公开(公告)号：EP0784989A2

公开(公告)日：1997-07-23

申请号：EP97300178.7

申请日：1997-01-14

申请人： Cook Incorporated

发明人： Ciaglia, Pasquale ,  Fischer, Frank J. Jr.

IPC分类号： A61M16/04

CPC分类号： A61M16/0488 ,  A61M16/0431 ,  A61M16/0434 ,  A61M16/0445 ,  A61M16/0472

摘要： A method and device (10) for providing an ostomy (102) through the wall (100) of the trachea. The method employs a balloon catheter (16) including an inflatable balloon (18), and entails percutaneously inserting the tip (56) of a wire guide (54) through the tracheal wall (100) so that the wire guide (54) lies across the tracheal wall (100); positioning the catheter (16) over the wire guide (54); advancing the catheter (16) along the wire guide (54) until the balloon (18) lies across the tracheal wall (100); and inflating the balloon (18) to atraumatically dilate a portion of the tracheal wall (100), thereby forming an ostomy (102). The method desirably includes the further steps of deflating the balloon (18) and inserting a tracheal tube (20) into the ostomy (102). The tracheal tube (20) can be positioned in the open ostomy (102) after removing the balloon (18) from the ostomy (102). However, the method is preferably carried out employing a device (10) having a dilator tube (12) which carries the catheter (16) and tracheal tube (20) on it. Such a construction allows the dilator tube (12), the balloon catheter (16) and the tracheal tube (20) to be advanced on the wire guide (54) together. The tracheal tube (20) can include an inflatable circumferential cuff (24) on it, providing a seal between the tracheal tube (20) and the tracheal wall (100). The diameter of the balloon (18) preferably is at least equal to, and more preferably is slightly greater than, the maximum diameter of any portion of the tracheal tube (20) (such as the uninflated cuff (24)) to be inserted into the ostomy (102). The method and device (10) of the present invention are particularly advantageous in that the ostomy (102) can be formed atraumatically and enlarged without risk of perforating the rear of the trachea, and in that the close dilation or slight overdilation of the ostomy (102), along with the taper of the distal end (14) of the dilator tube (12), protect the cuff (24) from damage during insertion of the tracheal tube (20) through the ostomy (102).

摘要翻译： 一种用于通过气管的壁（100）提供造口术（102）的方法和装置（10）。 该方法采用包括可充气球囊（18）的球囊导管（16），并且需要经皮插入导线器（54）的尖端（56）穿过气管壁（100），使得导线器（54）位于 气管壁（100）; 将导管（16）定位在导线器（54）上方; 沿导丝器（54）推进导管（16）直到球囊（18）穿过气管壁（100）; 并使气囊（18）膨胀以使气管壁（100）的一部分无损伤地膨胀，从而形成造口术（102）。 该方法理想地包括进一步的步骤，使气囊（18）放气并将气管管（20）插入造口术（102）。 在将气囊（18）从造口术（102）中取出后，气管管（20）可定位在开放式造口术（102）中。 然而，该方法优选使用具有在其上承载导管（16）和气管管（20）的扩张管（12）的装置（10）进行。 这种结构允许扩张管（12），球囊导管（16）和气管管（20）一起在导线器（54）上前进。 气管管（20）可以包括在其上的可充气圆周箍（24），在气管管（20）和气管壁（100）之间提供密封。 气囊（18）的直径优选地至少等于并且更优选略微大于要插入的气管管（20）（例如未膨胀的袖带（24））的任何部分的最大直径 造口术（102）。 本发明的方法和装置（10）是特别有利的，因为造口术（102）可以无损伤地形成和扩大，而没有穿过气管后部的风险，并且造口术的紧密扩张或轻微过度扩张 102）与扩张管（12）的远端（14）的锥度一起，在气管插管（20）通过造口术（102）插入期间保护袖带（24）免受损伤。

公开(公告)号：EP0784989B1

公开(公告)日：2004-06-02

申请号：EP97300178.7

申请日：1997-01-14

申请人： Cook Incorporated

发明人： Ciaglia, Pasquale ,  Fischer, Frank J. Jr.

IPC分类号： A61M16/04

CPC分类号： A61M16/0488 ,  A61M16/0431 ,  A61M16/0434 ,  A61M16/0445 ,  A61M16/0472

公开(公告)号：EP0784989A3

公开(公告)日：1998-04-22

申请号：EP97300178.7

申请日：1997-01-14

申请人： Cook Incorporated

发明人： Ciaglia, Pasquale ,  Fischer, Frank J. Jr.

IPC分类号： A61M16/04

CPC分类号： A61M16/0488 ,  A61M16/0431 ,  A61M16/0434 ,  A61M16/0445 ,  A61M16/0472

摘要： A method and device (10) for providing an ostomy (102) through the wall (100) of the trachea. The method employs a balloon catheter (16) including an inflatable balloon (18), and entails percutaneously inserting the tip (56) of a wire guide (54) through the tracheal wall (100) so that the wire guide (54) lies across the tracheal wall (100); positioning the catheter (16) over the wire guide (54); advancing the catheter (16) along the wire guide (54) until the balloon (18) lies across the tracheal wall (100); and inflating the balloon (18) to atraumatically dilate a portion of the tracheal wall (100), thereby forming an ostomy (102). The method desirably includes the further steps of deflating the balloon (18) and inserting a tracheal tube (20) into the ostomy (102). The tracheal tube (20) can be positioned in the open ostomy (102) after removing the balloon (18) from the ostomy (102). However, the method is preferably carried out employing a device (10) having a dilator tube (12) which carries the catheter (16) and tracheal tube (20) on it. Such a construction allows the dilator tube (12), the balloon catheter (16) and the tracheal tube (20) to be advanced on the wire guide (54) together. The tracheal tube (20) can include an inflatable circumferential cuff (24) on it, providing a seal between the tracheal tube (20) and the tracheal wall (100). The diameter of the balloon (18) preferably is at least equal to, and more preferably is slightly greater than, the maximum diameter of any portion of the tracheal tube (20) (such as the uninflated cuff (24)) to be inserted into the ostomy (102). The method and device (10) of the present invention are particularly advantageous in that the ostomy (102) can be formed atraumatically and enlarged without risk of perforating the rear of the trachea, and in that the close dilation or slight overdilation of the ostomy (102), along with the taper of the distal end (14) of the dilator tube (12), protect the cuff (24) from damage during insertion of the tracheal tube (20) through the ostomy (102).