Abstract:
A medical procedure drape, for use during a diagnostic and therapeutic procedures performed on a patient supported by a patient cart, including a cover and a holder for the endoscope. The cover superimposes a portion of the patient and a portion of the patient cart. The endoscope holder is fixed to a boundary of the cover and extends above the level of the patient support surface on the patient cart. The endoscope holder retains and supports the endoscope during insertion and at other such times that the endoscopist may wish to set the endoscope aside to perform other tasks.

Description:
FIELD OF THE INVENTION 
     This invention relates to a method and apparatus for use during a medical procedure and more particularity to a medical procedure drape for use during a medical procedure including esophagogastroduodenoscopy, with or without biopsy, polypectomy, esophageal dilatation, endoscopic photography, endoscopic ultrasound, fulgeration, coagulation, variceal injection or banding, stent placement, or endoscopic retrograde cholangiopancreatography. 
     BACKGROUND OF THE INVENTION 
     Upper Gastrointestinal Endoscopy (esophagogastroduodenoscopy, EGD) is a commonly used examination of the upper gastrointestinal tract employing a flexible fiberoptic endoscope. Other versions of the flexible Upper GI Endoscope are available for examination of the small intestine (enteroscopy), performing ERCP (Endoscopic retrograde Cholangiopancreatography), TEE (Transesophageal Echocardiography), esophageal and mediastinal ultrasonography. The basic instrument is 100 centimeters in length and is controlled by a handpiece that utilizes dials for altering the direction of the tip of the endoscope, and valves for controlling suction and air and water insufflation. An umbilical connects the handpiece of the instrument to a tower of electromechanical modules supplying suction, airflow, and water. An electronics package connected to the endoscope controls light and photography functions. The endoscope has an operating channel allowing the endoscopist to take biopsies and remove tissue from within the upper gastrointestinal tract. 
     The patient is brought to the endoscopy suite and the posterior oral pharynx is anesthetized with a topical anesthetic either swallowed or sprayed into the appropriate area. The patient is placed in the left lateral position with the head supported on a pillow. The patient is sedated or anesthetized with one of a variety of injectable agents administered in the intravenous access site. An appropriate drape is applied to the patient cart and to the patient in order to protect the patient, the environment, and the operator from any secretions from the upper GI tract during the procedure. An oral-pharyngeal suction cannula is available for assistance in keeping the mouth and the pharynx clear of secretions. The endoscope is brought up into the field and a bite block is used, if necessary, to prevent the patient from inadvertently biting the endoscope. The bite block is either placed between the incisors or placed on the shank of the endoscope for insertion between the incisors after the endoscope is placed in the esophagus. While the working end of the endoscope is inserted through the mouth and into the esophagus an assistant may hold the handpiece of the endoscope at the upper corner of the patient cart near the face of the patient, or the handpiece could be placed on the cart. 
     The problem arises that this employs the use of personnel who could be used elsewhere in the room to assist with other tasks. Placing the endoscope on the corner of the pillow or the patient cart can result in the endoscope sliding off of the cart and falling onto the floor while the endoscopist&#39;s attention is directed to the insertion of the endoscope into the patient&#39;s esophagus. Inadequate draping materials and methods frequently result in soiling and contamination of the patient, the patient cart, the endoscopist, and the endoscopy suite. 
     There is no specific item available to cover and protect the patient and the patient cart. Current practice consists of draping the patient with a disposable, movable plastic drape or a washable towel that is not impermeable to liquids. There is no specific item available to assist in managing the endoscope before, during, and after the endoscopy. 
     Soiling and contamination of the patient, the patient cart, the endoscopist, and the endoscopy suite environment can easily result without appropriate and adequate draping materials and methods. Clean-up is prolonged and timely transfer of the patient from the endoscopy suite is delayed by soiling and contamination. The utility and security of the endoscope is compromised by the lack of a secure holder for the endoscope during various stages of the procedure. 
     It is therefore an object of the invention to control secretions and eliminate soiling and contamination of the patient, the patient cart, the endoscopist, and the environment. 
     It is another object of the invention to support and protect the endoscope at various times during the procedure. 
