Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
~DWBLLINa V~ c~NNUL~
Th~ inven-t:ion rela~s to all in~welli.n~ vein cann~l:La With a ca.r)rlul~
body aon~lst:i~g ~u~stant~ally of a pJ E~t,:.c oalln~ and a h~nd:l.e. and
hav~ng an in-~e~nal piercing cannula provi~d with a matal c~annula
(trocar) .
~ntrAv~nou~ ~n~ tion and in~ravenouE3 d~ip inEuE3ion ar~ now
indisp~ ble in ~11 ~f ~di~a~ ~reatment. Their dhvelopmen~ wa~
accomplished in mElny E~m~ ep~ and over a lon~ period of time.
Mathods for phlebc~omy and Por madioation have long been kn~wn.
The discovery o~ blood oir~ulation ~ly ln the 17~h centur~
o~e~ted the anatomic phy~ologi~al b~ r~garding inf~sion and
tran~fusion. Soo~ the ~i~9~ attempt~ a~ infusion were made, ~irst
~n ahilnal~ and la~er also in human beingE;, althou~h lnitially
neither ~ny thqr~.peuti~ ~ffect nor an~r advanc~ment o~ knowledge
were o~t~in~d. Sln~e tho r~a~on ~o~ the ini~lal fail~re~ ~ere
pro~bly to be at~rlhuted primarily to ~p~ia conditions, th~
invention o~ th~ in~Qction ~yrl~ge in the l~th ~entury ~r~ opene~
the w~ ~o mod~rn in~ation ~herapy. How~v~r, a new chap~e~ in
tr~ fu~ion ~oie~14e was b~un a f ter ~he dlaco~ery o~ blood groups
at th~ begi~niny o~ ~hl~ ~entury, q~h~n the d~ai~i~e ba~es and
technologi~ could be devQloped whic~l are l~rgely what they are
today du~ ~o the ~t~m~lu~ ~ the t~o world war~ and the development
of int~rnal madi~ine and ana~tha iolo~y. In the me~n~im~
intra~nou~ ~her~py ~or paranter~l m~dlc~tion and fo~ the
replacem~ht o~ blood by tran~ ian or infusion hs~ become
wide~p~ead.
All illne~es ~n which the m~dica~o~ i~ t~ a~t ~api~ly or ca~no~
be ad~ini~;tered in any other w~y arR ~ ndica~ions f or in~ravl3nou~
in~ection. P~ec~i~ely :ln t~o~nec:tlon wlth 'che lE~ttar i:ype oP c2lse~:,
medlc~ on oVer a long period ~)f time is re~Uire~, so thE~t
intravenou~ drip infu~ion ig u6ed in adm~ tsr~ ~g the indit~ated
''3 ~
mediaatlon~ In thl6 caee an lnd~r~lling vein c:annula i~; used, whose
f~n~tion i~ t~ e ~escrihsd in det~il herewlth.
.~egardlee- of the l~ngth o~ tlme arld rat~ o:~ infu~ion, first A
~:uita~le ve;i n i~ ~:el~3ct~d . It i~ de~irable in the ca~;e o~ an
exten~ed in~uE~ n ther~py ~lx~3t to sRleo~ vain~ loaal~ed a5 di~tally
as po~ible, ~;o tllat i~ ~ny thrombo~i~ o~cura, more proximally
located c~p~n V-3in~ aah be re~;ortad ~o . In ~ny r~a~e, veint3 ~d~ ac~nt
to -~oint~ (wr~st~ bow~, etc. ) muElt be av~id~d hecau~e o'cherwls~
when mov~m~n~ or~u:rs th~3 ve~n may ~e in~ur~d or ~3ven punc~tu~ed no
matt~r how the o~n~ul~ i~ f ixed in place . As the uE;e of
in~ravenou3 ~luld trea~cment increases, a number o~ ~urther
developmants of cannul~e h~ve oom~ o ~ge ln ~he last ~w
~cade~. ~nar~as~n~ pre~erence 18 enjoyed by indwelllng cannulae
~ pl~tlc, o~ whiah th~ BO~oalle~ raun~le~ (ragl~tered tradem~rk
of ~ ~raun M~lsu~n ~G) is mo~t wid~ly use~.
