DE20020252U1 - Spray Catheters - Google Patents

Description

Weickmann & Weickmann

Patent attorneys
European Patent Attorneys · European Trademark Attorneys

H. WEICKMANN DIPL-ING. F.A. WEICKMANN

DlPL-CHEM. B. HUBER

DR.-1NG. H. LISKA

DIPL-PHVS. DR. J. PRECHTEL DlPL.-CHEM. DR. B.BÖHM DlPL.-CHEM. DR. W. WEISS DlPL-PHYS. DR. J. TDESMEYER DIPL-PHYS. DR. M. HERZOG

DiPL-PHYS. B. RUTTENSPERGER

DIPL-PHYS. DR-INC. V. JORDAN

Our sign:

24042G DE/LATFjd

Applicant:

Herbert Maslanka
In the young Steigle 4

78532 Tuttlingen

Spray catheter

P.O. Box 860 820, 81635 Munich, Germany, Tel. (089) 45563 0, Fax (089) 45563 999, email@weickmann.de

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Spray catheter Description

The invention relates to a spray catheter to be introduced into a cavity of a human body for spraying a liquid, in particular a dyeing liquid, onto the wall of the cavity, comprising a catheter tube to be connected at its proximal end to a liquid supply device and a spray head arranged at the distal end of the catheter tube and having at least one liquid outlet opening.

Such spray catheters are used, for example, to bring a suspected tumor-containing wall section of a body cavity, such as the esophagus, stomach, or colon, into local contact with a dye that colors any tumor tissue that may be present in a visually distinguishable way from the surrounding healthy or non-tumor-like tissue. Usually, a hollow probe is first inserted into the body near the area in question. The hollow probe contains a fiber optic for illuminating and visually examining the areas, as well as one or more open channels through which the spray probe is pushed to the wall area, rinsing fluid can be introduced to keep the area to be examined clear, or a biopsy instrument can be moved to the wall area in question. Depending on the application, it is also possible to push the spray catheter directly into the body cavity to be examined without such a hollow probe. These procedures are also known as chromoendoscopy or endoscopic vital staining.

A similar spray probe for applying a 2-component adhesive is known from DE-GM 295 16 077.2. There, a single fluid outlet opening opens onto the distal end of the spray catheter

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and sprays predominantly in an axial direction. In order to mix the two components before they exit the opening and to ensure centering when they exit the opening, there is a rotor inside the spray head, which makes the structure complicated. The liquid adhesive can only be brought relatively randomly close to the wall area to be examined. A large part of the cloud emerging from the opening spreads randomly away from the wall areas of interest, especially if the spray catheter is positioned more or less along the wall area.
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The object of the invention is therefore to provide a simply constructed spray catheter of the type mentioned at the beginning, with which the wall area of interest can be treated with liquid better than before.

To solve the problem, it is proposed that several liquid outlet openings open into a surface area of the spray head that is radially offset from the catheter's longitudinal axis, so that the liquid predominantly exits in the direction away from the catheter's longitudinal axis.

The orientation of the fluid outlet opening according to the invention allows the fluid to be directed specifically at the respective wall area, particularly when the catheter is positioned approximately along the wall area. This is regularly the case when examining tubular body cavities, such as the intestine or esophagus. Since the fluid can be applied more precisely, less fluid is needed overall, so that no excessive clouds are formed in the examination area, which makes the subsequent visual examination of the wall area easier.

Depending on the application - especially for examination of the colon - the relatively thin catheter tube can be several meters long, so that when applying the fluid there is a considerable pressure drop from proximal

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distally. If the spray head, as in the case of DE-GM 295 16 077.2, only has a single liquid outlet opening, the spray effect is insufficient due to the pressure in the spray head being too low, which makes it difficult to achieve the desired atomization of the liquid. However, since the spray head has several sufficiently narrow liquid outlet openings, the liquid or dye is sufficiently atomized even at a relatively low spray pressure. The several liquid outlet openings allow an overall sufficient liquid throughput even when the individual openings are very small, which promotes the formation of a spray jet of liquid mist.

