US2494393A - Removable appliance for use as an artificial dam in cases of rectal incontinence - Google Patents

Description

Jan. 10, 1950 o. F, LAMSON REMOVABLE APPLIANCE FOR USE AS AN ARTIFICIAL DAM IN CASES OF RECTAL INCONTINENCE Filed Feb. 5, 1949 Imventor 0/7150 Cltforneg Patented Jan. 10, 1950 REMOVABLE APPLIANCE FOR USE AS AN ARTIFICIAL DAM IN CASES OF RECTAL INCONTINEN CE Otis F. Lamson, Seattle, Wash.

Application February 5, 1949, Serial No. 74,745

7 Claims.

This invention relates to a, medical appliance arranged and adapted to serve as a damming instrument for the outlet end of an individuals bowels, particularly for individuals whose bowels empty through a natural anal opening but who lack normal muscular control for the outlet, or for those whose bowels empty through an artificial opening located, however, in the rectal region and such, for example, as the opening which is surgically provided in perineal or sacral colostomies. The device of the present invention, like the appliances illustrated and described in my prior U. S. patents numbered 2,324,520 issued July 20, 1943, and 2,457,244, issued December 28, 1948, embodies a balloon member capable of being inflated or deflated at will, and in the present instance is constructed to peculiarly adapt itself to either natural or artificial bowel outlets occurring in the rectal region, permitting the individual to which the same is applied to easily insert the device to or remove the same from the opening and perform the necessary inflation or deflation of the balloon with minimum effort and expedition as periodic calls arise for evacuating either gas or collected fecal matter from the bowels.

Individuals having rectal incontinence, but who otherwise are in good health, remain socially isolated and feel compelled to live a more or less secluded life in consequence of the embarrassment incident to uncontrolled drainage from the bowels, and while the condition is, normally, one which occurs only infrequently in early life, there are today a very considerable number of younger people so afilicted, largely returned veterans who suifer from the condition due to injuries received in combat. With these younger individuals rectal incontinence frequently becomes an almost insurmountable obstacle to normal living in that it interferes with almost every phase of social and economic activity and has been the causative factor for many instances of mental aberration attributed to depression. Of the many returned veterans who are afilicted with this condition, records of the Veterans Administration show that almost none have, heretofore, returned to anything approaching normal civilian life. The present device, even though only an artificial dam, suflices to give complete and certain control and hence restores the individuals morale to allow the user, where other conditions permit, to readjusthis outlook and again become an active and producing member of society.

Over and beyond the welfare of the indivldual, there has been the matter of unduly-heavy expense incident to taking care of hospitalized individuals who lack normal control of the bow els. This follows from the need-for a frequent change of bed linen which introducesexce'ssive laundering costs as well: as calling foralmost constant nursing care. With the general object of providing a device of simple construction which may be easily applied to and removed from the bowel outlet and which will effectively assure a positive dam ming of the latter, and with other more partic-. ular objects and advantages in view which will appear and be understood in the course ofthe following description and claims, the invention consists in the novel construction and in the adaptation and combinationof parts hereinafter described and claimed. t Figure 1 is a sectional 'view of the device in position in apatient. V v Figure 2 is a partial sectional view of them;- vice.

Figure 3 is a sectional view on line 3-3 of Fig ure I Designated by the numeral !0 in said drawing is a relatively short length of thick-walled flexible tubing, rubber by preference, having its center canal II open at both ends, and made a permanent adjunct of this tube is a jacket composed of gum rubber or other suitable elastic material. In point of appearance, this jacket suggests a clavate shape in that there is provided at one end a relatively long neck section I2 the normal contracted diameter of which is less than the outside diameter of the tube, and at the other end presents a somewhat larger sack-like head section l3-to be hereinafter termed a balloon. As applied to the tube, this balloon more or less loosely invests one end of the latter. The neck section tightly encompasses the other end andthere is provided between the' neck section and the tube a bonding coat of rubber cement. To complement this cement and positively secure the neck against liability L of being stripped back as the ballon inflates by force of pressure air fed through the canal H I also apply a seizing H! at the inner end limit of the neck.

Employed with my jacketed tube is an external fitting arranged and adapted to occupy a position within the gluteal cleft, and which is to say within the groove which separates the buttocks, and this fitting, which is or may be made of plastic, is comprised of a relatively straight pipe l5 of generally circular form .in cross section closed at one end and having a nipple l6 projecting as an axial prolongation from the other end, there being also provided a second and laterally projecting nipple ll located at or about the midlength of the pipe and which connects with the first-named nipple by the pipes center duct 20. Each of these two nipples are each by preference peripherally provided with the multipleaxiallyspaced circumferential flutings usual with the bib ends of slip-fit hose couplings.