~h~ known pla~tlc indw~lling v~in aahnUla COIl~i~t~ ~'ir9~ 0~ an
inte~nal pl~rcln~ oannula tha ku~ular p~r~. o~ Whi~h ~0116is~ oE
m~tAl (~o-calle~ ~trooar"~, ~nto whi~h R coni~al~y te~lnilla~ing~
alo~ely fi~ing plA~tio tube is slipped. Th~ pla~tic tu~e is
sllghtly shorter in l.ength thah the ~rocar an~ the tr~n~i~lon to
th~ conioal part is made ~aple~s at the tip o~ the cannulA by
pre~ise ~ach~ning, 6~ that, if it ls corre~tl~ halldled, any
de~orma~ion o~ the oonical (pl~ ) tip of the c~nnula making the
pehetrati~" of the ti~B di~ ult will b~ preven~ed.
Tha manipulatian o~ the k~own indwelling vain ~Rnnula is to be
desoxlbed herewlth: After about l~2 to l cm o~ ~h~ ~anrlula has
~een lneer~ed into the lum~n of tha vein, the metal ~oaar i~
retracted to ~uch ~n ~xtent ~hat i~ tip is fully ~nside of the
pla~ia ~annula. ~hu~ the ahamb~r at the ~nd of the plastio
~annul~ flll~ ~ith blood, ther~y permittlng lnspection of the
locatiorl o~ the i~ldw~lling veLn c:~nnulA. Then the pla~ a~lnUla,
t~ith t~le troc~r compl~tio~y ~h~ 21ed .~n lt, 18 adv~n~ed lnto th~
lumen all the w~y up ~o it~ handl~ w~ Le ~l~e v~in ls ~till ~ oke~l.
l'lli~ i~ th~ wely in wl~icll ~hR hletal t~p of th~ tronar iE3 pr~ven~ed
~rom injurinq the vein wall WhRn t~l~ indwell~ nq val~l oannulA i~
in6arted, l~ut the plastic ~e,nnul2. ret~.n~; thq n~ce~;Ary ~;ti~fne.sl~
50 as not t:o b~ k.i7)ke~l by the r~:is~an~e oP the ~)c1n to its
ad~an~e. ~tnally, t~ indwellin~ vein canllul~ is ~ixed onto the
skin by n~e~ dhe~3lv~ ~rip~ or tlle l.ike at t}le ~ontact WillC,~S
prc~vided on thq c~,nnula body, and the in~otion ~yringe o.r infusic~n
s~stem i6 conlle~tecl to it.
A~ explained above, thQ ~cn~wn indwalling v~in ~anl~ula ha~ alroady
bn~n v~2ry ~ar dev~loped ~gardlng lts U913~ However, even af~ter
in~tall~tiotl ~oJnplicEitiorl~3 aRn dev~lop clu~ to th~a ~ac~ that
reli~le fix~l:ion at the ~ o~ the ~atu~l aannula i~ aclliev~.d,
anfl y~t ~he transitien betwQ~3n the cannul~ ch~mbMr and t~le mn-lth
o~ t~ lfubiorl ~:ub~ e~3 no~ p~xmlt op~imum .eixati~n. Ev~n in
the ~a~3~ o~ ~mall ~11d th~r~tore ~llo~t~e.~ i~d~elling vein canJ~ e,
this portion oE th~ dw~llLng VQin ~s~nnula protrude~ o~l~ o~ ~he
tad "tr1Anyle" (point o~ ~ntry - right aolltaot wing - lef~.
aon~aa~ wing) .~n prc-langatlan o~ thQ long axl~ of the cannula.
