Title of Invention

AN INSTRUMENT FOR CAUSING A DILATION OF THE TRACHEA OPENING

Abstract

This invention relate to an instrument for causing a dilation of the trachea opening comprising a pair of shaft members pivotally held to each other, each of said shaft members having a jaw at the distal end cooperating with each other for causing an opening of the trachea opening, a handle at the proximal end of each shaft so as to cause an opening or closing of the jaws, characterized in that the jaws having cooperating faces with a respective longitudinal groove with an entry and exit location for passage of a wire, lateral protuberances provided away but in the proximity of the terminal end of said jaws so as to define a limiting means for the insertion of the jaws into the trachea opening and thereby prevent a secondary injury, a scale provided in the proximity of the proximal end of one of said shafts to provide a reading of size opening of the trachea.

Full Text

FIELD OF INVENTION This invention relates to an instrument for causing a dilation of the trachea opening so as to allow an introduction of a cannula. BACKGROUND OF INVENTION Percutaneous tracheostomy is a procedure where an opening is made in the anterior wall of the trachea to pass a desired size tracheostomy tube. A number of kits/techniques for the formation of elective or emergency percutaneous tracheostomy are described but many of these are associated with secondary injuries to the soft tissue and are even associated with life threatening complications. Commonly, an elective or emergency percutaneous tracheostomy is performed using a skin incision, puncturing the anterior tracheal wall with the cannula on needle, passing a guidewire through tracheal cannula and then formation of tracheal stoma onguidewire either in a gradual fashion using a number of dilators of increasing diameter or in a single step dilatation using the tracheostomy forceps. The tracheostomy forceps used for percutaneous tracheostomy has been described in European patent No EP00505390B1 and US patent No. US05279285. The technique, though, claimed to be for rapid and single step dilatation of tracheal stoma, commonly requires multiple dilatation of tracheal stoma before a desired size tracheostomy tube can be introduced. The forceps used to form the percutaneous tracheostomy lacks the measurement quality and hence the accuracy in formation of desired size stoma. Therefore, it is commonly associated with under or over splitting of inter tracheal ring membrane and hence an inappropriate size of stoma formation. On the other hand there is no guiding mark on the forceps to check its length of insertion in tracheal lumen for splitting the inter tracheal ring membrane. Therefore, the use of these forceps is associated with inadvertent tracheal tissue injuries, particularly when a less experienced physician or a trainee is performing the procedure. OBJECTS OF THE INVENTION An object of this invention is to propose an instrument for causing a dilation of the trachea opening which obviates the disadvantages associated with the instrument of the prior art. Another object of this invention is to propose an instrument for causing a dilation of the trachea opening which provides an accuracy in the size and formation of the trachea stoma. Still another object of this invention is to propose an instrument for causing a dilation of the trachea opening which provides an accuracy in the insertion of the instrument in the tracheal lumen. Yet another object of this invention is to propose an instrument for causing a dilation of the trachea opening which allows a percutaneous tracheostomy in a patient to be performed more speedily and with more simplicity. A further object of this invention is to propose an instrument for causing a dilation of the trachea opening, which significantly reduces the risk of secondary injury. BRIEF DESCRIPTION OF THE INVENTION According to this invention there is provided an instrument for causing a dilation of the trachea opening comprising a pair of shaft members pivotally held to each other, each of side shaft members having a jaw at the distal end cooperating with each other for causing an opening of the trachea opening, a handle at the proximal end of each shaft so as to cause an opening or closing of the jaws, characterized in that the jaws having co-operating faces with a respective longitudinal groove with an entry and exit location for passage of a wire, lateral protuberances provided away but in the proximity of the terminal end of said jaws so as to define a limiting means for the insertion of the jaws into the trachea opening and thereby prevent a secondary injury, a scale provided in the proximity of the proximal end of one of said shafts to provide a reading of size opening of the trachea. DESCRIPTION OF INVENTION WITH REFERENCE TO THE ACCOMPANYING DRAWINGS Further objects and advantages of this invention will be more apparent from the ensuing description when read in conjunction with the accompanying drawings and wherein: * FIG. 1 shows a first embodiment of this tracheostomy forceps according to this invention, and FIG.2 shows a second embodiment of this tracheostomy forceps according to this invention. Referring to Fig. 1, the instrument of the present invention comprises a pair of handles (a & b)provided at the proximal end of shafts (c & d), each of which have jaw end (e & f) with a co-operating face. The face of each jaw has a groove (g). The two shafts (c and d) are held to each other at their intermediate ends through a pivot (h). When the jaws are inclosed position, the groove (g) forms a passage with entry point (i) and exit point (j). In the proximity of handles (a & b), shaft (c & d) have co-operating ratchet parts (k & I) which enable the instrument to be locked with the jaws in a closed or dilated position. The passage thus formed allows threading of the guidewire through the entry point (i). In this embodiment the instrument is constructed in such a way that moving the handles together moves the jaws together. The external side of each jaw has a rounded protuberance (m & n) at the level of exit piont (j) of the passage. Below this point the jaw ends are curved along their length at an angle of 70° to 80° Near the locking arrangement, a scale (o) is transversely provided in the shaft (c ). The numbers are engraved on both surfaces of the scale that represent the size or the numbers