Medical devices for airway management and methods for placing medical devices

Abstract

Medical devices compatible with the camera, including oral airway devices, allow for the ventilation, intubation, and extubation of a patient under continuous visualization. Methods of ventilating, intubating, and extubating a patient using a medical device.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This PCT application claims priority to two U.S. patent applications: U.S. patent application 16 / 156,322 filed on October 10, 2018 and continuation-in-part patent application 16 / 416,592 filed on May 20, 2019, both of which are incorporated herein by reference. Technical Field

[0003] The present disclosure relates to the field of medical devices for airway management and provides disposable oral airway management devices, including various oral airway devices and adapters that are compatible with cameras to enable continuous visualization and monitoring during and after placement. Background Art

[0004] A variety of medical devices are used to stabilize a patient and facilitate his / her breathing, feeding, and drug delivery. Such devices are used for patients undergoing surgical procedures, patients after certain traumas including spinal cord injuries, and patients suffering from certain diseases including Alzheimer's disease. These devices include endotracheal tubes, airway devices, feeding tubes, oral airways, nasal cannulas, and many others.

[0005] The process of placing a breathing tube into a patient is called intubation. Instruments such as laryngoscopes, video laryngoscopes, fiberoptic endoscopes, and other proprietary scopes have been developed and are often used to place an endotracheal tube into a patient. These instruments provide accuracy during initial placement, but do not allow for continuous or moving images after the endotracheal tube is in the patient. Newer instruments such as the Vivasight SL or DL ​​endotracheal tubes provide continuous visualization but are expensive because a disposable camera must be used each time these instruments are used and cannot be transferred from one medical device to another. The Totaltrack VLM supraglottic airway has a dedicated, reusable camera that is used only with this instrument and cannot be transferred to another medical device.

[0006] Certain medical devices that provide continuous visualization are described in U.S. Patents 9,357,905, 9,415,179, 9,918,618 and patent publications US 2016-0038008; US 2016-0038014; and US 2016-0262603. In these devices, a camera is placed inside a camera tube, which is a separate lumen with a sealed distal end.

[0007] However, there is still a need for medical devices that can be easily, quickly, and reliably inserted and removed while also being compatible with cameras. There is still a need for devices that can monitor patients for adverse events such as airway secretions, apnea, vomiting, and internal bleeding during and after placement. There is still a need for devices that can ventilate patients. Summary of the invention

[0008] The present disclosure provides medical oral airway instruments and adapters that are compatible with cameras and can be used to manage a patient's airway and / or intubate a patient. A single practitioner can use these instruments to perform intubation operations, eliminating the need for multiple operators and / or excessive lifting forces. The use of a laryngoscope can also be avoided. The instrument ensures that the patient's larynx and vocal cords are seen during placement, ventilation, endotracheal intubation and / or extubation. They facilitate placement, exchange and / or removal operations without multiple or prolonged attempts. Current medical devices assemble various tools together for single-step placement, and multi-step intubation operations are no longer required. The present medical device can be used to intubate patients who are difficult to intubate, and can be used to intubate patients with at least some airway injuries. The medical device of the present invention is also suitable for monitoring adverse reactions in patients, such as vomiting and / or obstruction.

[0009] In one aspect, the present disclosure provides an oral airway device comprising an endotracheal tube (ETT) lumen having a distal opening and a proximal opening. The oral airway device comprises a curved body formed by a wall surrounding the endotracheal tube (ETT) lumen, wherein the wall has a distal end and a proximal end, and wherein the wall has a dorsal side and a ventral side. The wall also comprises two or more hollow passages, which are passages in the wall. Each passage extends over at least a portion of the wall along a distal / proximal axis of the wall. Each passage has a distal opening as an outlet of the wall and a proximal opening as an inlet of the wall. The wall may have a slit on its ventral side, and the slit leads to the ETT lumen.

[0010] In another aspect, the present invention provides an oral airway device having a body that is curved forward and is made of a wall, wherein the wall has a length between a distal end and a proximal end, the body having a tongue at the distal end, wherein the wall has a dorsal side and a ventral side, and the tongue has a dorsal side and a ventral side, the wall surrounds a central lumen, the central lumen has a proximal opening at the proximal end of the wall and a distal opening at the distal end of the wall, the distal opening of the central lumen opens the central lumen to the ventral side of the tongue, wherein when an endotracheal tube or tool is located in the central lumen, the central lumen is inclined at a predetermined angle to the dorsal side of the tongue, and the central lumen extends the endotracheal tube or tool out of the ventral side of the tongue; wherein the oral The luminal airway instrument further comprises a central ramp located on the ventral side of the tongue in front of the distal opening of the central lumen; wherein the wall further comprises a camera channel, the camera channel being a hollow channel in the wall, the camera channel extending along a distal / proximal axis, the camera channel having a distal opening as an exit from the wall and a proximal opening as an entrance to the wall, the distal opening of the camera channel opening the camera channel to the ventral side of the tongue, wherein the camera channel ramp is located in front of and / or within the distal opening of the camera channel, wherein when the camera is located in the camera channel, the camera channel is inclined at a second predetermined angle to the dorsal side of the tongue, and the camera channel extends the camera above the ventral side of the tongue;

[0011] And wherein the oral airway appliance further comprises a laryngeal cuff formed around a periphery of a ventral side of the tongue.In some embodiments, the laryngeal cuff comprises a slit aligned with the slit of the wall.

[0012] The oral airway appliance may further include a gastric tract that is a hollow passage in the wall having a proximal opening at a proximal end of the wall and a distal opening that opens on a dorsal side of the wall.

[0013] In some oral airway appliances, the laryngeal cuff of the oral airway appliance is formed only around the distal end of the periphery of the ventral side of the tongue, and the laryngeal cuff does not completely block the laryngeal inlet or the laryngeal cuff is absent and replaced by an upper esophageal cuff, and the oral airway appliance further includes a peripheral cuff with a slit, the peripheral cuff is wrapped around the wall, and is located near the distal end of the wall, and the slit of the peripheral cuff is aligned with the slit of the wall.

[0014] In certain oral airway appliances, the first predetermined angle is greater than the second predetermined angle.

[0015] In any of these oral airway appliances, the laryngeal cuff may be non-inflatable or inflatable, or only the outer portion of the laryngeal cuff may be inflatable while the distal portion of the laryngeal cuff is non-inflatable.

[0016] In some oral airway appliances, the wall is free of slits.

[0017] In certain oral airway devices, the central lumen has a diameter that is smaller than a diameter of an endotracheal tube, the central lumen does not carry an endotracheal tube, and wherein the oral airway device can be used in conjunction with a face mask to ventilate a patient.

[0018] Some oral airway appliances may further include at least one camera, wherein the camera is insertable into the camera channel, the camera is built into the wall, the camera is sealed to the wall, or the camera is slidably connected along the wall. The at least one camera can wirelessly transmit images, heart sounds, temperature measurements, and / or respiratory sounds to one or more monitors located at one or more remote locations.

[0019] The oral airway appliance may also include one or more of the following: a plug insertable from and removable from the proximal opening of the camera channel; and an attachment cover which is a hollow tube having a clip attached to the wall, the attachment cover insertable from and removable from the central lumen, and the clip enables the edges of the wall to gather at the slit location. Some oral airway appliances include one or more cameras, each camera: insertable into the camera channel and / or the central lumen, built into the wall, sealed to the wall, or slidably connected along the wall.

[0020] Some oral airway appliances also include a dorsal inflatable cuff located on the dorsal side of the tongue.

[0021] Some oral airway appliances also include a peripheral channel, which is a hollow channel in the wall, the peripheral channel having a proximal opening located at the proximal end of the wall and a distal opening that opens on the ventral side of the tongue proximal to the laryngeal cuff, wherein the peripheral channel has a slit that allows the peripheral channel to open to the dorsal side of the wall and / or the side of the wall.

[0022] In another aspect, the present invention provides an oral airway appliance comprising a tubular body formed by a wall, the wall having a length between a distal end and a proximal end, the tubular body being curved forward, the wall having a dorsal side and a ventral side and two sides, namely, a first side and a second side, wherein the oral airway appliance comprises three channels, a first channel, a second channel and a third channel, the second channel and the third channel being hollow channels in the wall along a distal-proximal axis of the wall, each of the two channels opening into a proximal opening at a proximal end of the wall, and each of the channels opening into a distal opening at a distal end of the wall,

[0023] wherein the first channel is located at the periphery of the first side, is a groove extending along the proximal-distal axis of the wall, and the first channel is not covered by the wall at least at the ventral side of the wall and / or a portion of the first side, the first channel opens at a proximal opening at the proximal end of the wall, and the first channel opens at a distal opening at the distal end of the wall. wherein the second channel is located at the center of the oral airway appliance, the second channel is compatible with a camera that can be inserted into and removed from the second channel, and the third channel is located at the periphery of the second side, the third channel is compatible with a camera that can be inserted into and removed from the third channel.

[0024] These oral airway appliances are compatible with a laryngoscope that includes a blade attached to a handle and has a holder attached to the ventral side of the wall into which the blade of the laryngoscope can be inserted and removed from the holder.

[0025] In other aspects, the present disclosure provides an oral airway device, comprising a handle having a length between a distal end and a proximal end, the handle being formed into a half-lumen capable of accommodating an endotracheal tube. The handle has a tongue at the distal end, the tongue having a ventral side and a dorsal side, wherein a laryngeal cuff is formed around a periphery of the ventral side of the tongue or at least a portion of a periphery of the ventral side, the tongue and the laryngeal cuff comprise a laryngeal mask, and the oral airway device comprises a camera channel extending along a proximal-distal axis of the handle, and the camera channel is a hollow channel in the handle or the camera channel is a tube attached along the handle, the camera channel has a proximal opening and a distal opening, the distal opening of the camera channel is located on the ventral side of the tongue, and the half-lumen opens through the distal opening on the ventral side of the tongue; wherein the laryngeal cuff is inflatable, non-inflatable, or some portions of the laryngeal cuff are inflatable and other portions of the laryngeal cuff are non-inflatable.

[0026] In another aspect, the present disclosure provides a method for ventilating a patient, the method comprising: inserting a camera into a camera channel in any oral airway appliance of the present disclosure, inserting an assembly of the oral airway appliance with the camera into the patient's oral cavity under continuous observation through the camera, placing the assembly in the patient's pharynx, establishing a closed system in the assembly, and connecting the assembly to a ventilator. The method further comprises inserting at least one of a tool and / or a suction tube into the oral airway appliance, and wherein the closed system is established by at least one of: placing a ventilation adapter on a wall of the oral airway appliance, and / or inserting the accessory cover into a central lumen of the oral airway appliance.

[0027] Another aspect of the present disclosure includes a system for managing the airway of a patient, the system comprising:

[0028] Any oral airway appliance having a camera channel of the present disclosure;

[0029] a camera that is insertable into and removable from the camera channel; and

[0030] A ventilator adapter having at least one cover for establishing a closed system in the oral airway appliance.

[0031] Another aspect of the present disclosure includes a method for intubating a patient, the method comprising:

[0032] a) inserting an endotracheal tube into the central lumen of an oral airway appliance of the present disclosure,

[0033] b) placing the components of step a) in the patient's body and inserting the endotracheal tube into the vocal cords under visualization by a camera;

[0034] c) separating the endotracheal tube from the oral airway appliance through the slit; and

[0035] d) while maintaining the endotracheal tube inserted, removing the oral airway appliance from the patient.

[0036] Other aspects of the present disclosure include a method for extubating a patient or exchanging an endotracheal tube in a patient with a first endotracheal tube placed in an oral airway appliance of the present disclosure, the method comprising:

[0037] a) removing the first endotracheal tube from the patient while the oral airway appliance remains in the patient under continuous visualization by a camera placed in a camera channel of the oral airway appliance; and

[0038] b) If the first endotracheal tube should be replaced, a second endotracheal tube is inserted into the central lumen of the oral airway appliance still in place in the patient under continuous viewing by the camera, and then passed through the patient's vocal cords. BRIEF DESCRIPTION OF THE DRAWINGS

[0039] Figure 1A An oral airway appliance including a peripheral camera channel is shown.

[0040] Figure 1B An oral airway appliance having a cuff and including a peripheral camera channel is shown.

[0041] Figure 1C Shows the installation Figure 1BEndotracheal tube and suction tube on oral airway device.

[0042] Figure 1D Shows removal Figure 1B Endotracheal tube on an oral airway device.

[0043] Figure 1E Shows Figure 1A The distal end of the oral airway device.

[0044] Figure 1F Shows Figure 1A The distal end of an oral airway device where the wings are pushed open.

[0045] Figure 1G Shows Figure 1A The distal end of an oral airway device is shown and the widened gap in the slit of the esophageal passage is shown.

[0046] Figure 1H is through Figure 1A Longitudinal section of an oral airway appliance.

[0047] Fig. 1I An oral airway appliance is shown wherein the camera channel is centrally located on the back side of the oral airway appliance.

[0048] Figure 1J Shown from the ventral side Fig. 1I Oral airway devices.