     SUMMARY OF THE INVENTION 
     In accordance with the present invention, there is provided a medical procedure drape, for use during a diagnostic and possibly therapeutic procedure performed on a patient supported by a patient cart, including a cover and a holder for the endoscope. The cover superimposes a portion of the patient and a portion of the patient cart. The endoscope holder is fixed to a boundary of the cover and extends above the level of the patient support surface on the patient cart. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A complete understanding of the present invention may be obtained by reference to the accompanying drawings, when considered in conjunction with the subsequent, detailed description, in which: 
         FIG. 1  is a perspective view of a patient positioned on the mattress of the patient cart ready to undergo an upper gi endoscopy with the flexible fiberoptic endoscope retained the endoscope holder; 
         FIG. 2  is a perspective view of a patient cart with the cover of the medical procedure drape and the endoscope holder; 
         FIG. 3  is a plan view of a medical procedure drape including the cover and the endoscope holder; 
         FIG. 4  is a plan view of a cover of a medical procedure drape in the present invention; 
         FIG. 5  is a perspective view of an endoscope holder of the present invention; and 
         FIG. 6  is a perspective view of a medical procedure drape of  FIG. 4  fixed to the endoscope holder of  FIG. 5 . 
     
    
    
     For purposes of clarity and brevity, like elements and components will bear the same designations and numbering throughout the Figures. 
     DESCRIPTION OF THE PREFERRED EMBODIMENT 
       FIG. 1  is a perspective view of a patient  10  positioned on the mattress of the patient cart  12  ready to undergo an upper GI endoscopy with the flexible fiberoptic endoscope  28  retained the endoscope holder  18 . 
       FIG. 2  is a perspective view of the patient cart  50  with the cover of the medical procedure drape  20  and the endoscope holder  18 . 
       FIG. 3  is a plan view of the medical procedure drape  16  and the endoscope holder  18 . 
       FIG. 4  is a plan view of the medical procedure drape  16  in the present invention. 
       FIG. 5  is a perspective view of the endoscope holder  18  of the present invention. 
       FIG. 6  is a perspective view of the medical procedure drape  16  of  FIG. 4  fixed to the endoscope holder  18  of  FIG. 5 . 
     The embodiments of the present invention described below are not intended to be exhaustive or to limit the invention to the precise forms disclosed in the following detailed description. Rather, the embodiments are chosen and described so that others skilled in the art may appreciate and understand the principles and practices of the present invention. 
     Referring now to  FIG. 1 , there is shown a medical procedure drape  16  including a cover and an endoscope holder  18 . During the procedure the patient  10  is sedated or anesthetized with intravenously administered medication while also having a topically applied anesthetic to the posterior oral pharynx. This may be accomplished by either swallowing a viscous liquid, or spraying a topical anesthetic directly on the mucosal surfaces of the posterior oral pharynx. The patient  10  is positioned on the patient cart  50  in the left lateral decubitus position with the head on a supportive pillow. The airway is protected by proper positioning to allow unobstructed spontaneous respiration and adequate pulmonary function. 
     The medical procedure drape  16  is positioned such that the cover of the medical procedure drape  20  will have the cephalad portion of the cover  22  superimpose the supportive pillow, while the caudal portion of the cover  24  superimposes the neck, chest, and arms of the patient  10 . A free flap of the cover  26  hangs over the side of the mattress of the patient cart  12 . The attached endoscope holder  18  is positioned so that the horizontal member  42  of the endoscope holder  18  is introduced between the mattress of the patient cart  12  and the deck of the patient cart  14 . The vertical member  40  of the endoscope holder  18  is aligned with the side of the mattress of the patient cart  12 . 
     The flexible fiberoptic endoscope  28  is positioned with the controlling handpiece of the endoscope  32  on the patient  10  side of the endoscope holder  18 , having the umbilical of the endoscope  34  lying in the notch  48  of the endoscope holder  18 . The working end of the endoscope  30  is lying on the cover of the medical procedure drape  20 , on the horizontal surface of the mattress of the patient cart  12 . This positions the working end of the endoscope  30  for manual insertion into the oral pharynx and esophagus of the patient  10 . The endoscope holder  18  allows the endoscopist to utilize both hands for the insertion of the flexible fiberoptic endoscope  28  without the possibility of the controlling handpiece of the endoscope  32  falling off of the patient cart  50  and sustaining damage. 