The spray jet can be oriented orthogonally to the longitudinal axis and inclined distally and proximally or inclined in the circumferential direction of the spray head. This should not exclude the possibility that it also scatters in the axial direction.

Preferably, the multiple liquid outlet openings are distributed over the circumference of the spray head. Irrespective of the angle of rotation of the spray catheter relative to the respective wall surface, an intensive liquid application is therefore achieved on this wall area.

Preferably, the plurality of liquid outlet openings are located in at least one cross-sectional plane normal to the longitudinal axis. This makes it relatively easy to produce the openings by clamping the spray head in a chuck that can be rotated about its longitudinal axis and then drilling the openings one after the other in the circumferential direction from the outside into the circumferential wall of the spray head, for example by means of a laser.

In a similar way, an even larger number of openings can be produced by distributing the openings over several axially offset cross-sectional planes normal to the longitudinal axis. With the large number

In the case of openings, a very short spray of liquid is sufficient to treat the wall area with a sufficient amount of liquid.

For ease of manufacture, the liquid outlet openings can be circular when viewed from the outside, but other shapes, such as slot-shaped, are also possible.

The holes leading from the inner chamber of the spray head to the openings can run orthogonally or at an angle to the longitudinal axis, or can be inclined in the circumferential direction. This allows the respective spray jet to be given a desired direction relative to the longitudinal axis.

The spray head can be cylindrical, with the liquid outlet openings according to the invention opening out on the outer surface of the cylinder. Preferably, but not necessarily, the distal end face of the spray head is closed.

Alternatively, the spray head can be conical, with the liquid outlet openings opening out at the cone surface. The cone tip can be closed. The transition area between the conical section and the tube can in turn be cylindrical. This cylinder section can be closed without holes as a guide surface or can also contain liquid outlet openings. It goes without saying that other tapered structures, such as spray heads with a conical section-shaped, in particular hemispherical tip, can also be provided instead of the cone. In the structures explained above, the spray head is rotationally symmetrical. In particular in the case of heads that do not spray over their entire circumference, the spray head can also be asymmetrical with respect to its longitudinal axis.

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Preferably, the spray head is made of stainless steel and the catheter tube is made of a flexible plastic tubing material.

Although the invention is primarily directed to the use of dye fluid, it is understood that other fluids are also possible, such as diagnostic or therapeutic agents or the like, which can be applied with such a catheter.

Embodiments of the invention are described with reference to the accompanying drawings.

Figure 1 schematically shows a spray catheter with catheter tube, spray head

and connected fluid supply syringe;

Figure 2a is a side view of a cylindrical spray head;

Figure 2b is a front view of the spray head of Figure 2a;

Figure 3a is a side view of a conical spray head;

Figure 3b is a front view of the spray head of Figure 3a;

Figure 4a shows a variant of the spray head of Figure 3a; and

Figure 4b is a front view of the spray head of Figure 4a.

Figure 1 shows a schematic of the overall structure of a spray catheter 1. It comprises an elongated, flexible plastic tube 3 with an outer diameter of approximately 0.5 to 5 mm, here 0.8 mm, to whose distal end a spray head 5 is attached, which is to be inserted into the body. The proximal end of the tube 3 can be connected to a liquid supply device, here a syringe 7. By pressing on the syringe plunger, liquid in the syringe, for example a dye that selectively stains tumors, is applied as a droplet mist through the tube 3 and the spray head 5 to a wall W of the body cavity adjacent to the spray head 5, as indicated by the arrows.

A cylindrical spray head 5 is shown in Figures 2a and 2b. It has approximately the same external diameter A as the tube 3 and is connected to it - coaxially to the catheter's longitudinal axis L-L - in a mechanically strong and liquid-tight manner by means of fastening means (not shown). Distributed over the circumferential surface 5a of the spray head 5, a large number of liquid outlet openings 9 open out, here in the order of 100 liquid outlet openings, through which the liquid flows out from a chamber 11 of the spray head 5 connected to the tube 3. The liquid outlet openings 9 are grouped in several planes E, E' that are normal to the longitudinal axis L-L and are arranged at the same distance from one another. The diameter d of the individual liquid outlet openings 9 is approximately 0.05 mm to 0.1 mm. The distance a between the holes in the circumferential direction or longitudinal direction is 0.05 to 0.1 mm. The wall thickness D of the spray head 5 is approximately 0.1 mm.