[0049] Figure 1K An oral airway appliance is shown wherein the camera channel is centrally located on the back side of the oral airway appliance and the esophageal channel includes a slit.

[0050] Figure 1L Shows Fig. 1I An oral airway device comprising a non-inflatable cuff.

[0051] Figure 1M An oral airway appliance comprising a central camera channel and a peripheral ETT lumen is shown.

[0052] Figure 1N Shown from the ventral side Figure 1M Oral airway devices.

[0053] Fig.1O Shows Figure 1M The distal portion of an oral airway device.

[0054] Figure 1P Shows Figure 1M The invention also provides a distal portion of an oral airway device, which also includes a distal cuff and an extended esophageal passage.

[0055] 1Q is pluggable Figure 1A box Figure 1B The device in the oral airway device.

[0056] Figure 1R Shows the Figure 1Q The equipment is installed Figure 1B on oral airway devices.

[0057] Figure 1S Shows the Figure 1Q The equipment is installed Figure 1B on oral airway devices.

[0058] Figure 1T A ventilator adapter for an oral airway appliance having a slit is shown.

[0059] Figure 1U Shown is a slit placed on an oral airway appliance Figure 1T ventilator adapter.

[0060] Figure 1V Another embodiment of a ventilator adapter for an oral airway appliance having a slit is shown.

[0061] Figure 2 An oral airway appliance having three peripheral channels is shown.

[0062] Figure 3A An oral airway appliance having three peripheral channels and an inflatable cuff is shown.

[0063] Figure 3B Shows the installation Figure 3A Endotracheal tube in an oral airway appliance.

[0064] Figure 3C Shows from Figure 3A The endotracheal tube during the removal of the oral airway appliance.

[0065] Figure 4A Another embodiment of an oral airway appliance according to the present disclosure is shown.

[0066] Figure 4B Shows Figure 4A An oral airway device comprising an inflatable cuff.

[0067] Figure 4C Shows loading the endotracheal tube and inserting the camera Figure 4A of oral airway devices.

[0068] Figure 4D Shows the installation to Figure 4A Endotracheal tubes and insertion of oral airway devices Figure 4A The camera in the oral airway appliance.

[0069] Figure 4E Shows the Figure 1Q The equipment is installed Figure 4B of oral airway devices.

[0070] Figure 4F Shows the insertion Figure 4B of oral airway devices Figure 1Q equipment.

[0071] Figure 4G The back side shows Figure 4B An oral airway device wherein the plug is inserted into one of the peripheral channels.

[0072] Figure 4H The stopper is shown covered with a cap.

[0073] Fig. 4I Shows Figure 4H of a plug from which the cover has been removed.

[0074] Figure 4J An oral airway appliance having a third peripheral channel is shown.

[0075] Figure 4K Shows Figure 4J The ventral surface of the oral airway device.

[0076] Figure 5A Another embodiment of an oral airway appliance according to the present disclosure is shown.

[0077] Figure 5B Shows the insertion into Figure 5A A camera is placed in one of the channels of the oral airway.

[0078] Figure 5C Shows the insertion into Figure 5A A camera in another channel of the oral airway.

[0079] Figure 5D Shows Figure 5A The distal end of an oral airway device, wherein a camera is inserted into one of the channels.

[0080] Figure 5E Shows Figure 5A The distal end of an oral airway instrument, which includes a light source, and a camera is inserted into one of the channels.

[0081] Fig. 5F Shown is inserted into Figure 5A A bougie in one of the channels of an oral airway appliance.

[0082] Figure 6An oral airway appliance having a peripheral passageway that is externally open along the body of the oral airway appliance is shown.

[0083] Fig. 7A One embodiment of an adapter in combination with an endotracheal tube is shown.

[0084] Figure 7B Another embodiment of an adapter in combination with an endotracheal tube set is shown.

[0085] Fig. 8A is another embodiment of an adapter according to the present disclosure.

[0086] Figure 8B Shown is a combination of an endotracheal tube and a camera. Fig. 8A adapter.

[0087] Figure 8C Another embodiment of an adapter comprising two hollow tubes and a stem is shown.

[0088] Fig.8D Shows the insertion into Figure 8C The bougie and camera are in the adapter.

[0089] Fig. 8E Another embodiment of an adapter is shown that includes a hollow tube attached to a camera head.

[0090] Fig.8F Shows the insertion into Fig. 8E The bougie in the adapter.

[0091] Figure 8G Another embodiment of an adapter according to the present disclosure is shown.

[0092] Figure 8H Shows the insertion Figure 8G The camera is inserted into and rotated within the adapter.

[0093] Figure 8I The camera and the endotracheal tube are shown Figure 8G Assemble the adapters together.

[0094] Figure 8J Shows Fig.8I The endotracheal tube is inserted into the endotracheal tube.

[0095] Figure 8K Shown by Figure 8C An adapter for combining a bronchoscope with a camera.

[0096] Figure 8L Shows the accommodation Figure 8K Bronchoscope and camera Figure 8Kadapter.

[0097] Figure 8M Shows how to manipulate the bronchoscope and camera housing the 8K by turning the bronchoscope handle counterclockwise. Figure 8K adapter.

[0098] Figure 8N Shows how to manipulate the bronchoscope and camera housing the 8K by turning the bronchoscope handle clockwise. Figure 8K adapter.

[0099] Fig.9A An oral airway appliance including a laryngeal cuff is shown.

[0100] Fig. 9B yes Fig.9A Longitudinal cross-section of the central lumen of an oral airway device.

[0101] Fig. 9C yes Fig.9A Longitudinal cross-sectional view of the camera channel of an oral airway appliance.

[0102] Fig.9D yes Fig.9A Longitudinal cross-section of the gastric tract with oral airway apparatus.

[0103] Fig.9E Shows Fig.9A Detail of the central ramp of the oral airway appliance.

[0104] Fig.9F Shows Fig.9A The oral airway device is assembled with the endotracheal tube, camera, and suction tube.

[0105] Figure 9G Shows Fig.9A An oral airway device that is assembled with an endotracheal tube, camera, and suction tube.

[0106] Figure 9H shows the Figure 9G The components of the endotracheal tube are separated.

[0107] Fig.9I An oral airway appliance having a laryngeal cuff and a distal inflatable cuff is shown.

[0108] Figure 9J Shows Fig.9I Another view of the oral airway appliance.

[0109] Figure 9K Shows Fig.9I Another view of the oral airway appliance.

[0110] Figure 9L Another embodiment of an oral airway appliance is shown.

[0111] Figure 9M yes Figure 9L The enlarged distal portion of an oral airway appliance.

[0112] Figure 9N Inserting the accessory cover into Fig.9A of oral airway devices.

[0113] Fig.9O Shows that there is Figure 9N A cross-sectional view of the attachment cover of the clip.

[0114] Figure 9P yes Figure 9N An enlarged side view of a portion of the accessory cover.

[0115] Figure 9Q is with Figure 9N The accessory cover is assembled together Fig.9A Oral airway devices.

[0116] Figure 9R An adapter is shown with slots for the camera and cables.

[0117] Figure 9S Shown is the housing for the camera and cables Figure 9R adapter.

[0118] Figure 9T Shows Figure 9S Components and Fig.9A Oral airway device combination.

[0119] Figure 9U Shows Figure 9S The component that houses another camera Fig.9A Oral airway device combination.

[0120] Figure 9V Shows Figure 9S Components and Fig.9A An oral airway device combined with an endotracheal tube.

[0121] Figure 9W yes Fig.9A A cross-sectional view of the wall of a tube body of an oral airway device.

[0122] Figure 9X An oral airway appliance that is compatible with a bag-mask is shown.

[0123] Fig. 10A An oral airway appliance having a peripheral channel and being compatible with a laryngoscope is shown.

[0124] Fig. 10B Shown assembled with laryngoscope Fig. 10A Oral airway devices.

[0125] Fig. 10C Shows the Fig. 10A The oral airway device is assembled with the bougie and camera.

[0126] Fig. 10D Shown is a housing for the bougie and camera Fig. 10A Oral airway devices.

[0127] Fig.11A A laryngeal mask with a handle and a camera channel is shown.

[0128] Fig. 11B The endotracheal tube is shown Fig.11A laryngeal mask.

[0129] Fig. 12A Another embodiment of an oral airway appliance according to the present disclosure is shown.

[0130] Fig. 12B Another embodiment of an oral airway appliance according to the present disclosure is shown. DETAILED DESCRIPTION

[0131] The present disclosure provides a medical device for airway management, which includes ventilating, intubating and monitoring a patient. The present disclosure also provides a method for quickly and accurately placing an airway management device in a patient and performing remote continuous real-time monitoring of the patient after placement.

[0132] The device comprises at least one hollow channel with an inlet and an outlet. The device is compatible with a camera that can be inserted into the channel. Thus, ventilation, intubation and / or extubation of the patient is performed under continuous visualization. The device can also monitor heart sounds, sound transmission and temperature.

[0133] Cameras compatible with the present device may include digital cameras connected to a power cord. The digital camera may include a CCD (charge coupled device) and / or a CMOS (complementary metal oxide semiconductor) sensor. The captured image may be transmitted by wire or wirelessly. The camera may also be equipped with an instrument for monitoring sounds, including respiratory sounds and heart sounds. The camera may be connected to a cable. The camera may transmit images, sounds, and heart sounds wirelessly to one or more remote locations. Thus, patients may be monitored remotely from different locations. This may be helpful when emergency personnel must immediately perform emergency rescue ventilation on site. Such emergency placement may be remotely guided and / or evaluated with the aid of a camera in the present device, wherein the camera may transmit images and sounds to a monitor, such as a telephone and / or computer screen located remotely, such as in a hospital and / or rescue room.

[0134] In the present disclosure, if the same element appears in several different figures, the element may be referred to by the same reference numeral. It should be understood that if an element is described in conjunction with one embodiment, other embodiments may also include the element. If an element is described in detail in a first embodiment and then referred to by the same reference numeral in conjunction with other subsequent embodiments, the description in the first embodiment still applies even if the description of the element is not fully repeated in the subsequent embodiments.

[0135] In one aspect, the present disclosure provides an oral airway device comprising an endotracheal tube (ETT) lumen having a slit for delivering a breathing tube, and one or more additional channels for securely assembling with one or more cameras and additional tools, including but not limited to a bougie and a gastric suction tube. The oral airway device also includes a ramp that ensures that the angle of entry of the endotracheal tube into the vocal cords is optimal, so that placement can be completed quickly and the risk of esophageal intubation and / or vocal cord injury is minimized. The oral airway device can also be used to ventilate the patient. The oral airway device can provide continuous visualization and monitor breath sounds and heartbeat. Therefore, if necessary, adverse reactions of ventilated and / or intubated patients can be continuously and remotely monitored, including vomiting, bleeding, obstruction, and any failure of the system that would require replacement of the endotracheal tube and / or oral airway device. The oral airway device can also provide continuous monitoring during placement, intubation, and extubation. Because the oral airway device includes a slit to the ETT lumen, the oral airway device can be separated from and removed from the endotracheal tube after the endotracheal tube is placed and while the endotracheal tube remains inserted. Some oral airway devices also include a laryngeal cuff that forms the seal necessary to ventilate the patient through the ETT lumen of the oral airway device. Oral airway devices can be made in different sizes to accommodate pediatric patients of varying heights and weights as well as adults, including obese patients.

[0136] Now refer to Figure 1A-1V , Figure 2 , Figures 3A-3C , Figures 4A-4K and Figures 9A-9W to describe these oral airway devices having an ETT lumen.

[0137] Reference Figure 1A , which provides one embodiment of an oral airway appliance according to the present disclosure, generally indicated at 460. The oral airway appliance 460 is a curved tube so that the appliance 460 can follow the top contour of the patient's mouth when the oral airway appliance 460 is inserted into the patient.

[0138] The curved tubular body of the oral airway appliance 460 is made of a wall 462 having a distal end 462A and a proximal end 462B.

[0139] In this disclosure, the "proximal end of an instrument" refers to the end of the instrument that is closest to the physician during insertion of the instrument into the patient. In this disclosure, the "distal end of an instrument" refers to the end of the instrument opposite the proximal end. The distal end is the end that is first inserted into the patient. The distal end is also considered to be the end farthest from the physician during insertion of the instrument into the patient.

[0140] In oral airway appliance 460, wall 462 is curved along a distal-proximal 462A-462B axis so that wall 462 follows the top contour of the patient's mouth. Wall 462 forms an arc. Wall 462 has a dorsal surface 462C and a ventral surface 462D. Due to the arcuate curvature, wall 462 is longer on dorsal surface 462C than on ventral surface 462D.

[0141] Typically, ventral side 462D contacts the patient's tongue during insertion of instrument 460 into the oral cavity. Dorsal side 462C is opposite ventral side 462D.

[0142] In the present disclosure, the ventral side of the device is the surface that contacts the patient's tongue during insertion into the patient's oral cavity. The distal surface is the surface opposite the ventral side. In the present disclosure, the lateral surface or side is the surface located between the dorsal side and the ventral side. The oral airway device in the present disclosure has two sides, a left side and a right side.

