Tracheostomy apparatus and device
A device and a method for the percutaneous placement of a tracheostomy tube composed of a handle, an inflatable balloon having a reversed truncated cone shape, a tube to inflate the balloon and another to contain a wire guide, a plastic structure in the middle between the balloon and the handle made of laminar elements to strengthen the apparatus movements of the handle transmitted to the tube and the balloon. Following placement of the tracheal tube, the balloon is deflated and the apparatus or device withdrawn.
1. A tracheostomy device, comprising:
a handle;
an inflating tube;
a wire guide tube;
an intermediate portion to sustain the inflating tube and the wire guide tube;
a tracheal tube surrounding the intermediate portion; and
a dilating balloon, being inflatable through the inflating tube, the balloon having a proximal portion and a distal portion, each of the balloon, the proximal portion of the balloon and the distal portion of the balloon having a respective proximal end and a respective distal end, the distal end of the proximal portion and the proximal end of the distal portion being separated by a major diameter, the proximal portion being active during dilation such that the proximal portion of the balloon forms a reverse truncated cone shape,
wherein, when the balloon is inflated, the balloon has a base diameter at the major diameter which is larger than the proximal portion of the balloon,
the shape of the balloon is tightly connected to the tracheal tube such that the proximal portion of the balloon is partially inside a lumen of the tracheal tube, and the proximal portion of the balloon outside the tracheal tube is larger in diameter than the tracheal tube such that, when the balloon is inflated, the dilating balloon causes a thrust to move forward the device in a trachea of a patient,
a distal portion of the inflating tube is connected to the distal end of the balloon; and
the distal portion of the balloon has a base diameter at the major diameter which is larger than a base diameter at a remainder of the distal portion of the balloon when the balloon is inflated; wherein the inflating tube has an end forming an opening through which a dilation force is first delivered to the distal portion of the balloon to inflate the balloon; wherein, outside of the tracheal tube, the balloon is devoid of a tubular section of constant diameter when the balloon is inflated.
2. The tracheostomy device according to claim 1 , wherein a distal region of the handle is connected to a proximal end of the tracheal tube by a twist-lock connector or a connector with two hooked arms.
3. The tracheostomy device according to claim 1 , wherein the handle handgrip is placed across the handle in a “T” shape.
4. The tracheostomy device according to claim 1 , wherein the intermediate portion sustains and carries the tracheal tube.
5. The tracheostomy device according to claim 1 , wherein the intermediate portion is curved.
6. The tracheostomy device according to claim 1 , wherein the intermediate portion is straight.
7. The tracheostomy device according to claim 1 . wherein the balloon has a shape of two adjacent, back-to-back cones when the balloon is inflated.
8. The tracheostomy device according to claim 1 , wherein the balloon has a shape of a proximal, truncated cone directly connected to a distal cone when the balloon is inflated.
9. The tracheostomy device according to claim 1 , wherein, outside the tracheal tube, the balloon has a non-constant diameter along its entire length when the balloon is inflated.
10. An apparatus for tracheostomy, comprising:
the tracheostomy device according to claim 1 ; and
a small dilator to facilitate an introduction of the device into the patient comprising, at an outer part, two opposite scalpel blades.
11. A method for performing a non traumatic tracheostomy with the apparatus according to claim 10 , comprising the steps of:
a) forming a punctured opening in the tracheal wall with a needle;
b) inserting a wire guide through the needle bore and withdrawing the needle;
c) inserting the small dilator
d) blading along the wire guide across the tracheal wall;
e) inserting the apparatus along the wire guide across the tracheal wall with the tracheostomy tube hooked to the handle and positioning the deflated balloon in the internal wall of the trachea;
f) inflating the balloon, having the inflation start from its distal end of the balloon to get dilation of said punctured opening by the pressure of the inflated balloon on the tracheal wall from inside the trachea outwards;
g) having the tracheal wall dilated, inserting the tracheostomy tube inside the trachea;
h) deflating the balloon and withdraw the apparatus from the tracheostomy tube.
12. The apparatus according to claim 10 , wherein the two scalpel blades are positioned at 180 degrees relative to each other.