     The endoscopist and the medical equipment cart containing light source, camera, suction, and air and water supplies are not depicted for clarity, and to demonstrate the detail and position of the medical procedure drape  16 , the patient  10 , and the patient cart  50 . 
       FIG. 2  is a perspective view of the medical procedure drape  16 , including the cover of the medical procedure drape  20  overlying the mattress of the patient cart  12 , and the endoscope holder  18  inserted in position between the mattress of the patient cart  12  and the deck of the patient cart  14 . The cephalad portion of the cover  22 , the caudal portion of the cover  24 , and the free flap of the cover  26  are demonstrated here. The relationship of the endoscope holder  18  and its location between the mattress of the patient cart  12  and the deck of the patient cart  14  are depicted. The patient  10 , the flexible fiberoptic endoscope  28 , and the pillow are omitted from this figure to depict the detail of this embodiment of the present invention. 
       FIG. 3  is a plan view of the medical procedure drape  16  including the cover of the medical procedure drape  20  and the endoscope holder  18 . The cephalad portion of the cover  22  used to superimpose the pillow is seen directly opposite the endoscope holder  18 . The cephalad portion of the cover  22  has an edge or side  52  that is disposed along the width of the support surface of the patient cart  50 . The free flap of the cover  26  is the portion of the cover of the medical procedure drape  20  which hangs vertically over the edge of the mattress of the patient cart  12 , thus protecting the patient cart  50 . The caudal portion of the cover  24  superimposes the chest and arms of the patient  10  and a portion of the patient cart  50 . The caudal portion of the cover  24  has an edge or side  54  that is disposed along the width of the support surface of the patient cart  50 . The cephalad portion of the cover  22  and the caudal portion of the cover  24  are further defined by an angularly disposed edge or side  56  that is positioned between edges  52  and  54  and is configured to define a cut-out section  58  that can accommodate the neck of the patient  10 . A cut-line  60  is also disposed along the width of the support surface of the patient cart  50  and specifically between the cephalad portion of the cover  22  and the free flap of the cover  26  to thereby allow the free flap to hang over the side of the patient support surface  50 . An adhesive strip with peel-off paper backing  38  is located on the reverse side of the cover of the medical procedure drape  20  to cause the cover to adhere to the patient&#39;s chest and right arm. 
       FIG. 4  is a plan view of the cover of the medical procedure drape  20 . The cover of the medical procedure drape  20  has an obverse side seen in this figure and a reverse side. It is constructed of a synthetic fabric which is flexible and impervious to liquids. Once again, as in  FIG. 3 , the cephalad portion of the cover  22 , the caudal portion of the cover  24 , and the free flap of the cover  26  are shown. Also shown is a flap of the cephalad of the cover  36  and is to accommodate adhesive attachment to the endoscope holder  18  as in  FIG. 3 . 
     On the reverse side of the cover of the medical procedure drape  20  is an adhesive strip with peel-off paper backing  38  to attach the caudal portion of the cover  24  to the patient  10 . 
       FIG. 5  is a perspective view of the endoscope holder  18 . The endoscope holder  18  can be constructed of rigid plastic, solid or corrugated cardboard. It is made up of two members, a vertical member  40  and a horizontal member  42 . They are joined by a hinge  44  which may be made of the same material as the rigid members, or may be constructed of a flexible fabric. The hinge  44  allows the endoscope holder  18  to be folded flat, like a book, when closed. The motion is constrained, when fully open, to a right angle configuration by a gusset  46  at each end of the endoscope holder  18 . The gusset  46  is constructed from a flexible fabric or tape material, adherent to each member. 
     The vertical member  40  has a notch  48  along the superior edge. It is shaped to accommodate the flexible fiberoptic endoscope  28  as depicted in  FIG. 1 . The caudal end of the endoscope holder  18  is tapered to a dimension approximating the thickness of the mattress of the patient cart  12 . 
     Since other modifications and changes varied to fit particular operating requirements and environments will be apparent to those skilled in the art, the invention is not considered limited to the example chosen for purposes of disclosure, and covers all changes and modifications which do not constitute departures from the true spirit and scope of this invention.