[0143] exist Figure 1A In the figure, the ventral side 462D and the right side 462R are shown. The left side 462L is opposite to the right side 462R and is Figure 1A is not visible in the figure. Figure 1A In the accompanying drawings, only a portion of the back side 462C is visible.

[0144] The wall 462 surrounds a lumen 468. The lumen 468 is hollow and has a distal opening 468A near a distal end 462A of the wall 462. The lumen 468 has a proximal opening 468B at the proximal end of the wall 462.

[0145] A medical device, such as an endotracheal tube or any other tool or device suitable for managing the airway of a patient, may be placed into or removed from lumen 468 by opening wall 462 along slit 466 extending along distal-proximal axis 462A-462B.

[0146] exist Figure 1AIn the embodiment of the present invention, the wall 462 has a slit 466 extending along the distal-proximal end 462A-462B axis on the ventral side 462D. In other embodiments, the slit 466 can be placed on other surfaces of the wall 462, as long as the slit 466 is configured so that the doctor can enter the lumen 468 through the slit 466.

[0147] Wall 462 is made of a flexible material such as plastic or rubber. Therefore, once the endotracheal tube is loaded in lumen 468, wall 462 can be closed back along slit 466, and it keeps the endotracheal tube in place.

[0148] Therefore, one of the purposes of lumen 468 is to deliver an endotracheal tube during placement of the endotracheal tube into a patient. Therefore, lumen 468 may be referred to as an endotracheal tube (ETT) lumen in the present disclosure. However, it will be appreciated that ETT lumen 468 may be used to deliver other breathing tubes and / or tools and / or devices suitable for managing the airway. As discussed in more detail below, if necessary, the ETT lumen 468 itself may be used to ventilate the patient. Therefore, apparatus 460 may be used with or without an endotracheal tube for managing the airway.

[0149] It should be understood that Figure 1A , the ETT lumen 468 is centrally located in the curved tubular body of the oral airway appliance 460. In other embodiments, and as discussed in more detail below, the ETT lumen 468 can be placed around the curved tubular body of the oral airway appliance 460.

[0150] Compared to conventional oral airway appliances without slits, the oral airway appliance 460 of the present disclosure has many technical advantages. First, by opening the wall 462 at the slit 466, it is easier to install an endotracheal tube or any other breathing tube or tool or instrument into the ETT lumen 468 of the oral airway appliance 460.

[0151] Second, the oral airway appliance 460 may be separated from and detached from the patient after the endotracheal tube has been inserted into the patient and with the endotracheal tube remaining inserted and in place within the patient, without first removing the entire assembly from the patient.

[0152] exist Figure 1A 4, wall 462 has two tabs 462E and 462F, one on each side of slit 466. Tabs 462E and 462F hold an instrument, such as an endotracheal tube, in place in ETT lumen 468 and prevent the endotracheal tube from falling out of ETT lumen 468 during insertion into a patient.

[0153] In other embodiments, the slit 466 may not have a tab. In some embodiments, the edges of the walls 462 may touch at the slit 466. In other embodiments, there is a gap between the edges of the walls 462 at the slit 466.

[0154] exist Figure 1A 4, at least some of the proximal portion of the ETT lumen 468 is not covered by the wall 462 on the ventral side 462D. Therefore, some of the proximal portion of the ETT lumen 468 is exposed on the ventral side 462D. In other embodiments, where the wall 462 does not have a tab, at least some of the proximal portion of the ETT lumen may still not be covered by the wall 462. Exposing a portion of the ETT lumen 468 facilitates the insertion of an endotracheal tube or other tool instrument into or removal from the ETT lumen 468.

[0155] In other embodiments, the slit 466 may still provide access to the ETT lumen 468, but may extend all the way from the proximal end 462B of the wall 462 to the distal end 462A or nearly all the way from the proximal end 462B of the wall 462 to the distal end 462A. In these embodiments, none of the ETT lumen 468 or only a very small portion of the ETT lumen 468 is not covered by the wall 462 on the ventral side 462D. In these embodiments, (not shown) two or more tabs (not shown) may be positioned on each side of the slit along the distal-proximal 462A-462B axis.

[0156] In some other embodiments, the slit 466 can be narrow so that the edges of the walls 462 can touch or nearly touch along the length of the slit 466. In other embodiments, the slit 466 has a gap so that there is a gap between the edges of the walls 462 along the slit 466. Figure 1A , slit 466 is on ventral side 462D. In other embodiments (not shown), slit 466 still provides access to the ETT lumen, but slit 466 is located on dorsal side 462C or at a location other than the ventral side. For example, between the dorsal and ventral sides.

[0157] At the distal end 462A, the wall 462 terminates on the dorsal side 462C with a tongue 470. The distal end 470A of the tongue 470 can be oval or rounded. The tongue 470 tapers at its distal end 470A. The tongue 470 is used to gently push aside the patient's tissues during insertion of the oral airway appliance 460 into the patient's oral cavity and pharynx. The tongue 470 extends distally from the wall 462.

[0158] There is a ramp 471 attached to the inner surface 462G of the tongue 470. The ramp 471 is located at the proximal end of the tongue 470 and is located distal to the distal opening 468A of the ETT lumen 468.

[0159] Ramp 471 extends beyond the surface of inner surface 462G of the tongue. The function of ramp 471 is to lift and support the distal end of a device mounted in ETT lumen 468 (eg, endotracheal tube) above the surface of inner surface 462G.

[0160] Wall 462 has at least two hollow passages 472 and 474. Passage 472 is a hollow passage in wall 462. Figure 1A In some embodiments, channel 472 is located at the periphery of ETT lumen 468. In other embodiments, ETT lumen 468 may be located at the periphery and channel 472 may be located at the center. Channel 472 may be used to insert a camera or some other tool or device. Therefore, channel 472 may be referred to as camera channel 472 in this disclosure. It will be understood that channel 472 may be used to insert other tools and / or devices.

[0161] The camera channel 472 has a proximal opening 472B, which is the entrance to the camera channel 472 and is located at the proximal end 462B of the wall 462. The camera channel 472 extends along the distal-proximal end 462A-462B axis of the wall 462. The end of the camera channel 472 is a distal opening 472, which is the exit from the camera channel 472. Figure 1A , the distal opening 472A is located near the distal end 462A of the wall 462. In other embodiments, the length of the camera channel 472 can be shorter, and the distal opening 472A can be set at any position of the length of the wall 462, for example, at a position two-thirds of the length of the wall.

[0162] Preferably, the distal opening 472A of the camera channel 472 is not sealed so that the camera can extend distally from the camera channel 472. In some embodiments, the distal opening 472A is made of a transparent material (in Figure 1A 472) so that the camera can capture images through the sealed window when it is located in the camera channel 472.

[0163] A camera (not shown) may be inserted through a proximal opening 472B in the camera channel 472. The camera may extend from a distal opening 472A of the channel 472. Any camera suitable for viewing a patient's organs may be used in the oral airway appliance. The camera may be inserted into and removed from the camera channel 472. The position of the camera at the distal opening 472A of the camera channel 472 may be adjusted as needed so that the patient's tissues may be monitored during placement and the oral airway appliance 460 may be monitored as it enters the patient's mouth and pharynx. The oral airway appliance 460 equipped with a camera may provide a continuous view of the patient's larynx and vocal cords. This facilitates accurate and rapid placement and avoids multiple lengthy attempts.

[0164] In some other embodiments, the oral airway appliance 460 can include at least one camera (not shown) built into, sealed to, or slidably coupled along the wall 462. In other embodiments, the oral airway appliance 460 can include multiple cameras.

[0165] At least one or more cameras can wirelessly transmit images to one or more monitors, and at least some of the monitors can be located at one or more remote locations. At least some of the cameras can have the ability to transmit images as well as heart sounds and voice.

[0166] In further embodiments, the oral airway appliance 460 can include an esophageal stethoscope (not shown) that can be built into the wall 462 or the esophageal stethoscope can be inserted into the passage 472, the ETT lumen, and / or the passage 472. In further embodiments, the oral airway appliance 460 can include a temperature probe (not shown) that can be combined with the esophageal stethoscope (not shown) or the temperature probe can be built into the wall 462 or the temperature probe can be inserted into the passage 472, the ETT lumen, and / or the passage 472.

[0167] In some embodiments, camera channel 472 is a hollow channel in wall 462 , and camera channel 472 is completely separated from ETT lumen 468 .

[0168] In other embodiments, the camera channel 472 is a semi-lumen that is connected to the ETT lumen 468 with a gap or slit. In other embodiments, there is a slit on one surface of the wall 462 that runs along the length of the camera channel 472. The camera can be easily inserted into and removed from the camera channel 472 by pulling the camera through the slit.

[0169] exist Figure 1A In some embodiments, the oral airway appliance 460 includes a second channel 474. In other embodiments, the channel 474 may be missing. In some other embodiments, there are more than one channel 474.

[0170] The channel 474 is a hollow passage in the wall 462. The channel 474 can be used to aspirate fluid by inserting a suction tube into the channel 474. In the present disclosure, the channel 474 may be referred to as the esophagus 474. The esophagus 474 can be used to aspirate stomach contents and prevent vomiting.

[0171] The esophagus may also be used to insert other tools including, but not limited to, bougies, stylets, forceps, esophageal stethoscopes, and / or cameras.

[0172] The esophagus 474 extends along the distal-proximal 462A-462B axis of the wall 462. Figure 1A In the embodiment of the present invention, the esophagus 474 is located outside the ETT lumen 468. Figure 1A As can be seen in FIG. 4 , channels 472 and 474 are located on the sides of ETT lumen 468 , and ETT lumen 468 is located between channels 472 and 474 .

[0173] In other embodiments, the camera channel 472 can be centrally located on the dorsal side 462C. In other embodiments, as discussed in more detail below, the esophagus 474 can be centrally located on the dorsal side 462C.

[0174] In other embodiments, as discussed in more detail below, the ETT lumen 468 can be disposed peripherally.

[0175] However, in all embodiments of the oral airway appliance 460, the relative positions between the ETT lumen 468, the camera channel 472, and the esophageal channel 474 are configured such that they allow the physician to see through the camera tool / device, wherein the camera tool / device extends from the ETT lumen and / or the esophageal channel 474.

[0176] The esophageal passage 474 opens at a proximal opening 474B adjacent to the proximal end 462 of the wall 462. The proximal opening 474B is an entrance through which tools can be inserted into the esophageal passage 474.

[0177] The esophagus 474 terminates in a distal opening 474A, which is an exit port near the distal end 462A of the wall 462. A tool or camera inserted into the passage 474 may extend from the passage 474 toward the distal end 474A.

[0178] In some embodiments, the esophageal passage 474 can extend through the tongue 470 to the tongue tip 470A. In this embodiment, the distal opening 474 is located distal to the distal end 462A of the wall 462.

[0179] A tool such as a suction tube (not shown) may be inserted through the proximal opening 474B in the esophageal passage 474. The suction tube (or any other tool inserted into the passage 474) may extend from the distal opening 474A of the passage 474. The esophageal passage 474 may be used to accommodate a bougie, stylet, camera, stethoscope, temperature probe, sound monitoring and / or heart sound equipment, which may be used in conjunction with the camera, forceps, and / or any other tool used during the intubation and / or extubation of a patient.

[0180] Any of these tools can be inserted and removed from the esophageal passage 474 and / or camera passage 472, and can also be used to accommodate these tools as needed. The position of the tool at the distal opening 474A can be adjusted as needed to manipulate the patient's tissue and / or provide suction when needed. In some embodiments, the esophageal passage 474 is a passage in the wall 462, and the esophageal passage 474 is completely separated from the ETT lumen 468.

[0181] In other embodiments, the esophagus 474 is a semi-lumen connected to the ETT lumen 468 via a slit 475, such as Figure 1A As shown. A slit 475 extends along the length of the esophageal passage 474. Figure 1A In the embodiment of the present invention, the slit 475 is open to the ETT lumen 468. In other embodiments, the slit 475 can open outwardly on the wall 462.

[0182] Although the respective positions of the two channels 472 and 474 in the wall 462 can be varied, the relative positions of the channels 472 and 474 are arranged so that when a camera is inserted into the camera channel 472 and extended from the distal opening 472A of the camera channel 472, the camera can see the distal end of the tool inserted into the esophageal channel 474 and extended from the distal opening 474A of the esophageal channel 474. Therefore, the operation process of the tool can be seen by using the camera as needed.

[0183] Because the oral airway appliance 460 combines multiple tools together, a single physician can perform the placement of the oral airway appliance 460. Multiple operators are not required to manipulate the different tools.

[0184] exist Figure 1A , the camera channel 472 is disposed in the wall 462 such that the distal opening 472A of the channel 472 opens on or near the ventral side 462D. The channel 474 is disposed such that its distal opening 474A opens on or near the dorsal side 462C of the wall 462. In other embodiments, the camera channel 472 is disposed in the wall 462 such that the distal opening 472A of the channel 472 opens on or near the dorsal side 462C. The esophageal channel 474 may be disposed such that its distal opening 474A opens on or near the dorsal side 462C of the wall 462.