~pon an incau~ious .or unc~vnscliou~ movomerlt of the patier~t, wilile
a3~eep for ~xampll3, it i~ e~e~ore ea~ily po~sible ~or t;his end
of th~ ~a~n~lula tc) be dl~pl~.ced. q~h~ in~usion ~ub~ can conl1e loo6e
from ~he indwell~ng vein c~nnula o~, due tc~ tll~ leverin~ aotion of
thio protruding free end of thn canJ~ul~, injuri~A oan ooo-~r irl tho
~atunl point~ of entry or ln tha ~ nterior of t;he v~in ~
,
It i~ theref~l3 t}l~ obj~3at o~ the invention to configur~ and
1~np~ove the abov~-de~cribed indw~lling vein canllula ~.o the.t the
abo~e~mer~t:Lorled di~RdvAIlta~e~ wil~ be avo1ded, And that th~
indwell1ng vein ~annul~ will bo improv~ in 11~ en~i~ety. It i6
~urtharmore de~l~ed to ~cili~ate the handlln~ o~ the indw~lling
v~in cannula and imp~ove it~ oper~tlon wi~hout having ~o lo~e ~he
lcnown adva~tage~. ~h~ indwelli~g vein c~nnula aacord~ hg to the
invention, in wh~ch ~he ~bove-deAcrib~d ~b~t i~ achieved, is
charaateri2ed ~l~stly, and es~ent~ally, b~ the ~act that the
a~h~ula body is provide~ wi~h a flexu~ at the poln~ of attachment
q~ the handle. ~y thi~ oon~iguration according to the in~ention
it i6 brought about ~h~t movement~ ~ran~mit~e~ to the it)dwqllin~
vein ~annula by ~he ih~U~ion t~be can no lon~er be tra~ itt~d to
~he plastic cantul~ lyin~ wl~h~n ~h~ vei~ pecially, the
indwelli~ vein c~nnula c~n no longer ~ct a~ a ri~id lever in the
area b~tw~n th~ point of entry an~ the openin~ for re~ei~ing th~
injection syrin~ or in~u~ion tube, ~o ~ha~ ~he po~sibility qf
injury ~a~ be rsliably for~all~d.
~he OOlnpunent~ re~erre~ to above ;~ w~ll as thosa clalm~d and thos~
d~aribed :I n ~he exampl~a~ of ~3~nbodimHnt, which ~re to ~e us~d in
accorcl~nce with ~.he ~nv~ntion, elr~ not ~ub~eot to any ~3peoi~1
~xohptioh~1 coTId~tion~ a~ to tll~1~ E3i~, corlfl~urR-t.~oJl, c:holc~ o~
h~tarial and technical c:ono~ption, ~o that the arit~ia o~ choLc~
k~own in kheir p~ ul~r ~ ap~ atio~l can be applied
without li~nitat.~on, e~nd ~pe~ially t:h~3~r aro ulabl~ 1nd~pen~n~1y
of Ohe anoth~ or th~ ~olutlc~l o~ tha problam or o~ ~t l~a:~t
p~ t ~hereoP .
Th~r~ are ~lff~ t p4~sibili~i~s for ~mbodying ~nd developing thH
teaching o~ the inv~n~i~n; ~he~ora th~ ~ec~ndAry ola1ms on the
one hand oa~ bo oon~ulted in thi~ r~gard, ~nd o~ ~he ~ther h~n~ so
~n the following ~xplanation of ~ preferred embo~1ment ~ the
indwelling ~in cannul~ in ~oniunat~on wlth the draw~ng, wherein:
~ig. 1 ls a sid~ VieW o~ ~he indwelling ~ein oannula aoaord~n~ to
th~ invent~on, in the assembled ~tate with tlp guard.
Flg. 2 i~ a ~lde view o~ th~ 1ndwelling v~in cannul~ according to
the lnv~n~i~n in th~3 dis~ ;em~lqd stat~ with ~he tip guard
remov~d .
Fig. 3 ~ sid~ vi~w o~ A part o~ ~he indw6a~.ling v~in cannula
accordin~ to th~ invention ~rom Fi~ur~ 2.
Fig. 4 i~ ~ ~id~ ~riew o:~ a par~ of th~ in~wellin~ v~ln cannula
e.ccor~llng ~o ~he invention ~xom F;l gur~ ~ .
