Anal fixation device
09775564 · 2017-10-03
Assignee
Inventors
- Thomas R. Parks (Mammoth Lakes, CA, US)
- Sanket Khandelwal (Culver City, CA, US)
- Adil E. Bharucha (Rochester, MN, US)
Cpc classification
A61B5/1107
HUMAN NECESSITIES
A61F5/0093
HUMAN NECESSITIES
International classification
A61B1/32
HUMAN NECESSITIES
A61F5/00
HUMAN NECESSITIES
A61B5/11
HUMAN NECESSITIES
Abstract
Anorectal diagnostic procedures are oftentimes carried out with the patient laying in the left decubitus position, which leads to non-representative response to test maneuvers due to the unnatural position and patient anxiety. Devices spanning, or fastened on, the interglutial cleft of a patient allow for a more natural patient position and eliminate non-representative responses.
Claims
1. An anal fixation device for use in anorectal diagnostic procedures, comprising: a housing configured to accept a probe and to maintain the probe in a fixed position relative to the subject's anus verge during an anorectal diagnostic procedure, said housing comprising two arms and a base which is a connection point of the two arms; and a probe support comprising a support arm and a retaining piece, wherein: a proximal end of said support arm is connected to the base such that the two arms can flex without moving said support arm, said support arm extending in-between the two arms, the retaining piece is connected to a distal end of said support arm, and the retaining piece is configured to accept the probe for performing anorectal diagnostic procedure.
2. The anal fixation device according to claim 1, wherein the two arms of said housing are configured to span the interglutial cleft of a subject.
3. The device according to claim 1, wherein the housing has a first, uncompressed width in an uninstalled configuration, and has a second, compressed width in an installed configuration.
4. The device according to claim 1, wherein the two arms oppose each other and are positioned to create an open space therebetween, wherein said support arm extends into said open space.
5. The anal fixation device according to claim 1, wherein the housing includes a plastic material.
6. The anal fixation device according to claim 1, wherein the housing is configured to be fastened at the interglutial cleft of the subject.
7. The anal fixation device according to claim 1, wherein the two arms form an open object or a closed object.
8. The anal affixation device according to claim 1, wherein the probe support comprises a means for fastening or retaining the probe.
9. The device according to claim 8, wherein the fastening means is selected from the group consisting of a belt-like elastic band, a clamp-like structure, a lock piece, a plastic or rubber stopper-type mechanism and a tapered lock piece.
10. The anal fixation device according to claim 8, wherein the fastening means comprises a belt-like elastic band attached to one side of said probe support.
11. The anal fixation device according to claim 10, wherein said probe support has a said clamp-like structure with a side opening capable of receiving the probe.
12. The anal fixation device according to claim 11, wherein the belt-like elastic band is configured to be secured across the side opening of said clamp-like structure to thereby secure the probe, by positioning a slit formed in the middle of the belt-like elastic band over and onto a knob formed as part of said probe support.
13. The anal affixation device according to claim 1, wherein the housing comprises a semi-rigid plastic material.
14. The anal fixation device according to claim 1, wherein said housing has a width defined as a dimension of the housing spanning the two arms, and a height that is defined as a dimension of the housing perpendicular to a width of said housing at an apex of the two arms, wherein said support arm extends between said arms approximately half of the length of the height of said housing.
15. An anal fixation device for use in anorectal diagnostic procedures, comprising: a housing comprising two arms and a base, wherein: the two arms form a shape selected from a group consisting of open shape and closed shape, the base is a connection point of the two arms, and said housing is configured to span the interglutial cleft of a subject; and a probe support comprising a support arm and a retaining piece, wherein: a proximal end of said support arm is connected to the base such that the two arms can flex without moving said support arm, the support arm extending in-between the two arms, the retaining piece is connected to a distal end of said support arm, and the retaining piece configured to accept and retain a probe for performing an anorectal diagnostic procedure.
16. The anal fixation device according to claim 15, wherein the housing comprises a semi-rigid plastic material.
17. The anal fixation device according to claim 15, wherein the probe support further comprises a fastening means for fastening and retaining the probe, said fastening means is selected from the group consisting of a belt-like elastic band, a clamp-like structure, a lock piece, a plastic or rubber stopper-type mechanism and a tapered lock piece.
18. The anal fixation device according to claim 15, wherein each arm comprises a foam strip having an adhesive material configured to be adhered to the subject's buttocks.
19. The anal fixation device according to claim 18, wherein said foam strip is located on an external surface of said two arms.
20. The anal fixation device according to claim 15, wherein the housing has a first, uncompressed width in an uninstalled configuration, and has a second, compressed width in an installed configuration.