[0185] As will be appreciated by those skilled in the art, in some embodiments, channels 472 and 474 may be interchangeable, i.e., a camera may be inserted into either channel as desired. In other embodiments, the instrument 460 may have more than two channels in the wall 462. These additional channels may be located at the periphery of the ETT lumen 468. In some procedures, a camera may also be placed in the ETT lumen 468 if desired.

[0186] exist Figure 1A In some embodiments, the wall 462 has a non-uniform thickness. The thickness of the wall 462 can be greater on the dorsal side of the wall 462 and / or in the sides 462L and / or 462R between the dorsal side 462C and the ventral side 462D to accommodate the generally hollow passages 472 and 474 in the wall 462. In other embodiments, the thickness of the wall 462 can be the same or nearly the same as the thickness of the perimeter of the oral airway appliance 460.

[0187] Figure 1B Another embodiment of an oral airway appliance 460 is provided. Figure 1B The oral airway appliance 460 of the embodiment includes all components except the cuff 476 as combined Figure 1A The cuff 476 is attached around the periphery of the wall 462 and is wrapped around the wall 462 proximal to the distal opening 468A of the ETT lumen 468 .

[0188] The cuff 476 can be inflated with the device 478. If necessary, after the device 460 is inserted into the patient, the cuff 476 is inflated to establish a closed system and ventilate the patient. The cuff 476 is attached to the wall 462 and does not extend beyond the slit 466 so that when the cuff 476 is not inflated, the edge of the wall 462 can still be pulled apart at the slit 466 where the cuff 476 is attached to the wall 462. Although in Figure 1B In some embodiments, the cuff 476 is inflatable, but in other embodiments, the cuff 476 can be a non-inflatable soft donut-shaped cushion.

[0189] Figure 1C An endotracheal tube 480 and a suction tube 482 are shown, both inserted into the oral airway appliance 460. Figure 1A and 1B All elements of the oral airway appliance 460 are shown. Figure 1CAs shown in FIG. 4 , an endotracheal tube 480 is inserted into the ETT lumen 468. The distal end 480A of the endotracheal tube 480 extends from the distal opening 468A of the ETT lumen 468. The endotracheal tube 480 is raised above the surface of the inner surface 462G by the ramp 471. This provides the following technical advantage, that is, the distal end 480A of the endotracheal tube 480 is prevented from pushing and dragging the surface of the instrument 460 and / or pushing against the patient's tissue when the instrument 460 is inserted into the patient's body.

[0190] Thus, with the aid of ramp 471 and under continuous observation by a camera inserted into camera channel 472, an endotracheal tube 480 (or any other instrument contained within the ETT lumen 468) can be quickly inserted because the position of the endotracheal tube 480 is guided and the endotracheal tube 480 is prevented from folding or otherwise preventing insertion.

[0191] The oral airway appliance 460 provides the ability to combine multiple cameras, each located at a different position, so that the patient's tissues can be viewed from different angles. This improves the accuracy of endotracheal tube placement.

[0192] exist Figure 1C , the suction tube 482 is inserted into the esophageal passage 474. The distal end 482A of the suction tube 482 extends from the distal opening 474A of the passage 474. Like the camera that can be inserted and removed from the camera passage 472, the suction tube 482 can also be inserted and removed from the esophageal passage 474.

[0193] Reference Figure 1D , which shows how the endotracheal tube 480 can be separated from the oral airway appliance 460 by pulling on the slit 466. This allows the physician to easily remove and / or replace the endotracheal tube while the oral airway appliance 460 is still placed in the patient. Alternatively, the oral airway appliance 460 can be easily removed from the patient while the endotracheal tube 480 remains inserted and in place in the patient. This provides a technical advantage of not having to perform multiple rounds of intubation and extubation.

[0194] Likewise Figure 1D As shown, the suction tube 482 can be easily removed from the oral airway appliance 460 through the slit 475 of the esophageal passage 474. The physician can use any other tool, such as a bougie, to remove the suction tube 482 while the oral airway appliance 460 remains inserted into the patient.

[0195] Reference Figure 1E , 1F and 1G, which are enlarged views of details at the distal end of the oral airway appliance 460. In these figures, the oral airway appliance 460 is shown from the ventral side 462D.

[0196] All components are combined Figures 1A to 1D Mark. Figure 1E 462, the distal opening 472A of the camera channel 472 can be seen near the ventral side 462D of the wall 462. In this embodiment, the camera channel 472 is a channel separate from the ETT lumen 468. The distal opening 474A of the esophageal channel 474 is located near the dorsal side 462C of the wall 462. Figure 1E In the embodiment, the esophageal passage 474 has a slit 475 extending along the length of the esophageal passage 474, which opens the esophagus 474 to the ETT lumen 468. This helps guide the placement of the oral airway device 460 through a bougie or stylet placed in the esophageal passage 474.

[0197] from Figure 1E As can be seen in the embodiment, the ETT lumen 468 is located between the channels 472 and 474. Figure 1F As shown, tabs 462E and 462F can be pushed aside so that a device, such as an endotracheal tube, can be loaded into the ETT lumen 468 of the oral airway device 460.

[0198] like Figure 1G As shown, when at least a portion of the wall 462 and / or the passage 474 is made of a flexible material, the slit 475 can also widen to a gap. The slit 475 facilitates removal of a suction tube or any other tool from the esophageal passage 474.

[0199] Figure 1H is a longitudinal section through an oral airway appliance 460. All components are in accordance with Figures 1A-1G Mark it.

[0200] Fig. 1I Another embodiment of an oral airway appliance 460 is shown. Figure 1A As discussed, the oral airway appliance 460 is a curved tube such that the oral airway appliance 460 follows the contours of the roof of the patient's mouth during insertion of the appliance 460 into the patient.

[0201] The curved tubular body of the oral airway appliance 460 is made of a wall 462 having a distal end 462A and a proximal end 462B. The wall 462 is curved along the distal-proximal 462A-462B axis so that the wall 462 follows the contour of the roof of the patient's mouth. The wall 462 forms an arc. The wall 462 has a dorsal side 462C and a ventral side 462D. Due to the arcuate curvature, the length of the wall 462 on the dorsal side 462C is longer than the length on the ventral side 462D. When the oral appliance 460 is placed in the patient, the ventral side 462D contacts the patient's tongue.

[0202] The wall 462 has a slit 466 extending along the distal-proximal 462A-462B axis on the ventral side 462D. The wall 462 surrounds the ETT lumen 468. The ETT lumen 468 is hollow and has a distal opening 468A at the distal end 462A of the wall 462. The ETT lumen 468 has a proximal opening 468B at the proximal end of the wall 462. The slit 466 enters the ETT lumen 468.

[0203] and Figure 1A The embodiments are different. Fig. 1I The wall 462 in the embodiment of does not have a flap, but some proximal portions of the ETT lumen 468 are still not covered by the wall 462 on the ventral side. Therefore, some portions of the ETT lumen 468 are exposed, which facilitates the insertion and removal of the ETT lumen 468 of the endotracheal tube.

[0204] At the distal end 462A, the wall 462 terminates with a tongue 470 on the dorsal side 462C. The distal end 470A of the tongue 470 can be oval or circular. The tongue 470 tapers at its distal end 470A. The tongue 470 is used to gently push aside the patient's tissue during the insertion of the instrument 460. The tongue 470 extends distally from the wall 462.

[0205] There is a ramp 490 / 492, which includes two blocks 490 and 492, each attached to the surface of the inner surface 462G of the tongue 470. The ramp 490 / 492 is inclined and disposed proximal to the tongue 470, distal to the distal opening 468A of the ETT lumen 468, such that the blocks 490 and 492 are located on the sides of the distal opening 468A of the ETT lumen 468.

[0206] The ramps 490 / 492 rise above the surface of the inner side 462G of the wall 462. The function of the ramps 490 / 492 is to elevate and support the distal end of a device mounted in the ETT lumen 468 (eg, an endotracheal tube) above the inner surface 462G.

[0207] The wall 462 has at least two hollow passages 472 and 474. The esophageal passage 474 is a hollow passage having a distal opening 474A and a proximal opening 474B and is positioned in the wall 462, as shown in conjunction with Figure 1A described.

[0208] However, in Fig. 1IIn an embodiment of the present invention, the camera channel 472 is located near the centerline on the back side 462C of the wall 462. The camera channel 472 is hollow and has a proximal opening 472B at the proximal end 462B of the wall 462. The camera channel 472 extends along the distal-proximal end 462A-462B axis of the wall 462. The camera channel 472 ends at a distal opening 472A at the distal end 462A of the wall 462. The distal opening 472A is preferably not sealed, whereby the camera can extend distally from the camera channel 472. In some embodiments, the distal opening 472A is sealed by a transparent material (not shown), whereby the camera can capture images through the sealed window while being located in the camera channel 472.

[0209] Reference Figure 1J ,This is Fig. 1I Ventral view of the oral airway appliance. Figure 1J It can also be seen from the figure that the sides of the distal opening 472A of the camera channel 472 are blocks 490 and 492. Therefore, when the camera is extended from the camera channel opening 472A, the blocks 490 and 492 are located at the side of the camera and fix the camera in the appropriate position. Figure 1J As shown, the ETT lumen 468 is open, and the distal opening 468A is directly above the camera lumen opening 472A. Therefore, when the endotracheal tube is loaded into the ETT lumen 468 and the camera is inserted into the camera channel 472, the distal end of the endotracheal tube can be continuously monitored through the camera from the distal opening 472A, and the endotracheal tube extends from the distal opening 468A of the ETT lumen. This facilitates intubation, including intubation of difficult to intubate patients and / or patients with collapsed airways.

[0210] Reference Figure 1K , which shows another embodiment of an oral airway appliance 460, wherein the camera channel 472 is located near the centerline of the back side 462C of the wall 462, as shown in combination with Fig. 1I In Figure 1K In an embodiment, the ETT lumen is disposed at a central location, the center of which is determined by proximity to a central axis of the oral airway appliance 460.

[0211] The esophageal passage 474 is circumferentially positioned in the side 462L or 462R of the wall 462. The esophageal passage 474 includes a slit 475 that extends externally along the distal-proximal axis 462A-462B in the wall 462. The edge of the wall 462 can be pushed apart along the slit 475 to facilitate the insertion and removal of a suction tube or any other tool into and from the esophageal passage 474.

[0212] The diameter of the esophageal passage 474 is configured so that it can accommodate the scope of an upper endoscope (EGD). Thus, the oral airway device 460 can be used to deliver an endoscope to the upper digestive tract while being used to manage the patient's airway. Thus, the oral airway device 460 with an esophageal passage that is compatible with an endoscope can be used for various procedures of the esophagus, stomach, and / or duodenum.

[0213] Reference Figure 1L , which provides another embodiment of an oral airway appliance 460 in which the oral airway appliance 460 ends with a distal soft and non-inflatable cuff 494.

[0214] As combined Fig. 1I and Figure 1J As discussed, Figure 1L The oral airway appliance 460 of this embodiment includes a camera channel 472 located near the centerline of the dorsal side 462C of the wall 462. It should be understood that any embodiment for the oral airway appliance 460 can end with a distal soft non-inflatable cuff 494.

[0215] exist Figure 1L In the embodiment of the present invention, a soft non-inflatable distal cuff 494 is connected around the periphery of the distal end 462 and the tongue tip 470A. It is noteworthy that the oral airway appliance 460 includes a slit 466 in the wall 462 on its ventral side 462D. The slit 466 leads to the ETT lumen 468. The cuff 494 has a slit 495 that is aligned with the slit 466. Therefore, the wall 462 and the cuff 494 can be pushed apart at the slits 466 and 495 to insert an endotracheal tube or some other breathing tube into the ETT lumen 468.

[0216] The soft, non-inflatable distal cuff 492 softens the impact of the oral airway appliance 460 against the patient's tissue during insertion. The soft, non-inflatable cuff 492 also helps occlude the patient's pharynx and establish a closed system for ventilation.

[0217] Reference Figure 1M , which provides another embodiment of an oral airway appliance 460. Figures 1A-1L As shown, the oral airway appliance 460 is a curved tube so that when the appliance 460 is inserted into the patient's body, the oral airway appliance 460 follows the contour of the roof of the patient's mouth.

[0218] The curved tubular body of the oral airway appliance 460 is made of a wall 462 having a distal end 462A and a proximal end 462B. The wall 462 is curved along the distal-proximal 462A-462B axis so that the wall 462 follows the contour of the roof of the patient's mouth. The wall 462 forms an arc. The wall 462 has a dorsal surface 462C and a ventral surface 462D. Due to the arcuate curvature, the length of the wall 462 on the dorsal surface 462C is longer than the length on the ventral surface 462D.

[0219] When the instrument 460 is placed in a patient, the ventral side 462D contacts the patient's tongue. Figure 1M , the ventral side 462D and the right side 462R are shown.

[0220] exist Figure 1M In an embodiment, the camera channel 472 is located near the center or central axis of the oral airway appliance 460. The camera channel 472 has a distal opening 472A and a proximal opening 472B. The camera can be inserted into the camera channel 472 and slide along the camera channel 472. The camera can extend distally from the distal opening 472A of the camera channel 472.

