RU2400125C1 - Laryngoscope for complicated intubations - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: laryngoscope comprises a hollow handle detachably connected with a curved blade whereon a light source is fixed, and a narrow plate pivotally connected with the blade, curved in the same direction, longer than the blade and having a rod for the plate return. The plate has a smooth surface, or a mirror element is fixed thereon opposite to the light source.

EFFECT: application of said device enables the glottis delivery in the indirect laryngoscopy in case of complicated intubation for the patients with various anatomic features of the bottom jaw and larynx with simultaneous design simplification.

5 cl, 2 dwg

Description

The invention relates to medicine, namely to technical means in the form of lamp laryngoscopes intended for examination of the patient’s glottis and complex tracheal intubations.

A device for mini-access during surgical operations is known, including a handle from a laryngoscope and a Cuzco mirror. On the upper part of the mirror, a part with a light guide is fixed from its outer side (RU 37307, class А61В 17/02, published 2004.04.20).

The known device is intended for insertion into a wound.

Also known is a laryngoscope, including a handle, a laryngeal mirror, an electric bulb and a curved tube, consisting of two halves, made with the possibility of separation when removed from the trachea (SU 209618, class A61B 1/267, published 03/14/1968).

Known laryngoscope is intended for intratracheal insertion of an elastic catheter.

Despite the fact that in both known designs the overview of the cavities under study is improved and the surgical access trauma is reduced, due to their design features they cannot be used to examine the glottis and tracheal intubation.

Various designs of KAWE lamp laryngoscopes intended for intubation are known, in particular a laryngoscope including a handle and a set of blades having a matte anti-corrosion polish that prevents reflection of the light flux. In particular, one of the curved-type blades included in this set has a variable curvature of the working end of the blade (http://www.nordmedica.ru/Catalog/larinl.html).

It should be noted that in some cases during intubation with the help of the above known designs of laryngoscopes, the glottis cannot be removed.

Also known laryngoscope for examining the oral cavity, pharynx and glottis of the patient, as well as for intubation of the trachea. It contains a hollow handle, an illuminator with a light source located inside it, and a light guide mounted on the handle, made of optically transparent material, part of which is made in the form of a focone, which has the shape of a blade. The illuminator is made in the form of two light sources mounted symmetrically with respect to the optical axis at an angle of not more than 3 ° to the latter. The first surface of the fiber from the illuminator is formed by two surfaces, the radii of curvature of which lie in two mutually perpendicular planes, and the second is made reflective (RU 2043068, class A61B 1/267, published 09/10/1995).

The well-known laryngoscope is aimed at increasing the illumination in the studied area, however, it is complex and expensive to perform.

Thus, the technical task of this solution is to enable the removal of the glottis with indirect laryngoscopy in case of difficult intubation for patients with various anatomical features of the lower jaw and larynx while simplifying the design of the device.

The claimed technical problem is solved in both variants of the invention due to the possibility of observing the reflected image on a mirror field. What is ensured by the following set of features.

The laryngoscope contains a hollow handle detachably connected to a curved blade on which a light source is fixed, and curved in the same direction as the blade and a narrower plate longer than it, having a lever for removing the plate from the blade, while the plate has a mirror surface, or, opposite the light source, a mirror element is fixed on it.

According to the invention, the plate is made with a curvature close to the curvature of the blade, with rounded thickenings formed at the free ends of the plate and blade. Also, the invention is characterized by the implementation of the light source either in the form of an electric lamp, or in the form of a fiber light guide or LED.

The laryngoscope is equipped with a mechanism for smooth movement of the plate relative to the blade with the possibility of its fixation in several working positions.

The invention is illustrated in the drawing, where figure 1 shows a laryngoscope in the closed position of the blade and plate (ready for insertion); figure 2 is the same (without a handle) in the open (entered) position of the blade and plate.

The laryngoscope shown in Fig. 1 mainly includes a curved laryngeal blade 2 detachably connected to the hollow handle 1, on which a light source is fixed, made, for example, in the form of an electric bulb 3. Also, a curved plate 5 is connected to the blade 2 by a hinge 4 with a lever 6 and a mechanism for fixing the position of the plate relative to the blade (not shown). This mechanism consists of a spring-loaded fixing ball placed on the blade and several blind holes (holes) formed on the plate. The cavity in the handle 1 is intended for the passage of electric wires in the embodiment of the light source in the form of an electric bulb or LED, or optical fibers in the embodiment of the light source in the form of a fiber waveguide.

The plate 5 is curved in the same direction as the blade 2, while on the plate 5 opposite the bulb 3 a mirror element is mounted and fixed, for example, made in the form of a mirror 9, which corresponds to one embodiment of the invention, or the surface of the plate from the side facing the light bulb 3 is made mirrored, which corresponds to another embodiment of the invention.

The curvature of the curved surfaces of the blade 2 and the plate 5 is selected from the condition under which the overall dimensions of the device in the closed position of the blade 2 and the plate 5 would not exceed the dimensions of the known laryngeal blades.

Plate 5 is made longer than blade 2 by 18-20 mm. This is due to the convenience of introducing a laryngoscope into the patient’s glottis, as in the closed position of the laryngoscope, the plate 5 is, as it were, a continuation of the blade 2. The lamp 3 is fixed near the free (working) end of the blade 2, and the mirror is located at a distance of 50-55 mm from the input end of the plate 5 and occupies its entire width. Both free ends of the blade and plate are provided with rounded bulges 7 and 8, respectively, to protect the patient's larynx from damage. The lever 6 is designed to divert the plate 5 from the blade 2 (figure 2).

The described location and dimensions of the mirror field make it possible to obtain a reflected image of the space of the larynx located before the end of the working blade.

The laryngoscope works as follows. Connecting the blade 2 and the plate 5, as shown in figure 1, the laryngoscope is inserted into the larynx of the patient, after which, using the lever 6, the plate 5 is taken to the necessary possible distance from the blade 2 (figure 2). By means of the image reflected on the mirror surface 9, the doctor has the opportunity to uniquely determine the shape, size and location of the glottis.

The main advantages of the proposed design of the laryngoscope are the following:

- the ability to visually determine and control the glottis both when determining its location, and when introducing an endotracheal tube;

- minimal differences in the overall dimensions of the blade together with the plate from the currently widespread models of laryngoscopes;

- the ability to visually control a larger surface of the larynx without changing the position of the working blade. Raising and lowering the mirror field on the curved surface of the plate allows you to see the reflected image of different sections of the larynx;

- simplicity and reliability of the design;

- the possibility of sterilization and disinfection of the laryngoscope by all methods accepted for this, including autoclaving, without additional assembly and disassembly.

Claims (5)

1. A laryngoscope containing a hollow handle detachably connected to a curved blade on which a light source is mounted, and curved pivotally connected to the blade in the same direction as the blade and a narrower plate longer than it, having a lever for removing the plate from the blade, this plate has a mirror surface or opposite the light source on it is mounted a mirror element. 2. The laryngoscope according to claim 1, characterized in that the curvature of the plate is close to the curvature of the blade. 3. The laryngoscope according to claim 1, characterized in that the light source is made in the form of an electric bulb, or a fiber light guide, or an LED. 4. The laryngoscope according to claim 1, characterized in that at the free ends of the plate and blade rounded thickenings are formed. 5. The laryngoscope according to claim 1, characterized in that it is equipped with a mechanism for smooth movement of the plate relative to the blade with the possibility of its fixation in several working positions.

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