Designated 2| and connecting with the nipple l6 of the fitting i is a length of flexible catheter hose, and there is permanently carried upon the free end of this hose a valve assembly of the usual or suitable construction. As shown, said valve assembly comprises a valve body 22 and a complementing hollow valve 23, thelatter being threadedly mounted for endwise movement into pipe l5 within said gluteal cleft and in snug contact with the anus, this positioning of the pipe perforce placing the balloon in the previously determined proper position within the rectum. The balloon may now be reinflated in the manner above described, supplying the volume of pressure air necessary to establish a positive damming action without discomfiture to the user. Should the user find it necessary to unduly inflate the balloon, this is indication that the tube, in the fitting thereof, was cut to too long a length and consequently is not occupying its proper position bearing against the inner mouth of the anal canal. With the appliance in position and properly inflated, the catheter hose passes between the legs and up the front of the body, its length being such as to reach approximately to the navel, and with and out of a position whereat its needle nose '24 seals the outlet end of the tube. Provided as a detachable adjunct of the appliance is an air syringe 25, indicated by dotted lines in Fig 2, and this syringe is or may be of ordinary construction presenting a tapering connector tip 26 arranged to find a friction fit within the mating socket provided by the hollow valve.

In using the device, the balloon is collapsed by squeezing the same within the hand in a manner to fully expel air therefrom, and the valve is then tightened upon its seat to assure that the balloon will remain in this collapsed condition. The purpose thereof is to enable the user to easily insert the balloon-invested end of the tube into the rectum. It may be here stated that it is quite essential to properly fit the appliance to the particular individual using same, and in compensation thereof I produce the jacketed tube to a somewhat greater length than the actual use requires. The procedure for fitting the device is to first insert the collapsed balloon into the rectum to a distance of from 2 to 3 inches, bearing in mind that the distance between the internal and external sphincter muscles will commonly vary between 1 and 1 inches. The indicated degree of insertion will hence insure that the balloon occupies a position within the large colon inwardly of the internal sphincter muscle. The user now applies the connector tip of the syringe to the mating socket of the valve 23 and, following a turning of the valve to unseat the needle nose 24, activates the syringe by squeezing the same, say five or six times. The pressure air delivered from the syringe through the catheter hose 21 to its connecting pipe l5, and thence through the tube Hi to the interior of the balloon, causes the latter to become inflated, and the user now pulls downwardly upon the projecting end of the jacketed pipe with suificient pressure to bring the inflated balloon snugly against the inner end limit of the anal canal. A mark is made upon the protruding end of the tube-jacketing neck section 12 at a point substantially flush with the external-surface of the anus and the balloon is now again collapsed by opening the valve 23. The collapsed balloon is withdrawn from the rectum, the jacketed tube stripped from the nipple i 1, and the tube is severed at the marked point, following which the tube is again applied to its related nipple and the device is then in condition for use. When new introducing the collapsed balloon to the rectum, the external pipe 15 is so disposed as to lie longitudinal to the gluteal cleft and with the nipple i6 pointing forwardly, or which is to say toward the anterior region of the body, and the tube is inserted in a degree suificicnt to seat the the valve closed and the syringe removed the user attaches the valved end of such catheter hose to the underwear, desirably using a safety pin 21 for this purpose. Unless the patient be greatly disabled, he can himself easily perform all steps necessary to the insertion and removal of the device, the control end of the catheter hose being easily accessible both for inflation and deflation of the balloon.

While there will perforce be some variation as between different individuals, the balloon should ordinarily be inflated to about a 2 /2 inch diameter, and the user will soon determine the required number of squeezes upon the syringe necessary to attain the required inflation. While individuals at the inception of use will not unnaturally feel minor discomfort, the individual becomes quickly accustomed to the appliance and substantially no distress, unless caused by an undue distension of the balloon, will be experienced after only a few days of usage.

With normal care, the appliance will give long and trouble-free service, it being important for protection of the balloon only that the same should not be boiled, that it be washed in warm, mild, soapy water, and that no petroleum product be employed as a means of lubricating the balloon for insertion into the rectum.

The invention, and the manner of its usage, should be clear from the foregoing detailed description of the illustrated now-preferred embodiment. Minor departures will suggest themselves and it is therefore my intention that no limitations be implied and that the hereto annexed claims be given the broadest interpretation to which the employed language fairly admits.

What I claim is:

1. A removable appliance for artificially damming the rectum of an individual afiiicted with rectal incontinence comprising, in combination: a thick-walled rubber tube arranged to be inserted by its forward end through the anal canal into the lower region of the individuals bowels and ,1 acketed by an elastic rubber body of sack-like shape, said rubber sack having its closed end loosely investing the inner end of the tube to serve as a ballon inflatable by pressure air delivered through the center duct of the tube and having its open neck tightly sleeved upon the outer end of the tube and cement-itiously bonded thereto throughout a material portion of the tubes length; a pipe of fairly extended length secured as an external fitting to the outer end of the tube and arranged in use to seat within the gluteal cleft snugly against the anus; and a valved control admitting to the attachment of an air syringe and connecting with the pipe for supplying pressure air for inflation purposes through the pipe and tube to the interior of the balloon.