[0221] The wall 462 surrounds the ETT lumen 468, which is disposed along the periphery of the central location of the camera channel 472. Some proximal portions of the ETT lumen 468 are not covered by the ventral side 462D of the wall 462. Thus, some proximal portions of the ETT lumen 468 are exposed, which facilitates the insertion and removal of an endotracheal tube into and from the ETT lumen 468.

[0222] As with other embodiments incorporating the oral airway appliance 460, the wall 462 also includes a slit 466 extending along the distal-proximal axis 462A-462B. The slit 466 is located above and opens into the ETT lumen 468. The edge of the wall 462 can be pushed apart along the slit 466. This facilitates the insertion or removal of an endotracheal tube into or from the ETT lumen 468. Figure 1M In the embodiment of the present invention, the slit 466 is located on the ventral side 462D of the wall 462. In other embodiments, the slit 466 can be located on the side - between the ventral side 462D and the dorsal side 462C or on the dorsal side 462C. The ETT lumen 468 is hollow and has a distal opening 468A at the distal end 462A of the wall 462. The ETT lumen 468 has a proximal opening 468B at the proximal end of the wall 462.

[0223] At the distal end 462A, the wall 462 terminates in a tongue 470 on the dorsal side 462C. The distal end 470A of the tongue 470 can be oval or rounded. The tongue 470 tapers at its distal end 470A. The tongue 470 is used to gently push aside the patient's tissue during insertion of the oral airway appliance 460. The tongue 470 extends distally from the wall 462.

[0224] As described in conjunction with other embodiments, the esophageal channel 474 is located outside of the camera channel 472 and can be used with various tools.

[0225] There is a ramp that includes two blocks 490 and 492, each attached to a surface of the inner surface 462G. The ramp 490 / 492 is located proximal to the tongue 470 and distal to the distal opening 468A of the ETT lumen 468, so that the blocks 490 and 492 flank the distal opening 468A and guide the endotracheal tube as it extends from the distal opening 468A of the ETT lumen 468.

[0226] like Figure 1N As further shown, Figure 1N Depicted Figure 1M On the ventral side of the instrument 460 in the ETT tube 468, the distal opening 468A of the ETT lumen 468 is flanked by blocks 490 and 492, which are slightly inclined toward the center of the inner surface 462G. Thus, the blocks 490 and 492 guide the distal end of the endotracheal tube toward the center of the tongue 470. Thus, the distal portion of the endotracheal tube is continuously viewed by the camera through the distal opening 472A through the camera channel 472.

[0227] exist Figure 1M and Figure 1N In the embodiment of the present invention, the esophageal passage 474 is located outside the camera passage 472. Figure 1N It can be seen that the distal end 474A of the esophageal passage 474 is open near the distal opening 472A of the camera passage 472. Therefore, if a tool (e.g., a stylet or a bougie) is inserted into the esophageal passage 474, the tool can be operated under continuous visualization of the camera inserted into the camera passage 472, and vice versa, the camera can be placed in the camera passage. If desired, two cameras can be used, with one camera located in the esophageal passage 474 and the other camera located in the camera passage 472.

[0228] Reference Fig.1O , it is Figure 1M4 is an enlarged view of the distal portion of the oral airway appliance 460. The distal opening 468A of the ETT lumen 468 is shown. The slit 466 provides access to the ETT lumen 468. When the blocks 490 and 492 are installed in the ETT lumen 468, the blocks 490 and 492 are located on the sides of the distal opening 468A and elevate / guide the endotracheal tube (not shown).

[0229] Reference Figure 1P , it is Figure 1M-1O An enlarged view of the distal portion of the oral airway appliance 460 is shown, wherein the difference is Figure 1P The embodiment of includes a soft non-inflatable cuff 496 that is attached around the periphery of the distal end 462A and the tongue 470 of the curved body of the oral airway appliance 460. The cuff 496 includes a slit 495 that aligns with the slit 466 in the wall 462. This allows the cuff 496 and wall 462 to be pushed apart to insert and remove the endotracheal tube into and from the ETT lumen 468. Figure 1P In the embodiment of FIG. 4 , the esophageal passage 474 extends through the tongue 470 and through the cuff 496 which includes an opening 497 that holds a suction tube or any other tool inserted into the esophageal passage 474 in place.

[0230] Thus, a suction tube or any other tool may extend distally from the cuff 496 and prevent fluid from accumulating on the tongue 470 and behind the cuff 496, which may necessitate removal for replacement or cleaning of the oral airway appliance 460.

[0231] It should be understood that although Figure 1P In the embodiment of the present invention, the distal cuff 496 is not inflatable, but in other embodiments, it can be inflatable. In other embodiments, the cuff 496 does not have a slit 495.

[0232] Figure 1Q An adapter, generally 500, is shown that can fit into the ETT lumen 468 of the oral airway appliance 460 or some other oral airway appliance. The adapter 500 includes two hollow tubes, an outer tube 502 and an inner tube 504 that is insertable and removable from the outer tube 502. The tubes 502 and 504 are curved to fit the shape of the lumen 468 of the oral airway appliance 460 or are made of a flexible material so that the tubes 502 and 504 can assume a curved shape once or before being inserted into the ETT lumen 468 of the oral airway appliance 460.

[0233] The length of the inner tube 504 is longer than the length of the outer tube 502. Figure 1Q As shown, the distal end 504A of the inner tube 504 extends distally from the distal end 502A of the outer tube 502. The proximal end 504B of the inner tube 504 extends proximally from the proximal end 502B of the outer tube 502.

[0234] The inner tube 504 can be inserted into or removed from the outer tube 502. Therefore, the length of the adapter 500 can be adjusted as needed by extending a longer or shorter portion of the inner tube 504 proximally from the outer tube 502. The outer tube 502 and the inner tube 504 are hollow. The inner tube 504 has a central lumen 506, which has a proximal opening 506B and a distal opening 506A. If the inner tube 504 is removed from the outer tube 502, the central lumen of the outer tube 502 can also be used to insert other instruments.

[0235] The outer tube 502 may include a latch 508 located near the distal end 502A.

[0236] Figure 1R The operation of installing the adapter 500 into the ETT lumen 468 of the oral airway appliance 460 is shown. Figure 1A-1Q to label all components.

[0237] Reference Figure 1S , which shows the adapter 500 inserted into the ETT lumen 468 of the oral airway appliance 460. The latch 508 of the adapter 500 is disposed at the proximal end of the flaps 462F and 462E and the proximal end of the slit 466. Thus, the latch 508 holds the flaps 462D and 462E together and prevents the slit 466 from widening into a gap. This is helpful when the cuff 476 is to be inflated in the patient because the adapter 500 prevents the slit 466 from widening into a gap. Thus, a closed system with the cuff 476 can be established and ventilation can be established.

[0238] Reference Figure 1T , which shows a ventilator adapter, generally 507. The ventilator adapter 507 is a cover that can be used to create a closed system in an oral airway appliance 460 having a slit and is used to connect the oral airway appliance 460 to a ventilator.

[0239] The ventilator adapter 507 includes a flat plate 508 having a distal edge 508A and a proximal edge 508B opposite the distal edge 508A. The flat plate 508 has a first longitudinal edge 508L and a second longitudinal edge 508R opposite the first longitudinal edge 508L. The flat plate 508 is bent inwardly along the longitudinal edges 508L and 508R so that a groove 508G is formed along the longitudinal edge 508L and a matching groove 508G is formed along the longitudinal edge 508R. At or near the distal edge 508B, the flat plate 508 is attached to a flat plate 509. The flat plate 509 is arranged generally perpendicular to the flat plate 508. The flat plate 509 includes a conduit 509A that can be used to connect the ventilator adapter 507 to the ventilator.

[0240] like Figure 1U and 1V As shown, the ventilator adapter 507 fits tightly over the oral airway appliance 460, and the catheter 509A fits over the proximal opening 468B of the ETT lumen 468. The sides of the oral airway appliance 460 fit within the grooves 508G. Thus, the ventilator adapter 507 prevents the slit 466 from separating. The ventilator adapter 507 seals the oral airway appliance 460 and establishes a closed system in the oral airway appliance 460. The patient can then be ventilated through the catheter 509A connected to the ETT lumen 468.

[0241] In some embodiments, the ventilator adapter 507 may include a second conduit 509B that is aligned with the proximal opening 474B of the esophageal passage 474 .

[0242] Reference Figure 2 , which provides another embodiment of an oral airway appliance, generally at 510.

[0243] Like oral airway appliance 460, oral airway appliance 510 also has a tubular body formed by wall 462, which is curved as described in connection with appliance 460. All similar components between appliances 460 and 510 are labeled with the same reference numerals. Like oral airway appliance 460, oral airway appliance 510 includes passages 472 and 474. Camera passage 472 is located in wall 460, which is peripheral to ETT lumen 468, which is located in the center of oral airway appliance 510. Camera passage 472 has a proximal opening 472B and a distal opening 472A. As described in connection with appliance 460, a camera can be inserted into or removed from camera passage 472 as needed.

[0244] The channel 474 in the oral airway appliance 510 includes a proximal opening 474B and a distal opening 474A. A tool such as a stylet or bougie may be inserted into the channel 474. The tool may be used while continuously viewing with a camera extending distally from the distal opening 472A of the camera channel 472.

[0245] Camera channel 472 and channel 474 are located outside of the ETT lumen 468 .

[0246] like Figure 2 As shown, in the oral airway device 510, there is an additional peripheral channel 514 in the wall 462. The channel 514 is located on the back side 462C of the wall 462, but not at the center of the back side 462C. The channel 514 has a slit 515 extending along the length of the channel 514. The slit 515 opens the channel 514 on the back side 462C of the wall 462. The channel 514 can be used to insert a suction tube that can be used to suck gastric fluid. Other tools can also be installed in the channel 514 as needed. The channel 514 is opened by a proximal opening 514B on the proximal end 462B of the wall 462. As needed, the suction tube or any other tool can be inserted into the channel 514 through the proximal opening 514B. The length of the channel 514 can vary. As described in conjunction with the device 460, the back side 460C of the wall 462 in the device 510 is curved. In some embodiments, the channel 514 ends at the highest point of the arc. In other embodiments, the channel 514 may terminate at any other location on the back side 462C of the wall 462. Figure 2 As shown, the channel 514 can extend back into the tongue 470 .

[0247] Reference Figure 3A , which provides another embodiment of an oral airway appliance, generally 520. The oral airway appliance 520 includes Figure 2 The oral airway device 520 includes the same elements as the oral airway device 510, except that the oral airway device 520 also includes an inflatable cuff 476. The inflatable cuff 476 is combined with Figure 1B 462C of the oral airway appliance 520. One function of the cuff 522 is to cushion the contact between the tongue 470 and the patient's tissue during insertion of the oral airway appliance 520.

[0248] Reference Figure 3B , which shows an endotracheal tube 480 mounted in the ETT lumen 468 of the device 520. Figure 3B In combination Figure 3AAll elements of the oral airway appliance 520 are described.

[0249] Reference Figure 3C , which shows the removal of the endotracheal tube 480 from the oral airway appliance 520. The endotracheal tube 480 can be removed from the ETT lumen 468 by pulling the endotracheal tube 480 out through the slit 466. Figure 3A-3B Label all components.

[0250] Reference Figure 4A , which shows another embodiment of an oral airway appliance provided by the present disclosure, the oral airway appliance is generally 530. The oral airway appliance 530 is a curved tube so that the oral airway appliance 530 follows the contour of the roof of the patient's mouth during insertion of the appliance 530 into the patient.

[0251] The curved tube body of the airway device 530 is made of a wall 532 having a distal end 532A and a proximal end 532B. The wall 532 is curved along the distal-proximal 532A-532B axis so that the wall 532 follows the contour of the top of the patient's mouth. The wall 532 forms an arc. The wall 532 has Figure 4A The dorsal side 532C and ventral side 532D and right side 532R are shown. As will be appreciated by those skilled in the art, due to the arcuate curvature, the wall 532 is longer on the dorsal side 532C than on the ventral side 532D. When the oral airway appliance 530 is placed in a patient, the ventral side 532D contacts the patient's tongue.

[0252] Wall 532 surrounds ETT lumen 468. ETT lumen 468 is hollow and has a distal opening 468A. ETT lumen 468 has a proximal opening 468B at the proximal end of wall 532.

[0253] The ventral side 532D of the wall 532 is recessed into the ETT lumen 468 such that some proximal portions 468C of the ETT lumen 468 are open and not covered by the ventral side 532D of the wall 532. In this embodiment, there are no slits 466 along the ventral side 532D of the wall 532. In contrast, some proximal portions 468C of the ETT lumen 468 are not covered by the wall 532. This facilitates the insertion and removal of medical devices, such as an endotracheal tube, into and from the ETT lumen 468.

[0254] At the distal end 532A, the wall 532 terminates on the dorsal side 532C with a tongue 470. The distal end 470A of the tongue 470 may be oval or rounded and tapers at its distal end 470A. The tongue 470 is used to gently push aside the patient's tissue during insertion of the oral airway appliance 530. The tongue 470 extends distally from the wall 532.