In this embodiment, the bores 13 connecting the chamber 11 with the liquid outlet openings 9 extend orthogonally to the longitudinal axis L-L (see Figure 2a, bore 13'), but can - at least partially - also run obliquely towards the longitudinal axis L-L (see Figure 2a, bore 13") so that the emerging jet is directed obliquely distally in front of the spray head 5, or also inclined in the circumferential direction U (see Figure 2b, bore 13'").

Here, the distal end surface 5b of the cylinder 5 is closed without holes.

Another embodiment with a conical spray head 50 is shown in Figures 3a and 3b. Here, the spray head 50 has a proximal cylindrical section 51, which is directly connected to the tube 3, and a distally adjoining conical end section 53. The liquid outlet openings 9 are distributed over the conical surface 53a of the distal section 53, as in the first embodiment, in several axially normal planes E, E'. In order to ensure that the distance a between the liquid

While the number of fluid outlet openings remains essentially uniform, the number of fluid outlet openings per level decreases in the distal direction. The cone tip 53b is closed without holes and tapers to a point, but can also be rounded. The cylindrical proximal section is closed without holes. The cylinder surface 51a adjoins the cone surface 53a and forms a guide surface here.

The dimensions of the diameter d of the openings, the distances a between the openings, the outer diameter D of the spray head and the wall thickness D essentially correspond to the first version. The cone angle α is 40 to 90°, for example, here approx. 60°.

A variant of a spray head with a hemispherical shape is indicated in dashed lines at 5a.

A further variant of the design of Figures 3a and 3b is shown in Figures 4a and 4b. Here, the proximal cylindrical section 51 also contains a plurality of liquid outlet openings 9 distributed over the circumference in two axially normal planes E", E"'. Otherwise, this design is similar to that of Figures 3a and 3b.

For example, to examine the esophagus, one can use a 1% Lugol's solution, which stains normal squamous epithelium brown, but diseased squamous epithelium less brown, which stands out yellowish-light from the normal squamous epithelium. The spray probe is continuously pulled cranially from the cardia, spraying 15 to 20 ml of Lugol's solution.

To examine Barrett's esophagus, a 0.5 to 1 percent methylene blue solution can be used as a staining solution, which stains specialized Barrett's epithelium darker and therefore better. In preparation, acetylcysteine or fluimucil is sprayed on and after a short waiting time,

The methylene blue is sprayed onto the area using the spray catheter and then rinsed with water if necessary. 0.5 to 1 percent methylene blue can also be used to examine the stomach, although the areas around the tumor in the stomach are less likely to stain. Otherwise, the procedure is the same as for Barrett's esophagus. Otherwise, the procedure is the same as for Barrett's esophagus.

To examine the colon, you can also use a 0.5 to 1 percent methylene blue solution or a 0.1 percent indigo carmine solution, which is sprayed onto the intestinal wall without preparation using a spray probe. In this case, the tumor edges are less colored and are more clearly visible.

Claims (23)