2. The appliance of claim 1 in which the air seal provided by the bonding cement is augmented at the juncture of the balloon and its neck by a seizing.

3. removable appliance for artificially damming the rectum of an individual afliicted with rectal incontinence comprising, in combination: a thick-walled rubber tube arranged to be inserted. by its forward end through the anal canal into the lower region of the individuals bowels and jacketed by an elastic rubber body of sack-like shape so applied as to have the open neck of the sack tightly sleeved upon and bonded by cement to the outer end of the tube and the closed end of the sack loosely investing the inner end of the tube, said closed end of the sack being ballooned by pressure air delivered through the center duct of the tube from a normally collapsed condition, whereat the same is enabled to pass with the tubes inner end freely through the anal canal, to an expanded compass exceeding that of the canals internal mouth; a pipe of fairly extended length secured as an external fitting to the outer end of the tube and arranged in use to seat within the gluteal cleft snugly against the anus, said pipe presenting a terminal nipple and providing an air-supply duct connecting the nipple with the center duct of the tube; and a catheter hose arranged to find secure engagement by one of its ends with said nipple and adapted, when the appliance is in use, to extend forwardly from the pipe between the legs of the user and thence upwardly to the region of the navel, the end of said hose which lies distant from the pipe having a valved fitting thereon formed to admit of being removably connected with an air syringe and serving as a remote source of control for the balloon.

4. A removable appliance for artificially damming the rectum of an individual afiiicted with rectal incontinence and which comprises, in combination: a flexible tube arranged to be inserted by its forward end through the anal canal into the lower region of the individuals bowels; an inflatable balloon member carried upon the inner end of said tube and ballooned by pressure air delivered. through the center duct of the tube, said balloon member, when collapsed, being arranged to pass freely with the inserted end of the tube through the anal canal into and from an operating position within the bowels and, upon being there inflated, acting to bear against the internal mouth of the canal throughout the perimeter of the latter; a fitting carried upon the outer end of the tube arranged to resist inward pull transmitted from the inflated balloon to the tube and having an elongated form permitting the same to seat within the users gluteal cleft and bear snugly against the anus, said fitting providing an air-supply duct connecting with the center duct of the tube; and a valved connection leading to said air-supply duct and permitting the attachment of an air syringe for supplying pressure air for inflation purposes through said tube to the balloon.

5. A removable appliance for artificially damming the rectum of an individual afilicted with rectal incontinence comprising, in combination: flexible tube arranged to be inserted by its forward end through the anal canal into the lower region of the individuals bowels; an inflatable sack-like balloon investing said inner end of the tube and adapted by injection. of pressure air to be ballooned from a normally collapsed condition permitting the same to pass freely through said anal canal into an expanded compass exceeding that of the anal canals internal mouth, said sack-like body having the neck portion thereof drawn tight and fixedly secured about the tube to seal the interior of the balloon against escape of ballooning air introduced thereto; a pipe of fairly extended length secured as an external fitting to the outer end of the tube and arranged in use to seat within the gluteal cleft snugly against the anus and provided with connecting nipples one extending laterally and acting to engage the outer end of the tube and the other extending longitudinally as an axial prolongation of the pipe; and a catheter hose arranged to engage by one of its ends with the axially prolonged nipple and adapted, when the appliance is in use, to extend forwardly therefrom between the legs of the user and thence upwardly to the region of the navel, the end of said hose which lies distant from the pipe having a valved fitting thereon formed to admit of being re movably connected with an air syringe and serving as a remote source of control for the balloon.

6. The appliance of claim 5 in which the laterally extending nipple is placed more or less central to the length of the pipe.

'7. A removable appliance for artificially damming the rectum of an individual afiiicted with rectal incontinence and which comprises, in combination: a flexible tube arranged to be inserted by its forward end through the anal canal into the lower region of the individuals bowels; an inflatable balloon member carried upon the inner end of said tube and ballooned by pressure air delivered through the center duct of the tube, said balloon member, when collapsed, being arranged to pass freely with the inserted end of the tube through the anal canal into and from an operating position within the bowels and, upon being there inflated, acting to bear against the internal mouth of the canal throughout the perimeter of the latter, means being provided for supplying a controlled volume of pressure air from a point outside the body through said tube to the balloon while the latter occupies its operating position within the bowels; and a fitting securely carried upon the outer end of the tube arranged to take a bearing purchase within the gluteal cleft for resisting inward pull transmitted from the inflated balloon to the tube.

OTIS F. LAMSON No references cited.

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