[0255] A ramp 534 is provided near the tongue 470 and distal to the distal opening 468A. The ramp 534 raises and supports the distal end of an instrument such as an endotracheal tube inserted into the ETT lumen 468.

[0256] The wall 532 has at least two hollow peripheral channels 472 and 474. The camera channel 472 is hollow and is located at the periphery of the ETT lumen 468. The camera channel 472 has a proximal opening 472B at a proximal end 532B of the wall 532. The camera channel 472 extends along an axis of the distal-proximal ends 532A-532B of the wall 532. The channel 472 terminates at a distal opening 472A at a distal end 532A of the wall 532.

[0257] A camera (not shown) may be inserted through a proximal opening 472B in the channel 472. The camera may extend from a distal opening 472A of the channel 472. Any camera described herein or known in the art may be used in the oral airway appliance 530. The camera may be inserted and removed from the camera channel 472. The position of the camera at the distal opening 472A of the camera channel 472 may be adjusted as needed to monitor the patient's tissue and / or the insertion of the oral airway appliance 530.

[0258] In some embodiments, the camera channel 472 is a hollow channel in the wall 532, and the camera channel 472 is completely separate from the ETT lumen 468. In other embodiments, the camera channel 472 is a semi-lumen that connects into the ETT lumen 468. In other embodiments, there is a slit (not shown) that runs along the length of the camera channel 472. The slit of the channel 472 can run along the wall 532 and open outwardly on the wall 532. The camera can be easily inserted into and removed from the camera channel 472 by pulling the camera through the slit.

[0259] The structure of the second channel 474 is similar to that of the first channel 472. Channel 474 is a peripheral hollow channel. Channel 474 extends along the distal-proximal end 532A-532B axis of wall 532. Channel 474 is located at the periphery of ETT lumen 468. Figure 4A As shown, channels 472 and 474 are located to the sides of ETT lumen 468 , with ETT lumen 468 located between channels 472 and 474 .

[0260] Passages 472 and 474 may have the same diameter, or may have different diameters.

[0261] The esophagus 474 terminates at a distal opening 474A at a distal end 532A of the wall 532. A tool, such as a suction tube, may be inserted into the proximal opening 474B in the esophageal passage 474. The suction tube (or any other tool inserted into the esophageal passage 474) may extend from the distal opening 474A of the esophageal passage 474. Any tool described in conjunction with other embodiments of the present disclosure may be used in the oral airway appliance 530.

[0262] These tools are insertable and removable from the esophageal passage 474. The position of the tool at the distal opening 474A can be adjusted as needed to manipulate the patient's tissue or provide suction. In some embodiments, the esophageal passage 474 is a passage in the wall 432, and the esophageal passage 474 is completely separated from the ETT lumen 468. In other embodiments, the esophageal passage 474 is a semi-lumen that is connected to the ETT lumen 468. In other embodiments, there is a slit extending along the length of the esophageal passage 474. The slit leads to the ETT lumen 468, or the slit opens the esophageal passage 474 outside the wall 532.

[0263] The relative positions of channels 472 and 474 are arranged so that when a camera is inserted into camera channel 472 and extended from distal opening 472A of camera channel 472, the camera can see the distal end of the tool, where the tool is inserted into esophageal channel 474 and extended from distal opening 474A of esophageal channel 474. Therefore, the operation of the tool can be seen with the camera.

[0264] As will be appreciated by those skilled in the art, in some embodiments, channels 472 and 474 may be interchangeable, i.e., a camera may be inserted into either channel as desired, or both cameras may be used simultaneously. In other embodiments, the oral airway appliance 530 may have more than two channels in the wall 532. These additional channels may be located at the periphery of the ETT lumen 468.

[0265] Reference Figure 4B , which shows another embodiment of an oral airway appliance according to the present disclosure, the oral airway appliance is generally 540. All of the components in the appliance 540 are the same as the components of the oral airway appliance 530, except that the oral airway appliance includes an inflatable cuff 542 located at the distal portion of the wall 532. The inflatable cuff 542 can be inflated using an appliance 544.

[0266] Reference Figure 4C , which shows the endotracheal tube 480 being installed into the ETT lumen 468 of the oral airway appliance 530. Figure 4C Also shown is the insertion of the camera 12 into the camera channel 472. Figure 4A All other components are numbered.

[0267] Figure 4D An endotracheal tube 480 is shown mounted in the ETT lumen 468 of the oral airway appliance 530 and the camera 12 is inserted into the camera channel 472 .

[0268] Reference Figure 4E , which shows the insertion of the device 500 into the ETT lumen 468 of an oral airway device 540, which includes an inflatable cuff 542. Figures 4A-4D All other components are numbered.

[0269] Reference Figure 4F , which shows the insertion Figure 4B The device 500 is combined with the ETT lumen 468 of the oral airway device 540. Figures 4A-4E All other components are numbered.

[0270] Reference Figure 4G , which shows the oral airway appliance 540 shown from the dorsal side 532C. Figures 4A-4F All components are numbered. Plug 546 is inserted into the proximal opening 472B of camera channel 472. Plug 546 covers camera channel 472 and can be used when it is necessary to establish a closed system for ventilation. Figure 4G In the accompanying drawings of , the plug 546 is used in the camera channel 472. In other embodiments, the esophageal channel 474 can also be covered by the plug 546.

[0271] Reference Figure 4H and Fig. 4I , the plug 456 includes a hollow cylinder 548 and a cap 550, which is attached to the hollow cylinder 548 by a bendable wire 552. Figure 4H As shown, the cap 550 can cover the proximal end 548B of the hollow cylinder 548. Fig. 4I As shown, the cap 550 can be removed from the hollow cylinder 548. This allows air to pass through the hollow cylinder 548. The hollow cylinder 548 is designed so that the hollow cylinder 548 can fit tightly into a channel such as the channel 472 and / or the channel 474. Therefore, the hollow cylinder 546 can have the shape of a bottle stopper. The diameter of the distal end 548A can be smaller than the diameter of the proximal end 548B. The hollow cylinder 548 can include a ridge 554s.

[0272] Reference Figure 4J , which provides another embodiment of an oral airway appliance according to the present disclosure, the oral airway appliance is generally 560. Figure 4ALike the illustrated oral airway appliance 530, the oral airway appliance 560 is a tube that is curved so that the oral airway appliance 560 follows the contour of the roof of the patient's mouth when inserted into the patient.

[0273] The curved tubular body of the airway device 560 is made of a wall 562 having a distal end 562A and a proximal end 562B. The wall 562 is curved along the distal-proximal 562A-562B axis so that the wall 562 follows the contour of the roof of the patient's mouth. The wall 562 forms an arc. The wall 562 has a dorsal surface 562C and a ventral surface 562D. As will be appreciated by those skilled in the art, due to the arcuate curvature, the length of the wall 562 on the dorsal surface 562C is longer than on the ventral surface 562D. When the device 560 is placed in a patient, the ventral surface 562D contacts the patient's tongue.

[0274] Wall 562 surrounds ETT lumen 468. ETT lumen 468 is hollow and has a distal opening 468A. ETT lumen 468 has a proximal opening 468B at the proximal end of wall 562. Thus, ETT lumen 468 extends along a distal-proximal axis 562A-562B.

[0275] The ventral side 562D of the wall 562 is recessed into the ETT lumen 468 such that some proximal portions 468C of the ETT lumen 468 are open and not covered by the ventral side 562D of the wall 562. Thus, some proximal portions 468C of the ETT lumen 468 are not covered by the wall 562. Keeping portions 468C of the ETT lumen 468 not surrounded by the ventral side 468C of the wall 564 facilitates the insertion and removal of a medical device central lumen 468 (e.g., an endotracheal tube).

[0276] At the distal end 562A, the wall 562 terminates on the dorsal side 562C with a tongue 470. The distal end 470A of the tongue 470 may be oval or rounded, and the tongue 470 tapers at its distal end 470A. The tongue 470 is used to gently push aside the patient's tissue during insertion of the instrument 560. The tongue 470 extends distally from the wall 562.

[0277] There is a ramp 534 proximal to the tongue 470 and distal to the distal opening 468A. The ramp 534 elevates and supports the distal end of an instrument such as an endotracheal tube inserted into the ETT lumen 468.

[0278] The wall 562 has at least two hollow peripheral channels 472 and 474. The camera channel 472 is hollow and disposed at the periphery of the ETT lumen 468. The camera channel 472 has a proximal opening 472B at a proximal end 562B of the wall 562. The camera channel 472 extends along a distal-proximal 562A-562B axis of the wall 562. The camera channel 472 terminates at a distal opening 472A at a distal end 562A of the wall 562.

[0279] A camera (not shown) may be inserted through a proximal opening 472B in the camera channel 472. The camera may extend from a distal opening 472A of the channel 472. Any camera described herein or known in the art may be used in the oral airway appliance 560. The camera may be inserted and removed from the camera channel 472. The position of the camera at the distal opening 472A of the camera channel 472 may be adjusted as needed to monitor the patient's tissue and / or the insertion of the oral airway appliance 530.

[0280] In some embodiments, the camera channel 472 is a hollow channel in the wall 562, and the camera channel 472 is completely separate from the ETT lumen 468. In other embodiments, the camera channel 472 is a semi-lumen that connects into the ETT lumen 468. In other embodiments, there is a slit (not shown in the figures) that runs along the length of the camera channel 472. The slit of the camera channel 472 can run along the wall 562 on the outside.

[0281] The structure of the second channel 474 is similar to that of the first channel 472. Channel 472 is a peripheral hollow channel. Channel 474 extends along the distal-proximal end 462A-462B axis of the wall 562. Channel 474 is located at the periphery of the ETT lumen 468. Figure 4J As shown, channels 472 and 474 are located to the sides of ETT lumen 468 , with ETT lumen 468 located between channels 472 and 474 .

[0282] Passages 472 and 474 may have the same diameter, or they may have different diameters.

[0283] The channel 474 terminates at the distal end 562A of the wall 562 with a distal opening 474 .

[0284] These tools can be inserted into and removed from the channel 474. The position of the tool at the distal opening 474A can be adjusted as needed to manipulate the patient's tissue or provide suction. In some embodiments, the channel 474 is a channel in the wall 564, and the channel 474 is completely separated from the ETT lumen 468. In other embodiments, the channel 474 is a semi-lumen that is connected to the ETT lumen 468. In other embodiments, there is a slit extending along the length of the channel 474. The slit leads to the ETT lumen 468.

[0285] The relative positions of channels 472 and 474 are arranged so that when a camera is inserted into camera channel 472 and extended from distal opening 472A of camera channel 472, the camera can see the distal end of the tool, where the tool is inserted into channel 474 and extended from distal opening 474A of channel 474. Therefore, the operation of the tool can be seen with the camera.

[0286] As will be appreciated by those skilled in the art, in some embodiments, channels 472 and 474 may be interchangeable, i.e., a camera may be inserted into any of the two channels as desired. In some embodiments, two cameras may be used simultaneously.

[0287] like Figure 4J As shown, the oral airway appliance 560 includes a third channel 564 extending along the dorsal-ventral axis 562A-562B on the dorsal side 562C. Figure 4J In the embodiment of the present invention, the channel 564 is a semi-lumen that opens to the dorsal side 562C. The channel 564 also has a proximal opening 564B. The channel 564 can be used to load a gastric suction tube or endoscope used in an EGD procedure. When both instruments are loaded into the oral airway instrument 560, the gastric suction tube or endoscope can be placed in the patient's body in one step, and the endotracheal tube is also placed in the body.

[0288] The gastric suction tube or endoscope can then be easily removed from the channel 564 while the oral airway device 560 remains inserted into the patient. Because the channel 564 has a groove-like shape, it can hold the gastric suction tube or endoscope in place and prevent it from sliding and sliding. The length of the channel 564 can vary. In some embodiments, the channel 564 extends along all or most of the dorsal side 562C of the wall 562. In these embodiments, the channel 564 terminates at or near the distal end 562A of the wall 562. In other embodiments, the channel 564 extends along only a portion of the wall 562 and terminates at a location near the distal end 562A of the wall 562.

[0289] Reference Figure 4K , which is a ventral view of the oral airway appliance 560 viewed from the ventral side 562D. Figure 4J Label all components.

[0290] A distal opening 472A to the camera channel 472 is shown. A distal opening 474A to the esophageal channel 474 is also shown. A proximal portion 468C of the ETT lumen 468 is not covered by the ventral side 562D of the wall 562. The ramp 534 is shown. A distal portion 470A of the tongue 470 is also shown.

[0291] like Figure 4K 564, the oral airway appliance 560 may include a ring 566 attached externally near the distal end 562A of the wall 562. One of the functions of the ring 566 is to hold a gastric suction tube or endoscope loaded into the channel 564 in place. The gastric suction tube or any other tube or tool can be pulled through the ring 566. Thus, the ring 566 positions the gastric suction tube or any other tube or tool on the oral airway appliance 560 and prevents the gastric suction tube or any other tube or tool from being separated from the oral airway appliance 560. Those skilled in the art will understand that the ring 566 can be attached to the oral airway appliance 560 or any other oral airway appliance provided in the present disclosure, including the oral airway appliances 460, 510, 520, 530, or 540.