1. A spray catheter ( 1 ) to be inserted into a cavity of a human body for spraying a liquid, in particular a dye liquid, onto the wall (W) of the cavity, comprising: - a catheter tube ( 3 ) to be connected at its proximal end to a fluid supply device ( 7 ) and - a spray head ( 5 ) arranged at the distal end of the catheter tube ( 3 ) and having at least one liquid outlet opening ( 9 ), characterized in that a plurality of liquid outlet openings ( 9 ) open into a surface region ( 5a ) of the spray head ( 5 ) which is radially offset from the catheter longitudinal axis (LL), so that the liquid predominantly exits in the direction away from the longitudinal axis (LL). 2. Spray catheter according to claim 1, characterized in that the plurality of liquid outlet openings ( 9 ) are distributed over the circumference of the spray head ( 5 ). 3. Spray catheter according to claim 1 or 2, characterized in that the plurality of liquid outlet openings ( 9 ) lie in at least one cross-sectional plane (E) normal to the catheter longitudinal axis (LL). 4. Spray catheter according to claim 2 or 3, characterized in that the liquid outlet openings ( 9 ) are distributed over several axially offset cross-sectional planes (E, E') normal to the catheter longitudinal axis (LL). 5. Spray catheter according to one of the preceding claims, characterized in that the liquid outlet openings ( 9 ) are circular when viewed from the outside. 6. Spray catheter according to one of the preceding claims, characterized in that the opening width or the diameter (d) of the respective liquid outlet opening is 0.01 to 0.4 mm, preferably 0.03 to 0.25 mm, especially preferably 0.05 mm to 0.1 mm. 7. Spray catheter according to one of claims 2 to 6, characterized in that the distance (a) between two adjacent liquid outlet openings ( 9 ) corresponds to 0.3 to 4 times, preferably 0.5 to 1 times their opening width or their diameter (d). 8. Spray catheter according to one of claims 2 to 7, characterized in that adjacent liquid outlet openings have a distance of less than 0.4 mm, preferably between 0.05 mm and 0.2 mm. 9. Spray catheter according to one of claims 1 to 8, characterized in that a channel ( 13 ') leading from a chamber ( 11 ) in the spray head ( 5 ) to the respective liquid outlet opening ( 9 ) runs orthogonally to the peripheral wall section of the spray head ( 5 ) containing the liquid outlet opening ( 9 ) or orthogonally to the catheter longitudinal axis (LL). 10. Spray catheter according to one of claims 1 to 8, characterized in that a channel ( 13 " or 13 ''') leading from the chamber ( 11 ) in the spray head ( 5 ) to the respective liquid outlet opening ( 9 ) runs obliquely to the catheter longitudinal axis (LL) or inclined in the circumferential direction (U). 11. Spray catheter according to one of the preceding claims, characterized in that the channel ( 13 ) leading from a chamber ( 11 ) in the spray head ( 5 ) to the respective liquid outlet opening ( 9 ) is designed as a cylindrical bore. 12. Spray catheter according to one of the preceding claims, characterized in that the thickness (D) of the wall of the spray head ( 5 ) containing the liquid outlet openings ( 9 ) is 0.05 mm to 0.3 mm, preferably 0.1 to 0.2 mm. 13. Spray catheter according to one of the preceding claims, characterized in that the spray head ( 5 ) is rotationally symmetrical to the catheter longitudinal axis (L-L). 14. Spray catheter according to claim 13, characterized in that the outer diameter (A) of the spray head is 0.5 to 5 mm, preferably 1.5 to 2.5 mm. 15. Spray catheter according to one of the preceding claims, characterized in that the spray head ( 5 ) is cylindrical, wherein the liquid outlet openings ( 9 ) open into the cylinder surface ( 5a ). 16. Spray catheter according to claim 15, characterized in that the distal end face ( 5 b) of the cylinder ( 5 ) is closed. 17. Spray catheter according to one of claims 1 to 14, characterized in that at least one distal section ( 53 ) of the spray head ( 50 ) is conical, wherein the liquid outlet openings ( 9 ) open into the conical surface ( 53a ). 18. Spray catheter according to claim 17, characterized in that a proximal section ( 51 ) of the spray head ( 50 ) is cylindrical, the cylindrical surface ( 51a ) of which adjoins the conical surface ( 53a ) of the distal section ( 53 ). 19. Spray catheter according to claim 18, characterized in that the cylinder jacket surface ( 51a ) is designed as a closed guide surface. 20. Spray catheter according to claim 18, characterized in that at least one liquid outlet opening ( 9 ) also opens into the cylinder jacket surface ( 51 a'). 21. Spray catheter according to one of claims 17 to 20, characterized in that the spray head ( 5 ) is closed in the region of its conical tip ( 50b ). 22. Spray catheter according to one of claims 1 to 14, characterized in that the spray head is spherical in shape, in particular hemispherical. 23. Spray catheter according to one of the preceding claims, characterized in that the spray head ( 5 ) has at least 10, preferably at least 50 liquid outlet openings ( 9 ).