GB2273243A

GB2273243A - Self retaining conjunctivo-rhinostomy tube

Info

Publication number: GB2273243A
Application number: GB9226365A
Authority: GB
Inventors: Vishwas Vasant Kayarkar
Original assignee: Individual
Current assignee: Individual
Priority date: 1992-12-12
Filing date: 1992-12-12
Publication date: 1994-06-15
Also published as: GB9226365D0

Abstract

This self-retaining conjunctive-rhinostomy tube basically comprises main body 1, outer retaining elements 2 and inner retaining elements 3. The element may comprise Fenestrations (4, Fig. B). Inner elements 3 may be connected e.g. by straps 7 to introducer 8, or the tube 1 may be placed inside a sleeve introducer (12, Fig. G). <IMAGE>

Description

SELF RETAINING CONJUNCTIVO-RHINOSTOMY TUBE This invention relates to the field of ophthalmic surgery for the relief of watering from the eye.

The problem of watering from the eye due to punctal or canalicular fibrotic scarring, what ever the cause, or due to congenital total/ partial absence of lacrimal drainage system is very difficult to deal with.

Some conjunctivo-rhinostomy procedures and some tubes had been devised in the past but the results are still less than satisfactory. The previously designed tubes require a proper full dacryocystorhinostomy procedure to be done which is time consuming, technically demanding and causes fair amount of damage to the surrounding tissues and can have significant degree of bleeding during,and sometimes afterwards, the procedure. The tubes tend to get out of position easily, at times are lost and are usually difficult to replace in position.

This invention is a special type of tube designed to maintain a constant and clear passage for the drainage of tears from the eye to the nose in the presence of-lacrimal passage obstruction of the type described above.

With a newly invented technique it can be installed in position easily. Once in position due to its design it will retain itself in position and will not be easily dislodged. It can be re-introduced in position at another time,if neccessary, also easily. The newly invented technique does not require the full dacryocystorhinostomy procedure with its inherent liabilities.

The tube will now be described by way of example with reference to accompanying drawings.

Fiqure A shows the basic self retaining conXiunctivo-rhinostomy tube comprising of following parts : Main body 1 Outer retaining elements 2 Inner retaining elements 3 The main body (1) of the tube is reasonably firm/ rigid, while the retaining elements (2 and 3) may be rigid, semi flexible or flexible.

Figure B shows the outer retaining elements in which fenestrations {4) can be incorporated if the surgeon wants to put sutures through them for additional stability.

Figure C shows the inner retaining elements (3) in which fenestrations (5) can be incorporated to help its introduction into the newly made conjunctivorhinostomy tract.

Figure D shows the tube wherein the inner retaining elements (3) are connected by breakable connections (6) to the straps~(7) which are in turn connected to the introducer (8) which has a arrow like head (9).

Figure E shows the tube with fenestrations (5) on the inner retainina elements through which are threaded the strap (7) which in turn is connected to the introducer (8) at it's tail end-(l0).

Ie;t c4F De,c4 + Figure F shows the introducer (8) which if so desired can have a central empty bore (11t all along it's length from the tail to the head. The introducer can be introduced' into the newly formed conjunctivo-rhinostomy tract, in some what difficult cases, by means of sliding it down along it4s:bor# on conjunctivo-rhinostomy guide. The introducer has holes (14) at it's tail end.

< x Figure G shows the tube which has another cylindrical tube over it's length like a sleeve (12) which has two small flaplike structures (13) near it's end close to the outer retaining elements. This sleeve (12) can be pushed down over the' inner retaining elements to straighten them so that they are in same direction as the body (1) of the tube. The tube can now be introduced through the newly formed tract of conjunctivo-rhinostomy and once the inner retaining elements have entered completely into the nasl cavity the sleeve (12) can then be pulled outwards by means of the flaps (13). Once the sleeve slides outwards the inner retaining elementsspring back to their original configuration. The flaps (13) can then be trimmed away.

Now the functioning of the tube will be described. The main body (1) is positioned in the newly formed conjunctivo-rhinostomy tract allowing the tears from the eyes to flow through it's central cylinder unhindered to the nose. The outer retaining elements (2) are positioned at the medial canthus of the eye and the inner retaining elements are positioned on the lateral wall 4inside the nasalçcavity. Due the design of the tube the whole thing retains itself in position quite satisfactorily.

Once the conjunctivo-rhinostomy tract has been made using the self retaining conjunctivo-rhinostomy clamp and the drill the tube can be introduced in position as follows : When using the tube with design as shown in Figure 6 the procedure has been described under that paragraph.

When using tube as shown in Figure D the introducer can be inserted through the new tract by itself as it is semirigid itself. If there is any difficulty then it can be introduced over4 the guide as described in paragraph detailing Figure F provided the introducer is of the design with central bore (11).

Once the introducer enters the nasal cavity it is grasped by entering through the nostril and then the introducer is pulled out through the nostril. Then the straps (7) are gently dragged upon so that the traction pulls the inner retaining elements (3) closer to each other and at the same time start entering the new tract easily. The traction is continued until the inner retaining elements enter the nasal cavity itself and the outer retaining elements (2) are at the medial canthus. At thi stage the outer retaining elements are at the medial canthus, the main ,,dy is in the tract itself and the inner retaining elements are in the nasal cavity positioned close to the lateral wall. Now the tube is held by the forceps and the straps (7) are held between thumb and fingers of the other hand and gentle but firm jerk is given on the straps so that the breakable connections (6) give way completely and the tube remains in position and the introducer and the straps can now be disposed off.

When using the tube as shown in Figure E the procedure is identical to as described in the paragraph before, except in this design there are no breakable connections. So once the tube has been properly positioned then the single strap (7),which is attached to the tail end (10) of the introducer (8) after looping through the fenestrations of inner-retaining elements, is now cut and the strap and the introducer are disposed off as described before.

Claims

1. A conjunctivo-rhinostomy tube with radially outwardly projecting retaining elements at its opposite ends.

2. A tube according to Claim 1 wherein retaining elements are fenestrated.

3. A tube according to any preceding claim wherein the retaining elements are more flexible than the main body of the tube.

4. A tube according to any preceding claim wherein the retaining elements at one end of the tube are connected with a relatively stiff introducer by means of flexible elongated elements.

5. A tube according to any preceding claim wherein the introducer has a central hollow cylindrical bore along the long axis extending it's entire length, wherein the guide can be received slidably in the introducer.

6. A combination comprising a tube according to Claim 1 to 3 and a hollow sleeve introducer, the tube being a sliding fit inside the sleeve introducer, and wherein the sleeve introducer when slid over one end of the tube straightens the retaining elements there in the direction of long axis of the tube, and wherein the sleeve introducer has elongated extensions at one end.