Fi~ . 5 i~ R plan vl~w of th~ part of i:he indwE311ing ~r~in c: ~nnula
a~cordlng ~ thq inven~lon ~rom Figure 4, aJld
Flg. 6 1:3 an ~nl~.rg~d ~ec~lon of thQ ~.n~wc~ll.Ln~ v~ln ~an~lula
ac~ordin~ to the inv~n~lorl, on the clrcl~3 in brok~3n lin~
~rom Fig~. ~ an~ 5.
F~ g. ~ ~3howl!3 th~ indw~llinç~ v~in c~nnula ~ccordln~ to t.ll~3
in~n-tion, indiaat~d as a whwl~ at 1~ in a oid~ vi~w. q'hH
indwelling v~in a~nnul~ 1, re~ularly a dlspt)~a~ annul~ in
thi~ a~ nbl~d ~ e ~fore it:~ ~ir~t ~Jg~. For ~reat~r ~larlty,
th~3 indwelllng va~n oannula 1 i~ shown in it~ .inflividual componan-t~;
in a ~id~ vi~w and plan v1~3w irl F~gure!3. 2 and 3, r~p~ctlvely.
~rl p~tiaular, th~3 indw~lling v~in s~.nnula 1 acct~rding t~o thQ
inventlon;l f~r~ ha~ ~he cannula l~o~.y 2 witl~ ndle aonn~ction 3
~nd thQ plasti~ nnula 4 ~orm~3d ths~ Li]c~wlse ~ormed ther~on
are the ~ixation wingE~ s which serve a~ support:ing and aclhering
Ine~S16 ~or fa~ nin~ ~h~ indwe1ling vein c~nnul~ 1 on th~ skin.
Thelr und~r~i~e~; are o~ten provided with n~tahes in or~er better
to b~3 ad~p~d ~o 'che ~hap~ o~ an arm ~ ~or ex~mpl~ .
s ~
PugllrQn 1 ~o 3 Purth~rmor~ nl~o~ At, 11~ t~ interior oE the
cannula body 2 ma~ o~ pla~'cic~, ~here :16 an ln~ e car1nula e~uipp~d
w~th a hollow me~al n~edl~, the ~;o-::alled "troc:ar" 7. ~he tip o~
the ~ro~a~ 7 iE~ bevel-ground, a~ it appe~; qultra c:learly ~rom
~igures 2 and 3. For ea~ier hand:llny, th~ p1erclng ln~ide cannul~
~ i~ e~uipp~l with a holding lu~ 8. rrhe inclw~lling vein Gannula
1 i~3 clc~;efl with a trocar cap ~ which i~ ~uc~h that, when ~h~ troa~r
7 i~ remo~recl, thin aap can A~e:o ~erv~ for s~lincJ t:he ,::annula body
2~ ~o~ that purpo~, nnc1 al~o, ol~ c~ou~E;e, to ancJc~tmnodatQ ~n
injection E~yrlnge or ~rl infu~ion tuloe no~ E~hown, bo~h ~he cannul~
body 2 and ~hl3 in~id~ cannul~ ~ are made ho~.low cylin~ric~l at
thei~ and r~motq ~rom ~he tip. L~ E:tly, it ~an b~ en i n Fl~6 .
and 3 that th~ indwellin~ ~ein ~annulae 1 are prov~d~d with tip
uard~3 10 to protect again~;t i~jury and damagQ.
In accordnnce with th~ ih~ nti on the ar~d Df~ the c~Q~nnula body 2
remotQ ~r~m the tip :l~ providecl, a~ ~he p~ I nt o~ attachme!nt o~ the
harldla 3, wi~h a ~.exure 1~, ~o that th~ in~eetion ~yrin~e c~r the
end of the ln~u~ n tubo ~o lt~ngar n~eds t~o be ln line wi~h ~he
lollg axi~ of the oannula (not et3p~3~ia~y indica~cl in ~he drawing~.