21. The anal fixation device according to claim 15, wherein the two arms oppose each other and are positioned to create an open space therebetween, wherein said support arm extends into said open space.
22. The anal fixation device according to claim 15, wherein the housing includes a plastic material.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
(1) The subject matter regarded as the invention is particularly pointed out and distinctly claimed in the concluding portion of this specification. The invention, however, both as to organization and method of operation, together with objects, features, and advantages thereof, may best be understood by reference to the following detailed descriptions when read with the accompanying drawings in which:
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(13) It will be appreciated that for simplicity and clarity of illustration, elements shown in the figures have not necessarily been drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. Further, where considered appropriate, reference numerals may be repeated among the figures to indicate corresponding or analogous elements.
DETAILED DESCRIPTION
(14) In the following detailed description, numerous specific details are set forth in order to provide a thorough understanding of the invention. However, it will be understood by those of ordinary skill in the art that the present invention may be practiced without these specific details. In other instances, well-known methods, procedures and components have not been described in detail so as not to obscure the present invention.
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(16) The length of bracket 1 may rest between the commode seat and the patient's buttocks, thereby stabilizing bracket 1. Then, a catheter probe 4 is threaded through a central opening or hole 5 in bracket 1, inserted an appropriate depth into the patient, and, then, fastened to bracket 1 via the catheter fixation element 2. Bracket 1 may be manufactured from a material such as hard plastic or metal that is durable and remains rigid under the body weight of a subject.
(17) Advantages of this first embodiment include its manufacture simplicity and ability to provide a strong structure that securely holds catheter probe 4 in place, proximate to the buttocks.
(18) A second embodiment of the present invention is shown in
(19) A wedge, such as wedge 7 shown in a front view of
(20) In one embodiment, wedge 7 has two lateral sides that lie adjacent to the patient's skin on either side of the interglutial cleft, a front side 24 and a back side 26. In certain embodiments, wedge 7 is approximately 2-10 cm wide (i.e., from one lateral side to another lateral side, ‘bridging’ the interglutial cleft), and preferably 3-8 cm wide, and more preferably 4-6 cm wide. In one embodiment, wedge 7 is 4 cm wide. In certain embodiments, wedge 7 is approximately 2-10 cm deep (i.e., the front side closer to the front of the patient to the back side closer to the back of the patient), and preferably 3-8 cm deep, and more preferably 4-6 cm deep. In one embodiment, wedge 7 is 4 cm deep.
(21) In one embodiment, each side of wedge 7 is manufactured to have the same angle. In one embodiment, each side of wedge 7 has an angle of (between) approximately 0-45 degrees, and preferably between 5 degrees and 30 degrees, and more preferably between 10 degrees and 20 degrees, with respect to a vertical line from one end to another (i.e., with respect to a longitudinal axis 28 of the wedge). In one embodiment, each side of wedge 7 has an angle of 15 degrees.
(22) In another embodiment, wedge 7 may incorporate or have two different angles on its sides. Specifically, in order to accommodate anatomical/morphological variations in patients, wedge 7 may be formed with sides that are not equally angled, e.g., sides that are angled to match (suited for) the morphological angles of a specific patient. In addition, the side of wedge 7 that attaches to the buttocks may be pulled somewhat by catheter probe 4, and it may be desirable to make the sides of wedge 7 not equally angled so as to avoid discomfort to the patient.
(23) In another embodiment of the present invention, each side of wedge 7 may have different angles such as, for example, four different angles depending on the needs or anatomy of the patient. In yet another embodiment of the present invention, wedge 7 may have multiple sides manufactured at the same angle, and multiple sides manufactured at different angles such as, for example, two sides having a first angle and two different sides having a second, different, angle. In another embodiment, three sides of wedge 7 may have the same angle, while the fourth side has a second, different, angle.
(24) Wedge 7 may be made of, for example, a soft compliant material that accommodates for differences in patient anatomy/morphology and patient movement (for example, changing width of interglutial cleft) during the clinical procedure.