[0292] In another aspect, the present disclosure provides an oral airway appliance that includes a channel but does not include an endotracheal tube (ETT) lumen 468. Reference will now be made to Figures 5A-5F , Figure 6 and Figures 10A-10D to describe these oral airway appliances.

[0293] Reference Figure 5A , which provides another embodiment of an oral airway appliance, generally 580. The oral airway appliance 580 includes a tubular body formed by a wall 582 having a distal end 582A and a proximal end 582B. The oral airway appliance 580 may include a handle 589 located near the proximal end 582B, which may assist the physician in manipulating the oral airway appliance 580 during insertion or removal of the oral airway appliance 580. The handle 589 may be adhered to the wall 582, or the handle 589 may be removably attached to the wall 582 such that after insertion of the oral airway appliance 580 is completed, the handle 589 is removed.

[0294] Wall 582 is curved along a distal-proximal axis 582A-582B and follows the contour of the roof of the patient's mouth when the oral airway appliance 580 is inserted into the patient. Wall 582 has a dorsal side 582C and a ventral side 582D. Wall 582 forms an arc that follows the contour of the roof of the patient's mouth such that ventral side 582D contacts the patient's tongue when the appliance 580 is inserted into the patient.

[0295] The oral airway appliance 580 has a number of hollow passages 584, 586, and 588 extending through the body 582. In other embodiments, the oral airway appliance 580 may have more or less than three passages.

[0296] Each of the channels 584, 586, and 588 opens with a proximal opening 584B, 586B, and 588B, respectively, at or near the proximal end 582B of the wall 582. Each of the channels 584, 586, and 588 opens with a distal opening 584A, 586A, and 588A, respectively, at or near the distal end 582A of the wall 582. In some other embodiments, an inflatable or non-inflatable cuff (not shown) is attached around the wall 582, near the distal end 582A of the wall 582.

[0297] exist Figure 5A In the embodiment of the present invention, the oral airway appliance 580 includes three channels. In other embodiments, the oral airway appliance 580 may include more than three channels, i.e., four or five channels, or may include less than three channels, i.e., two or one channel. Channels 584, 586, and 588 are channels in the tube body 582. Channels 584, 586, and 588 may be used to accommodate various devices. Figure 5A As shown, camera 12 can be inserted into one of channels 584, 586 and / or 588.

[0298] Figure 5B The camera 12 is shown inserted into the channel 584 of the oral airway appliance 580. Figure 5A Label all components.

[0299] Figure 5C Insertion of the camera 12 into the passage 586 is shown. Thus, the oral airway appliance 580 is compatible with cameras, and more than one camera may be used. At least one of the distal openings 584A, 586A, and / or 588A is not sealed. This allows a tool or camera 12 to extend distally from the oral airway appliance 580. The camera 12 is attached to a cable 16. The cable 16 may be used to move the camera 12 further distally or to remove the camera from the oral airway appliance 580 while the oral airway appliance 580 remains inserted in the patient. The oral airway appliance 580 may be used to accommodate a number of various tools, such as bougies and suction tubes, which may be manipulated under continuous visualization of the camera.

[0300] In addition to embodiments where the camera may be inserted into one or more channels, in other embodiments, the camera may be built into the wall 582. The oral airway appliance 580 may be used in conjunction with multiple cameras so that the patient's tissue may be viewed from multiple locations.

[0301] Figure 5Dand 5E 582A of the oral airway appliance 580. The distal opening 584A of the channel 584 and the distal opening 588A of the channel 588 are shown. The camera 12 is inserted into the channel 586 and can be seen at the distal opening 586A of the channel 586. Figure 5D In the embodiment of the present invention, the camera 12 includes a light source 18. Figure 5E In the embodiment, the light source 18 is incorporated into the wall 582.

[0302] Fig. 5F A bougie 590 is shown inserted into the passage 586 of the oral airway appliance 580. The distal end 590A of the bougie 590 extends distally from the distal end 586A of the passage 586. Figures 5A-5E , a bougie or any other tool inserted into one of channels 584 , 586 , and / or 588 may be operated under continuous visualization of camera 12 .

[0303] Figure 6 Another embodiment of an oral airway appliance having a generally 600 channel is shown. The oral airway appliance 600 includes a tubular body formed by a wall 602 having a distal end 602A and a proximal end 602B. The wall 602 is curved along a distal-proximal axis 602A-602B and follows the contour of the roof of the patient's mouth when the appliance 600 is inserted into the patient. The wall 602 has a dorsal side 602C and a ventral side 602D. In some embodiments, the oral airway appliance 600 may include a handle 609 attached to the wall 602 on the dorsal side 602C near the proximal end 602B. The handle 609 facilitates manipulation of the appliance by the physician during insertion and removal of the appliance. The handle is removably attached so that the handle can be separated from the wall 602 after the oral airway appliance 600 is placed.

[0304] The wall 602 forms an arc that follows the contour of the roof of the patient's mouth so that the ventral side 602D contacts the patient's tongue when the appliance 580 is inserted into the patient. The oral airway appliance 600 has several passages 604, 606, and 608 that pass through the wall 602 along a distal-proximal 602A-602B axis.

[0305] Each of the channels 604, 606, and 608 opens at or near the proximal end 602B of the wall 602 with a proximal opening 604B, 606B, and 608B, respectively. Each of the channels 604, 606, and 608 opens at or near the distal end 602A of the wall 602 with a distal opening 604A, 606A, and 608A, respectively. Figure 6In the embodiment of the present invention, the oral airway appliance 600 includes three channels. In other embodiments, the oral airway appliance 600 can include more than 3 channels, i.e., 4 or 5 channels, or can include less than 3 channels, i.e., 2 or 1 channel.

[0306] Channel 608 is a peripheral channel. It is a semi-cavity that is open to the outside on wall 602. Therefore, channel 608 can be described as a recess in wall 602 that extends along distal-proximal axis 602A-602B. Channel 608 creates a groove in which a camera, tool or tube can be placed. Due to its groove-like shape, channel 608 holds the camera, tool or tube in place and prevents it from getting stuck.

[0307] However, because the passageway 608 is open along the distal-proximal axis 602A-602B, the camera, tool, or tube may be easily removed from the passageway 608 while the oral airway appliance 600 remains inserted and in place within the patient. Figure 6 In the drawings of FIG. 6 , the channel 608 is open to the outside of the right side 602R of the wall 602. In other embodiments, the channel 604 can lead to the dorsal side 602C or the ventral side 602D of the wall 602.

[0308] Channel 606 is a hollow channel in wall 602. Channel 604 has Figure 6 The channel 608 in the embodiment has the same structure.

[0309] Channel 604 is located outside of channel 606. Channel 604 is a half cavity that opens outward from wall 602. Figure 6 6, the channel 604 is open to the left side 602L of the wall 606. In other embodiments, the channel 604 can open to the dorsal side 602C or the ventral side 602D of the wall 602.

[0310] Thus, the channel 604 can be viewed as a recess in the wall 602 that extends along the distal-proximal axis 602A-602B. The channel 604 creates a recess in which a camera, tool, or tube can be placed. Due to its recess-like shape, the channel 604 holds the camera, tool, or tube in place and prevents it from getting stuck. However, because the channel 604 is open along the distal-proximal axis 602A-602B, the camera, tool, or tube can be easily removed from the channel 608 while the oral airway appliance 600 remains inserted in place in the patient's body.

[0311] like Figure 6As shown, the camera 12 attached to the cable 16 can be placed in the channel 604, while the bougie 590 is placed in the channel 608. Since the channel 608 is a groove, the bougie 590 with the curved distal end 590A can still be placed in the channel 608. The distal end 590A of the bougie 590 is placed at the distal end of the distal opening 608A of the channel 608. Then, the rest of the bougie 590 is placed in the channel 608.

[0312] It will be understood that although Figure 6 In the embodiment of the present invention, both peripheral channels 604 and 608 are semi-lumens that open outwardly along the distal-proximal 602A-602B axis of the wall 602. In other embodiments, the oral airway appliance 600 may include only one peripheral channel and / or only one of the two peripheral channels may open outwardly along the distal-proximal 602A-602B axis of the wall 602. Figure 6 In some embodiments, the opening is a gap. In other embodiments, the opening may be a slit.

[0313] If already combined Figures 5A to 5F As described, any of the three channels 604, 606 and / or 608 may be used to insert a camera or tool, including, for example, forceps, aspiration tube, stethoscope, temperature probe, bougie, or stylet.

[0314] In some embodiments, the oral airway appliance 600 can include an inflatable or non-inflatable cuff (not shown) attached to the periphery of the wall 602 and proximate the distal end 602A. In embodiments where the peripheral passageway opens to the wall 602 with a groove, the cuff can also have a slit that aligns with the groove so that the cuff does not pass over the groove.

[0315] Other embodiments of the present disclosure provide an adapter that converts a medical device or tube, such as an endotracheal tube, into a medical device or tube that is compatible with a camera.

[0316] Fig. 7A One embodiment of an adapter is shown in . In this embodiment, the adapter 610 is a plastic tube having a distal end 610A and a proximal end 610B that couples to an endotracheal tube 612. The adapter 610 may have a slit extending along the tube from the proximal end 610B to the distal end 610A.

[0317] The endotracheal tube has a distal end 612A and a proximal end 612B. There is an inflatable cuff 614 that wraps around the endotracheal tube 612 near the distal end 612A. The distal end 610A of the adapter 610 is located distal to the cuff 614. The adapter 610 extends along a distal-proximal axis 612A-612B. The adapter 610 can be attached to the endotracheal tube 612, for example, by adhering to the endotracheal tube 612 along the distal-proximal axis 612A-612B. Alternatively, the adapter 610 can be placed below the cuff 614 so that the adapter 610 can slide along the endotracheal tube 612.

[0318] The proximal end 610B of the adapter 610 protrudes proximally from the proximal end 612B of the endotracheal tube 612. Once the endotracheal tube 612 is placed in the patient, the cuff 614 can be inflated using the instrument 616.

[0319] The adapter 610 is a hollow tube that may or may not have a slit and that has an opening 610C at a distal end 610A and an opening 610D at a proximal end 610B.

[0320] The camera 12 with the cable 16 can be placed in the adapter 610 through the proximal opening 610D. When the camera 12 is not in use, it can be removed from the adapter 610. If a closed system for ventilating a patient is desired, the proximal opening 610D can be plugged with a plug 546. The distal end 610C of the adapter 610 is not sealed. Therefore, the camera 12 can extend distally from the adapter 610. Fig. 7A In some embodiments, the adapter 610 is placed under the cuff 614, which can be used to hold the adapter 610 with the endotracheal tube 612. In at least some embodiments, the adapter 610 can slide distally and proximally along the endotracheal tube 612.

[0321] Reference Figure 7B , the distal end 610A of the adapter 610 is disposed at the proximal end of the cuff 614. Fig. 7A All other components are numbered. Figure 7B In an embodiment, the adapter 610 can be attached to the endotracheal tube 612 so that the adapter 610 can still slide along the distal-proximal axis 612A-612B. Alternatively, the adapter 610 can be adhered to the endotracheal tube 612 and the adapter 610 will not slide.

[0322] Reference Fig. 8A, which provides another embodiment of an adapter generally designated 620 according to the present disclosure. The adapter 620 includes a hollow tube 622 having a distal end 622A and a proximal end 622B. The hollow tube 622 may have a slit (not shown) extending along the distal / proximal axis 622A / 622B.

[0323] The hollow tube 622 has an opening 622C at the distal end 622A and an opening 622D at the proximal end 622B (in Fig. 8A (not shown in the figure). The diameter of the hollow tube 622 is compatible with the diameter of the endotracheal tube 612. Therefore, the endotracheal tube 612 can be inserted into the hollow tube 622. If there is a slit, it is helpful to insert the endotracheal tube 612 into the hollow tube 622 and remove the endotracheal tube 612 in the hollow tube 622.

[0324] At least one second hollow tube 624 is attached to the hollow tube 622. The second hollow tube 624 has a distal end 624A and a proximal end 624B. The second hollow tube 624 has an opening 624C at the distal end 624A. The second hollow tube 624 has an opening 624D at the proximal end 624B. The distal end 624A of the second hollow tube 624 is aligned with the distal end 622A of the hollow tube 622. The proximal end 624B of the second hollow tube 624 is aligned with the proximal end 622B of the hollow tube 622.

[0325] The diameter of the second hollow tube 624 is compatible with the camera 12, so that the camera 12 connected to the cable 16 can be inserted into the second hollow tube 624 through the proximal opening 624D. Since the distal end 624C is not sealed, the camera 12 can extend distally from the second hollow tube 624. At least in some embodiments, the distal end 624A of the tube 624 can be sealed with a transparent window that prevents the camera 12 from contacting body fluids.

[0326] The adapter 620 may include one or more additional hollow tubes. Fig. 8A , a third hollow tube 626 is shown. In other embodiments, the third hollow tube may not be present, or the adapter 620 may include multiple hollow tubes 626. The hollow tube 626 is attached to the hollow tube 620. The hollow tube 626 has a distal end 626A and a proximal end 626B. The hollow tube 626 has an opening 626C at the distal end 626A. The hollow tube 626 has an opening 626D at the proximal end 626B.