The operatic:n o~ thi~ Elexu~e 11, which 1Ej known ~n other ~ields
of app~ tlon, can he cle~rly un~rstoo~ ~rom Fi~ures ~ and 5
whlch show the ~annula body 2 in a ~ld~ vi~w and plan Vir3W,
respeativsly. ~ccordln0 to ~ ~urther teacl~ing of the inventlon,
the ~l~xure ~1 is of ~uch a n~u~ ~nd l~lg~.h that it p~r~its
bending over so degraes~ In thlE~ manner, ~c1r example, ~n in~usion
tube ~an be attach~ to the indw~lling vein a~nnula 1 perpendir~ula~
to th~ ~rm (~nd ~l~noe i~lso perpendlculAr -to t}l~ v~ln) . Po~s;i ble
move~nentE; c~f the infusion tube are transmitted le~s to the cannula
bt~dy 2 ~hAn in ~he case o~ conv~n~ional in~we~lin~ veln cannul~e.
In ~rthf~r c~nv~loEInl~nt oi~ t:h~ inventic~n, ~h~ ~r~l~ body ~ i~
p~ovid~l with ~ ~inyer plate 1~ at the han~le 3. It 1~ ~pec!i~lly
Advanta~eous i~, accor~lng t:o ~ furthe~ ~e~ g of the inven~ion,
th~ fin~ pl~ta 12, adapted to the al~atomy o~ the fin~3r pad af
an ~ndex Pinger, i~ ~urved in ~h~pe ~nd~t~r providod wit~h nubs 13
tc~ prevent any glippin~ of the ~ir~e~ C~h the b~nnula bc~dy 2. Th~
above-àe~cribed confi~ur2l~ion p~lnitE; ~peo~all~ a3aBy hzln~lincJ c?f
the indwelling vein cannula 1 ~cordin~ to the inven~io3~ ince it
ce,n ba ~uid~d aecurely and neve~hele~ en~itively witll th~e~
finge~, the in~ex PihgRr lylr~g orl thR 1~ger platR 12, and the
thumb and mi~dle f~n~r laterally gripping the holding lug 8 oP the
in~ide pier~ing o~nnula 6~ Here again can ~9 s~en the speal~l
a~vantage of th~ previously de~cribed con~igUration o~ the
indwe~lin~ vei~ cannul~ 1 aoo~ding to ~ inv~ntio~, becau~e
~aaeration of the ~ei~ ls a very ~requent oomplioatio~ o~
phl~b~tomy, though in ~08t CaSeg lt ls harml~fifi. on~ i~ taught to
'Ihold the indwelling ~in oannula llghtly,i' so a~ ~o ~el ~h~
~e~istance o~ the vein wall, and to ~-lid~ th~ in~ect~on neeclle ~
~en~ltively ~ po~ibl~, ~o a~ ~o ~a a~l~ to sot it lmm~di.ately
when blood e~ter~ the cannul~. Thls recomm~nclatio~ uppor~ed
by the de~ign de~aribed ~bo~e~
~t i~ not ~hown t~at in~walling vein cannulae ~e often provid~d
with two ports, ~r exampl~ to permi~ the cannula ~v be Plushed
out. These a~ us~ally provided ~t ~he point of attachmen-t of the
cannula ~ody at thq ~ixation wing~. ~h~re~ore it i~ de~irabl~
th~t, ln ~he ca~e o~ indwellin~ vein cannulAe in accordanç~ wlth
the invention/ the ~inger plate ~imult~n~ously form the cover o~
the .second port.
L~tly, an ~ddlti4nal ~eachin~ o~ the inventlon consists in
pxovidln~ ~t leAst one cros~ bore 14 ~t its tlp. For easie~
compr~hen~ion, the area with~n ~he brokell circle K of Fl~rss 3
ti `J ~
and 5 ;i.B ~hown ~nlarged in Fig. ~. Xn th~ ~3mhodimen~ own, and
to ~his ~xtent pre~err~d, thQ plaE~tlc aannula ~ ~;hown only a~ its
tip has ~le cro~ bor~ 14, bllt conf igurAt~ion~ wi1:h ~everal cros~
bor~ are a~ onceivi~ble. B~ mear~ o~ the~;e ~ro~s bores
uni~o~ low 1~ aahlev~d, atld clo~ging (~or exalnpll3 by blot)~l ~lots
du~ to contao~. bekween t~l~ tlp c~:f the cantlu:la And the VRill wall,
or m~chaniaal damage to the delicate, tapering Gannu1a tip, et~. )
aan be rel iably prev~nted .