(25) In certain embodiments of the present invention, as shown in a cross-sectional front view in
(26) Catheter probe 4 may be fastened to wedge 7. For example, in addition to stiff or semi-stiff inner member or tube 9′, an additional element may be used to affix catheter probe 4 within/to wedge 7. For example, a tapered lock piece 8 (i.e., wedge), as shown in
(27) Wedge 7 may be provided with a suitable adhesive 3, for example, on opposing sides of wedge 7, as shown in a side view in
(28) Fastening of wedge 7 to the buttock(s) and fastening of catheter probe 4 to the wedge 7 can be done in any order. However, a preferred order of fastening is to first fasten wedge 7 to the body such that the central opening is directed toward the anal verge, and catheter probe 4 is then fixed to the wedge 7 by being inserted or threaded through tube 9′ such that it passes through the anus at the proper axial position. Catheter probe 4 may be fastened to wedge 7 through tube 9′ by the tapered lock piece 8 or other suitable means for immobilizing catheter probe 4 within wedge 7, as shown in
(29) A third embodiment of the present invention is shown in
(30) In certain embodiments, half wedge 6 may have the shape of a full wedge 7 that has been split from one end to the other, such that three side surfaces of the half wedge shape taper outward from a base end to an upper end, and the remaining side surface is non-tapered, i.e., is substantially perpendicular with respect to the base and upper surfaces. In certain other embodiments, the shape of half wedge 6 may be unrelated to (dissimilar to) the shape of the shape of wedge 7. In one embodiment, half wedge 6 has an internal end, an external end, a front side and a back side, a lateral side that lies against the patient's skin on one side of the interglutial cleft and an opposing lateral side that does not lie against the patient's skin. In certain embodiments, due to the angling of half wedge 6, the internal end thereof has a comparatively much smaller surface area than that of the external end.
(31) The catheter probe 4 is fastened to the half wedge 6 by a suitable means for attachment, such as, for example tape or a plastic holding device configured on half wedge 6. Optionally, half-wedge 6 has a channel or groove formed into the surface of the lateral side of half-wedge 6 that does not lie adjacent to the patient's skin, in order to support the position of the probe.
(32) Half wedge 6 may be configured with different angles on the side of half wedge 6 that guides catheter probe 4 towards the anal cavity relative to the side of the half wedge 6 that attaches to the buttock. For example,
(33) In one embodiment, as shown in
(34) In another embodiment, as shown in
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(36) Half wedge 6 may be manufactured from a material that is durable, such as hard plastic or metal, or from a more compliant material comprising semi-rigid and soft foams or sponge elastomers, or other suitable soft, elastic material.
(37) Half wedge 6 should preferably be small enough to fit comfortably within the interglutial cleft of a human body, with the base end having the smaller cross-sectional area being fit adjacent to the anal verge, as shown in
(38) In certain embodiments, half wedge 6 is 0.5-5 cm wide, preferably 1-4 cm wide, and more preferably 1-3 cm wide. In one embodiment, half wedge 6 is 2 cm wide. In certain embodiments, half wedge 6 is approximately 0.5-5 cm deep (i.e., the front side closer to the front of the patient to the back side closer to the back of the patient), preferably 1-4 cm deep, and more preferably 1-3 cm deep. In one embodiment, half wedge 6 is 2 cm deep.
(39) Advantages of this third embodiment include its simplicity, relatively unobstructed opening for stools to pass, low production/manufacturing costs, freedom of anatomical movement of the patient, and in situ proximity to skeletal support (ischial tuberosity) to minimize movement of catheter probe 4 in the axial direction relative to the anus.
(40) A fourth embodiment of the present invention is shown in
(41) In certain embodiments of the present invention, as illustrated in top view in
(42) In certain embodiments of the present invention a width 14 of leaf spring housing 11 is defined as the dimension of leaf spring housing 11 spanning arms 15a and 15b (e.g. the width of leaf spring housing 11 bridges the interglutial cleft when the device is fastened to the buttocks of the patient). In certain embodiments, the height of leaf spring housing 11 is defined as the dimension of leaf spring housing 11 perpendicular to the width at/of the apex (i.e. the curved portion, or connecting ‘area’, connecting arms 15a and 15b) of the “U”-shaped leaf spring housing 11. In certain embodiments, leaf spring housing 11 is approximately 1-5 cm high, preferably 1-4 cm high, and more preferably 2-4 cm high. In one embodiment, leaf spring assembly 11 is 3 cm high. In certain embodiments of the present invention, leaf spring housing 11, when in a resting position, i.e., it is not yet installed, is approximately 1-7 cm wide, preferably 2-6 cm wide, and more preferably 3-5 cm wide. In one embodiment, leaf spring housing 11 is 4 cm wide. It is noted, however, that the compliance (i.e. flexibility) of the housing may change the overall width of leaf spring housing 11 once it has been fastened to the buttocks of the patient due to compression thereof. In other words, leaf spring housing 11 may have a ‘free’ width or ‘released’ position, or ‘decompressed’ width, or expanded width, which is the width, or position, or state of device 11 when no external force is applied to it (such as when the device is not installed on a subject; e.g., when the device resides in a package), and a ‘compressed’ width, which is the device's width when the device is installed on a subject. The ability of the width (14) of leaf spring housing 11 to forcedly (i.e., under pressure) change, or flex, from the free width to the compressed width enable the spring-like arms 15A and 15B to be in compressive/tight contact with the subject while providing an opening suitable for the passage of stools.