of the tracheostomy tube on one edge, and dilatation of stoma in mm on the other edge. The ratchet (1) has a pointer (p) extending downwardly to provide a reading on both sides of scale (s). When the ratchets are in closed position, the jaw ends are closed and the free end of the. scale traverses through a slit (q) in the shaft (d) When the handles are moved apart the jaw ends open, which is guided with the sliding of pointer (p) on the scale. The jaw ends beyond the protuberances (m,n) are made in such a fashion that when opened; the outer width is nearly equal at any given point and therefore provides known dilatation represented on the scale. The protuberances (m, n) perform the function of a limiting means to limit the insertion of the jaw ends into the trachea opening and mark the measured dilatation of stoma. Fig. 1 also shows an alternative embodiment of the instrument and with particular reference to the scale ( o ). A plurality of holes (z) spaced from each other are provided on one end of scale (o). Such holes can receive any suitable locking means such as a locking pin. Thus, and as by way of example, if a 7 mm diameter slit is required, the jaws (e, 0 are opened till the scale (o) shows a reading of 7 mm, and a locking pin is then inserted into a hole (z) for locking the instrument at 7 mm. Alternatively, the graduations (o) can be avoided and instead the graduation are provided against holes (z). Thus, the jaws (e,f) can be opened to the required measurement, as provided on the scale and which can then be locked by a locking pin. Fig. 2 shows an alternative embodiment of the tracheostomy instrument according to this invention, and comprises two shafts (c & d) pivoted at a point (h) in such a way that when the handles (a & b) are moved together the jaw ends (e&f) are moved apart. The face of the each jaw has a groove (g) A metallic strip ( r) between the shafts keeps the the ratchet parts (k &l) apart and the jaw ends (e & f) closed. When the jaw ends are in closed position there extends a passage with entry point ( i ) and exit point (j ). The passage thus formed allows threading of the guidewire through the entry point (i). The external side of each jaw end has a rounded protuberance (m & n) at the level of exit point (j) of the passage. Protuberances (m & n) work in the same manner as described in Fig. 1. The jaw ends (e&f) are curved at around 70° to 80° angle along their length to provide the safety during the procedure. nging the handles (a&b) together enables the sliding of the ratchet parts (k, I) in increasingly locked position while the jaw ends are passively opened in the increasing order. Near the locking arrangement, a scale (o) is held transversely to shaft ( c ). The numbers are engraved on both surfaces of the scale that represent the size or the number of the tracheostomy tube on one edge and dilatation of stoma in mm on the other edge. The ratchet (l)has a pointer ( p ) extending downwardly to provide a reading on the scale. When the handles are brought together, the scale traverses through the slit (q) and the pointer (p) moves on the scale. The jaw ends open and the dilatation oftracheal stoma is guided with the sliding of pointer (p) on the scale. The shaft ( c ) is spring loaded by a resilient strip (u). WE CLAIM; 1. An instrument for causing a dilation of the trachea opening comprising a pair of shaft members pivotally held to each other, each of said shaft members having a jaw at the distal end cooperating with each other for causing an opening of the trachea opening, a handle at the proximal end of each shaft so as to cause an opening or closing of the jaws, characterized in that the jaws having co-operating faces with a respective longitudinal groove with an entry and exit location for passage of a wire, lateral protuberances provided away but in the proximity of the terminal end of said jaws so as to define a limiting means for the insertion of the jaws into the trachea opening and thereby prevent a secondary injury, a scale provided in the proximity of the proximal end of one of said shafts to provide a reading of size opening of the trachea. 2. An instrument as claimed in claim I, wherein the shaft members (c.d.) are pivoted together such that moving the handles (a, b) together moves the jaws (e, f) together. 3. An instrument as claimed in claim I wherein the scale has graduation, the other of said shaft having a pointer to transverse over said scale and thereby provide a riding of the trachea stoma. 4. An instrument as claimed in claim 3 wherein the scale has a plurality of holes spaced from each other for receiving a locking pin. 5. An instrument as claimed in claims 3 & 4 wherein said graduations are provided with said holes. 6. An instrument as claimed in claim 1 comprising a resilient strip having one end to bear against a shaft. 7. An instrument as claimed in claim I comprising a ratchet member provided with each shaft, said ratchet members extending inwardly and engageable with each other to facilitate a locking action. 8. An instrument as claimed in any one of the claims 1-6 wherein the jaws have a curved surface extends downwardly from said protuberances. 9. An instrument as claimed in one of the claims 1-6 wherein one of said shafts (c) has a transversely fitted scale (0) marked on both the sides with upper border (t) in tracheotomy size and lower border (s) in mm dilatation of stoma. 10. An instrument as claimed in claim 7 wherein the other shaft (d) has a slit (q) to allow free traverse for the scale (0) during the movement of members (c, d). 11. An instrument as claimed in one of the claims 1-8 wherein one ratchet (1) has a pointer (p) towards the scale (0) which moves on the scale during the movement of members (c, d) and provided a reading of the opening of jaws (e, f) in size of the tracheostomy tube or dilatation of the stoma. 12. An instrument as claimed in any one of the proceeding claims wherein the jaw (e, f) are tapered towards their distal ends. 13. An instrument for causing a dilation of the trachea opening substantially as herein described and illustrated.

Documents:

827-del-2000-abstract.pdf

827-del-2000-claims.pdf

827-del-2000-description (complete).pdf

827-del-2000-drawings.pdf

827-del-2000-form-1.pdf

827-del-2000-form-19.pdf

827-del-2000-form-2.pdf

827-del-2000-form-3.pdf

827-del-2000-gpa.pdf

827-del-2000correspondence-others.pdf

827-del-2000correspondence-po.pdf