oesophagus; prevention of the reflux of the blood to the upper respiratory tract and reduction of ab ingestis pneumonias; more effective suction of the blood in the gastric cavity; and keeping of a desired pressure in the operating area. During trials, however, a device conceived as above has shown some problems limiting its actual use. A first significant problem depends on the fact that, after the device is put into the mouth of the patient and the distal bladder has been inflated, the operator using the endoscope has to put such instrument into the operating area by passing it sideways on the still deflated proximal bladder. When the latter bladder is in turn inflated to define an isolated operating room where the endoscope has to carry out a sclerosis, it is easy to occur that the endoscope is pushed against the wall of the oesophagus, thus causing the patient to feel pain. In order to overcome such problem, according to the present invention the endoscope probe is passed inside the proximal bladder. To this end such bladder is provided with a suitable tubular duct passing therethrough completely apart from and independent of the main duct . Is is self evident that such a solution solves any problem relative to the inflation of the bladder pushing the endoscope against the walls of the oesophagus and ensures the tight adherence of the proximal bladder to the walls of the oesophagus. However, one can run the risk that blood and cleaning liquid can rise from the operating room through such duct up to above the proximal bladder or seep through the endoscope and the wall of the tubular duct crossing the proximal bladder when the endoscope is in its operating position. Such occurrence is in any case avoided by providing the entrance and, if necessary, also the output of such duct with a diaphragm valve or sealing ring which throttles any flow of liquid under a predetermined pressure. This allows only the endoscope to pass and nothing else. A second problem which has been arising consists in that it is not always possible to locate the field where the operation takes place via endoscope. In order to overcome such problem, the invention provides that the last length of the device just before the distal bladder is black coloured by about 5 cm or coloured by a colour which is in contrast with the remaining portion of transparent material . Further features and advantages of the invention will be more readily apparent from the following detailed description with reference to the accompanying drawings that show one preferred embodiment thereof only by way of a not limiting example. In the drawings : Fig. 1 is a general view of the device,- Fig. 2 shows in particular the length of the device between the two bladders with the entrance of the tunnel for the endoscope into the proximal bladder and the black-coloured length preceding the distal bladder,- Fig. 3 is a section view of the proximal bladder showing the off-center position of the tunnel for the endoscope and the presence of a diaphragm valve. With reference to the figures the device or the probe of the invention includes a composite, flexible tubular member consisting of a duct A-H with circular section from which two tubular ducts FG and FI both with circular section and reduced diameter branch off at point F Two bladders BC and DE are provided in the length between point A and point F. The length of the duct between the two bladders BC and DE is perforated. The whole device is better described in European Patent Application No. 0 874 657 of the same Applicant which is integral part of the present disclosure and incorporated therein by reference. Advantageously, according to a peculiar feature of the present invention, bladder DE of natural rubber or latex has a pipe or duct 6 allowing the endoscope to pass and running parallel to pipe or duct AH. Thus, when inflating the bladder, the endoscope is no longer squeezed against the wall of the oesephagus and the inflated bladder does not interfere with the activity of the operator using the endoscope. The section view of Fig. 3 shows the relative position of the duct for the endoscope and the supply pipe AH. It is evident that the position can be varied in a suitable way and it should be appreciated that the two ducts are fully independent of and not communicating with each other. The same figure shows a diaphragm valve 8 at the input of the duct 6 which prevents blood and cleaning liquids from rising from the operating room to above the proximal bladder. A similar valve can also be provided at the output of duct 6 from the proximal bladder. According to a further feature of the invention the last length of pipe AH before the distal bladder is of a contrasting colour, preferably black, in order to allow the operator to locate quickly and skilfully the point where the sclerosis or any other endoscopic intervention has to be carried out.

Claims: Claims 1. In a probe adapted to provide an isolated operating room at the distal end of the oesophagus consisting of a tubular member of flexible material which connects at its distal end two bladders that are inflated to isolate the operating field from the gastric cavity and the proximal portion of the oesophagus, the inside of such tubular member being suitably divided into three ducts, one aspiration duct with greater diameter being connected directly to the length between the two bladders which is perforated, and two smaller ducts communicating with such bladders independent of each other, an improvement consisting in that, in order to avoid that the endoscope is squeezed against the walls of the oesophagus when the proximal bladder is inflated, the endoscope probe is passed inside the proximal bladder into a suitable tubular duct which is completely apart from and independent of both said bladder and the main tubular duct. 2. In a probe according to claim 1, the improvement consisting in that at the entrance and/or the output of said tubular duct crossing the proximal bladder there is a sealing means adapted to prevent blood and cleaning liquids from rising from the operating room between the two bladders trough said tubular duct to above the proximal bladder 3. In a probe according to claim 1, the improvement consisting in that the last length of the main tubular member before the distal bladder is made of either a black-coloured material or a material having a colour in contrast with the remaining portion.

Inventors: PATERNUOSTO MARIO IMMACOLATO, PATERNUOSTO, MARIO, IMMACOLATO
Applicants: PATERNUOSTO MARIO IMMACOLATO, PATERNUOSTO, MARIO, IMMACOLATO
Application year: 2000
Main classification: A61M25
IPC codes: A61B17, A61M25