(43) In certain embodiments of the invention, arms 15a and 15b are approximately 1-6 cm long, preferably 2-5 cm long, and more preferably 3-4 cm long. In one embodiment, arms 15a and 15b are 3.5 cm long. In one embodiment the length of arms 15a and 15b from the apex of leaf spring housing 11 is approximately 5 cm, although it is noted that other lengths are possible depending on the length of arms 15a and 15b. In some embodiments, the lengths of arms 15a and 15b are substantially identical, although in other embodiments this need not be so (i.e., their lengths may differ).
(44) As may be seen in
(45) In this embodiment, there are two main functional elements on leaf spring assembly 10. The first functional element is the two-armed housing 11, which is designed or configured to maintain positive contact pressure between the attachment surface on the patient's buttocks while also conforming to changes in anatomical and physiological opening variations of individual patients. This is accomplished by using a relatively “soft” spring constant with large free spacing of the opening between the two “arms” 15a and 15b.
(46) The second functional element of the leaf spring assembly 10 is a probe support 13, which is configured to hold probe 4 securely in a set, or fixed, position relative to leaf spring assembly 10. Probe support 13 has a retaining piece/element 13B, which may be in the form of a ring or a semicircle/half/partial ring (e.g., C-shaped clam, gripper or clasp), or other probe attachment element, which is attached at the (distal) end of a support or connecting arm 13A. Probe support arm 13A may be connected to housing 11, extend in-between two arms 15a and 15b and configured to accept a catheter probe for performing the anorectal diagnostic procedure. Support (or connecting) arm 13A is attached to leaf spring assembly 10 in such a way that it is rigid relative to housing 11 (i.e., connection point) of arms 15a and 15b and provides for (enables, or can be used for) attachment and removal of catheter probe 4. As shown in
(47) Fastening of leaf spring assembly 10 to the buttock(s) and attachment of catheter probe 4 to leaf spring assembly 10 may be carried out in any order. However, in a preferred order, leaf spring assembly 10 is first fastened to the body. In certain embodiments of the present invention, the outer surfaces of arms 15a and 15b of leaf spring housing 11 (including the foam strips 12) are fastened to the sides of the buttocks using contact adhesive, such as, for example, a suitable adhesive 3, as shown in an anterior view in
(48) In the preferred order, catheter probe 4 is then fixed or fastened to probe support 13 of leaf spring housing 11 by attaching it to retaining piece 13B, e.g., by being threaded or inserted through a ring or clamped by a C-shaped clamp or gripper element or other attachment feature, in such a way that catheter probe 4 is directed toward the anal verge, such that it passes, e.g., by being pushed, through the anus and is at the proper axial/depth position. Catheter probe 4 may be fastened to the probe support 13 by any suitable means, such as, for example, a belt-like elastic band, a clamp-like structure, a lock piece such, for example, tapered lock piece 8, a plastic or rubber stopper-type mechanism, or any other suitable fastening means.
(49) A person having ordinary skill in the art will appreciate that there are many different ways in which catheter probe 4 may be fastened to retaining piece 13B of probe support 13 of leaf spring housing 11. For example,
(50) Thus, with respect to leaf spring assembly 10, three design goals are addressed herein: 1) patient freedom of movement is minimally affected; 2) catheter probe 4 is secured and maintained centrally to and directed toward the anal verge; and 3) a maximal opening is provided to allow for passage of stools or waste material. Advantages of the invention include simplicity of design, largely unobstructed opening for passage of stools, low production/manufacturing costs, freedom of anatomical movement, and in situ proximity to skeletal support (ischial tuberosity) to minimize movement of catheter probe 4 relative to the anus.
(51) It may sometimes be difficult to adjust a band (e.g., the belt-like elastic band mentioned above) and, considering the sensitivity of the region of the anus verge, manipulation of the band at that region should be minimized to minimize discomfort. It may sometimes be difficult to adjust the clasp, or clamp, and reposition the probe particularly when the patient is seated on the commode. Such difficulties, or concerns, may be mitigated by configuring the catheter/probe fixation device such that it is self-contained in/between two semicircular (half), adjustable, rings that encircle and centralize the probe. The two adjustable semicircular rings may be configured to function as a clamp.
(52) While certain features of the present invention have been illustrated and described herein, many modifications, substitutions, changes, and equivalents may occur to those of ordinary skill in the art. It is, therefore, to be understood that the appended claims are intended to cover all such modifications and changes as fall with the true spirit of the invention.