Note: Descriptions are shown in the official language in which they were submitted.
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The present invention relates to an intercostal
tube designed to be inserted between the ribs of a pa-tient
for drainage purposes of the chest area, made of relatively
stiff but pliable plastic material with its inserting end at
a sharp taper that nevertheless preserves the adequate
rigidity to permit the tube to be compressed -transversely
and inserted between the ribs, without widening -the portion
of the tube required to pass between the ribs, which would
require a larger opening in the patient, and increased pain.
Intercostal tubes have been heretofore made with
squared ends. When such a tube is inserted between the
ribs, it is very difficult to insert because of the squared
end and the large area that must be inserted. Accordingly,
the end to be inserted is usually squeezed or compressed
transversely to make the tube narrower to require less of an
incision in order to pass between the ribs. But this squee-
zing increases the vertical dimension of the tube and there-
by requires a larger opening in the area between the ribs,
which can cause the patient pain. It is also recognized
that some tubes for other uses have been made with sloping
ends but not of the present material and not with the pre-
sent type of end that can be inserted between the ribs. An
example of this is the Sanders U.S. patent No. 2,458,305.
Also intravascular catheters have been made with trocars
wherein the trocar has a sloping end. But in that case, the
trocar is usually of metal and it is of a very small size
designed to enter a vein or -the like part of the human body.
Thus it does not have the problem of being flexible and yet
being stiff enough to be inserted between the ribs, or of
being widened upon being squeezed.
According to the present invention therefore there
is provided an intercostal tube of plastic material, the
tube being of a size to enable drainage from a body cavity
into which it is inserted, and being flexible about its
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longitudina1 axis but relatively resistant to transverse
crushing force; the tube having a sloping tip end portion
for insertion into the body by way of a passage therein made
such as one between the ribs; the end of the tube being
blunted to reduce its tendency to bend or to snag body tis-
sue during insertion, the sloping tip, when viewed trans-
versely of the tube axis, extending in a single slope from a
point on the surface of the tube toward the end of the tube
and toward the opposite side of the tube bu-t terminating
short of the opposite side of the tube, leaving a continuous
end that is blunted and that extends around the tube, and
the blunted part of which when viewed from the end of -the
tube, is arcuate and is relatively rigid agains-t collapse
upon being forced through a passage such as the one bet-
ween -the ribs. Suitably the slope is abou-t -twenty-five
degrees to -the longitudinal axis, and the tip of the tube
being rigid enough to be inserted between the ribs without
bending.
The present invention will be fur-ther illustrated
by way of the accompanying drawings, in which:-
Figure 1 is a view of an intercostal tube broken
away, showing the present invention;
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Figure 2 is a top plan view thereof;
Figure 3 is an end view of a squared-end tube of
the prior art with the end of the tube compressed to narrow
it for its entrance between the ribs; and
Figure 4 is an end view of the present invention
showing the sloping end of the tube squeezed for insertion.
The tube 10 is here shown as having its upper,
discharge end 11. Its other end is given an acute sloping
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edge 12 that has an angle of approixmately twenty-five
degrees to the axis of the tube, which means -that i-ts top
angle is approximately twenty-five degrees. Preferably the
sloping edge does not extend entirely across the tube but it
stops, leaving an end edge 13 that is arcuate and thereby
stronger against bending under axial pressure than the end
of the tube would be if the sloping edge 12 went entirely
across the tube, and the end were nearly pointed.
The tube has drainage tubes 15 spaced from its end
12, to admit fluids -Erom the body after insertion. These
fluids can drain out the upper end 11.
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The tube may be made of one of the polyhaloginated
polyethylenes or its equlvalent plastic material suitable for
medical use. Typically, these products are known under the
trademarks Tygon or TeElon. They are flexible but rather resis-
tant to distortion transversely of the tube. The tubes are nor-
mally about 18 to 20 inches long, to 40 French diameter, with
walls approximately 2 millimeters thick for a tube of approxi-
mately 14 millimeters outside diameter, or 40 French.
In use:
The tube of the present invention can be inserted
between the ribs into the thoracic area. In this, the lip 13
remains strong enough that the end of the tube will not collapse
and bend over, this result coming from the fact that the lip is
somewhat blunt and is arcuate in shape. The steep slope 12 per-
mits the tube to be inserted between the ribs with the minimum
size of the opening between the ribs to receive the tube. Usu-
ally, a clamp is applied to the inserted end of the tube, as is
indicated by the arrows in Figures 1 and 4. This squeezes the
end, as shown in Figure 4. Because of the sloping edges, and the
cut-away sides, the squeezing applied along the sloping end does
not bulge lateral parts of the tube significantly beyond the
diameter of the tube. In Figure 3, the lateral extension of a
square-ended tube, when squeezed, is illustrated. Such extension
causes pain to the patient.
Thus, the invention does not require a trocar as is
true of the Calinog U.S. patent 3,703,899. It remains flexible
so that its axis can be bent. It is insertable without the tro-
car because it remains rigid enough with the extreme slope of the
edge 12 and with the enlarged end produced by the cutoff 13.
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