[0327] The distal end 626A of the hollow tube 626 is aligned with the distal end 622A of the hollow tube 622. The proximal end 626B of the hollow tube 626 is aligned with the proximal end 622B of the hollow tube 622. The diameter of the hollow tube 626 is compatible with the camera 12, so that the camera 12 connected to the cable 16 can be inserted into the hollow tube 626 through the proximal opening 626D. Since the distal end 626C is not sealed, the camera 12 can extend distally from the hollow tube 626. The hollow tubes 624 and 626 can be used interchangeably to accommodate cameras and tools, such as bougies and / or stylets. The camera can be inserted into one of the hollow tubes 624 or 626, and the tool can be inserted into the other hollow tube. The endotracheal tube is loaded into the hollow tube 622.

[0328] Reference Figure 8B , which shows an endotracheal tube 612 and a camera 12 loaded into an adapter 620. Figure 8B As can be seen from the components in the figure, the camera 12 placed in the tube 624 can provide continuous visualization during the placement of the endotracheal tube 12. If a tool is needed to guide the placement of the endotracheal tube 12, the tool can be inserted into the third hollow channel 626.

[0329] like Figure 8B As shown, the adapter 620 can be rotated clockwise and / or counterclockwise about the endotracheal tube 12. This allows the camera 12 and / or tools to be moved as needed. The adapter 620 can also slide along the distal-proximal 612A-612B axis of the endotracheal tube 612. This allows additional flexibility in combining the camera and / or tools closer to or further away from the distal end 612A of the endotracheal tube 612.

[0330] Because the diameter of hollow tube 622 and the diameters of hollow tubes 624 and 626 can be designed to accommodate a variety of instruments, adapter 620 can be used with a variety of endotracheal tubes and / or other instruments.

[0331] Reference Figure 8C , which shows another embodiment of an adapter generally designated 640 according to the present disclosure. Adapter 640 includes a hollow tube 642 having a distal end 642A and a proximal end 642B. Hollow tube 642 has an opening 642C at distal end 642A and an opening 642D at proximal end 642B (in Figure 8C not shown).

[0332] At least one second hollow tube 644 is attached to the hollow tube 642. The second hollow tube 644 has a distal end 644A and a proximal end 644B. ​​In other embodiments, the adapter 640 may include a plurality of second hollow tubes 644, for example, 2 or 3 or 4 second hollow tubes 644.

[0333] The second hollow tube 644 has an opening 644C at a distal end 644A. The second hollow tube 644 has an opening 644D at a proximal end 644B. ​​The distal end 644A of the second hollow tube 644 is aligned with the distal end 642A of the hollow tube 642. The proximal end 644B of the second hollow tube 644 is aligned with the proximal end 642B of the hollow tube 642. The diameter of the second hollow tube 624 is compatible with the camera 12, so that the camera 12 connected to the cable 16 can be inserted into the second hollow tube 644 through the proximal opening 644D. Since the distal end 644C is not sealed, the camera 12 can extend distally from the second hollow tube 644. The bougie 590 or any other tool or tube, i.e., an endotracheal tube, can be placed in the hollow tube 642.

[0334] The adapter 640 can also include a stylet or rod 646 that extends along the hollow tube 642 for at least some of the length of the hollow tube 642 and provides support for the adapter 640. In other embodiments, the rod 646 is not present. In other embodiments, the adapter 640 does not include a stylet or rod 646.

[0335] like Fig.8D As shown, the camera 12 is loaded into the second hollow tube 644, and the bougie 590 is loaded into the hollow tube 642 of the adapter 640. The adapter 640 can rotate clockwise and counterclockwise around the bougie. The adapter 640 can slide distally and proximally along the bougie. In this way, different tissue areas can be seen as needed.

[0336] Reference Fig. 8E , which provides another embodiment of an adapter generally designated 660 according to the present disclosure. The adapter 660 includes a hollow tube 662 attached to the camera head 12. The hollow tube 662 includes a distal end 662A and a proximal end 662B. The camera head 12 is attached to the hollow tube 662 externally and adjacent to the distal end 662A. The cable 16 extends along the length of the hollow tube 662.

[0337] like Fig.8F As shown, a bougie 590 or other tool may be placed in hollow tube 662. Adapter 660 may be rotated clockwise and counterclockwise about bougie 590. Adapter 660 may also be slid distally and proximally along the length of bougie 590. As described in conjunction with adapters 620 and 640, adapter 660 may include additional hollow tubes.

[0338] Reference Figure 8G , which provides another embodiment of an adapter generally designated 680 according to the present disclosure. The adapter 680 includes a hollow tube 682, Figure 8GA portion of a hollow tube 682 is shown. The camera head 12 with the cable 16 can be inserted into the hollow tube 682. The hollow tube 682 is made of a plastic that is flexible enough to be bent into the shape required for insertion. However, once bent, the hollow tube 682 will retain that shape. Any adapter provided in the present disclosure can be made of such a material and have the property of retaining the shape into which it is placed. Alternatively, an adapter according to the present invention can be made of a flexible material. Figure 8H The camera 12 is shown inserted into the adapter 680.

[0339] Fig.8I Shows how to Figure 8H The assembly is inserted into the endotracheal tube 480.

[0340] Figure 8J The endotracheal tube 480 is shown with the adapter 680 inserted therein. The adapter 680 accommodates the camera, which is now located at the distal end 480A of the endotracheal tube 480. The camera cable 16 can extend proximally to the proximal end 480B of the endotracheal tube 480. The camera 12 can also include a light source and a Figure 8J Shown glowing.

[0341] Figure 8K Shows Figure 8C The adapter 640 is combined with the camera head 12 having the cable 16 and the bronchoscope 648 .

[0342] As combined Figure 8C As shown, the adapter 640 includes a hollow tube 642 having a distal end 642A and a proximal end 642B. The hollow tube 642 has an opening 642C at the distal end 642A and an opening 642D at the proximal end 642B.

[0343] At least one second hollow tube 644 is connected along the length of the hollow tube 642. The second hollow tube 644 has a distal end 644A and a proximal end 644B. ​​In other embodiments, the adapter 640 may include a plurality of second hollow tubes 644, for example, 2 or 3 or 4 second hollow tubes 644.

[0344] The second hollow tube 644 has an opening 644C at a distal end 644A. The second hollow tube 644 has an opening 644D at a proximal end 644B. ​​The distal end 644A of the second hollow tube 644 is aligned with the distal end 642A of the hollow tube 642. The proximal end 644B of the second hollow tube 644 is aligned with the proximal end 642B of the hollow tube 642.

[0345] The diameter of the second hollow tube 624 is compatible with the camera 12, so that the camera 12 connected to the cable 16 can be inserted into the second hollow tube 644 through the proximal opening 644D. Since the distal end 644C is not sealed, the camera 12 can extend distally from the second hollow tube 644.

[0346] exist Figure 8K In the embodiment of the present invention, a bronchoscope 648 is placed in the hollow tube 642 through the proximal opening 642D. The bronchoscope 648 includes a plastic rod 650 attached to a mechanism 652 having a handle 654. The plastic rod 650 can be operated by toggling the handle 654 of the mechanism 652, for example, to bend the plastic rod 650 in various directions. Many prior art bronchoscopes include a light and a lens for viewing patient tissue. With the aid of the adapter 640, any bronchoscope, including those that do not include a light and a lens, can be used with the camera 12 that provides continuous visualization. In order to combine the bronchoscope 648 with the adapter 640, the distal end 650A of the rod 650 is inserted into the hollow tube 642 through the opening 642D. The distal end 650A is then placed near the distal end 642A inside the hollow tube 642. The distal end 650A of the rod 650 can extend distally from the opening 642C of the hollow tube 642 of the adapter 640.

[0347] Adapter 640 may also include a stylet or rod 646 ( Figure 8K ), a stylet or rod 646 extends along at least some length of the hollow tube 642 and may provide support for the adapter 640 if desired.

[0348] Reference Figure 8L , which shows an adapter 640 that houses the shaft 650 of a bronchoscope 648 in a hollow tube 642, while the camera is housed in a hollow tube 644. Thus, the bronchoscope 648 is operated under continuous visualization by the camera 12.

[0349] 8M and 8N, while the adapter 640 is inserted into the patient, the shaft 650 of the bronchoscope 648 can be manipulated and bent in different directions by turning the handle 654. These operations are performed under continuous visualization of the camera 12.

[0350] Reference Fig.9A , which provides another embodiment of an oral airway appliance, generally 700, in accordance with the present disclosure. The oral airway appliance 700 includes a tubular body 701 that is curved (arc-shaped) forward so that the oral airway appliance 700 follows the contour of the roof of the patient's mouth during insertion of the oral airway appliance 700. In the present disclosure, "anteriorly" is used in its standard anatomical sense, e.g., the distal portion of the appliance 700 curves toward the front of the subject.

[0351] The curved tubular body 701 of the oral airway appliance 700 is made of a wall 702 having a length between a distal end 702A and a proximal end 702B. The wall 702 has a ventral side 702D and an opposite dorsal side 702C (at Fig.9A See also Figure 9W , which shows a cross-sectional view of the tube body 701.

[0352] exist Figure 9W , a cross-section of wall 702 shows a camera channel 718 in wall 702, a central lumen 704 in wall 702, and a gastric passage 720 in wall 702. Also shown are dorsal side 702C of wall 702, ventral side 702D of wall 702, and sides 702L and 702R of wall 702, as well as slit 706 in wall 702 that leads to central lumen 704. Wall 702 can be made of a thermoplastic that is soft enough to be inserted into a patient's mouth, but also hard enough to maintain its curved shape. Conventional oral airway appliances are tubes that are hollow plastic cylinders. Unlike conventional oral airway appliances, wall 702 has a thickness, and body 701 is not hollow. Instead, central lumen 704 and passages 718 and 720 are hollow passages in wall 702 of body 701 that are filled with a thermoplastic material. See Figure 9W .

[0353] Refer again Fig.9A , viewed from the ventral side 702D from the proximal end 702B to the distal end 702A, the curved tube 701 bends forward to follow the contour of the roof of the patient's mouth during insertion while improving the alignment of the oral airway appliance 700 to the laryngeal entrance.

[0354] Wall 702 includes a back side 702C (at Fig.9A Not shown, but see Figure 9W ), a ventral side 702D opposite to the dorsal side 702C, and two lateral sides (sides): one on each side between the sides 702C and 702D. Fig.9A In FIG. 7 , the ventral side 702D and the right side 702R are shown. The left side 702L is opposite to the right side 702R and is Fig.9A Not visible in, but see also Figure 9W When oral airway appliance 700 is placed in a subject, ventral side 702D is generally located anteriorly, or in other words, closer to the front of the subject than dorsal side 702C. When appliance 700 is placed in a subject, proximal end 702B remains external and outside of the subject's oral cavity.

[0355] Due to the arcuate curvature, the length of the wall 702 on the dorsal side 702C is longer than the length on the ventral side 702D.

[0356] The curved tube 701 ends at its distal end with a tongue 703. The tongue 703 extends distally from the curved tube 701 and tapers gradually at its distal end 703A. The tongue 703 has a ventral side 716 and a dorsal side 703C, which is opposite to the ventral side 716 and is Fig.9A The back side 703C is not shown in FIG. However, as described in detail below, Fig. 9B 9C and 9D show the dorsal side 703C of the tongue 703.

[0357] When Fig.9A As shown when the tongue 703 is viewed from the ventral side 716, the tip 703A of the tongue 703 can be oval, nearly oval, circular, or nearly circular to facilitate insertion of the oral airway appliance 700 and prevent or at least minimize damage to the patient's tissue.

[0358] The tongue 703 has a ventral surface 716 that serves as a platform on which to house a number of other components, as discussed in more detail below. The ventral surface 716 can be flat or nearly flat, which distinguishes the tongue 703 from a laryngeal mask, in which the body of the laryngeal mask is typically bowl-shaped.

[0359] The curved tube 701 and tongue 703 are made of a thermoplastic polymeric material that maintains a fixed or substantially fixed anterior curvature. The polymeric material is sufficiently rigid to maintain the shape of the oral airway appliance 700, including the anterior curvature. However, the material is sufficiently flexible and soft so that it has less impact on the patient's tissue during insertion. Suitable materials may include synthetic plastic polymers, such as polyvinyl chloride. Suitable materials may also include rubber, such as styrene-butadiene rubber.

[0360] Although the curved tube 701 may maintain its shape, a bougie may also be incorporated into the wall 702 along the side 702L so that the bougie may provide additional support to the oral airway appliance 700 .

[0361] The wall 702 surrounds a central lumen 704, which may be referred to in the present disclosure as an endotracheal tube (ETT) lumen, because the central lumen 704 may be used to place an endotracheal tube. However, it will be understood that the ETT lumen 704 may be used to deliver other breathing tubes and / or tools, such as a bougie 590, and / or an instrument suitable for managing the airway. As discussed in more detail below, the ETT lumen 704 itself may be used to ventilate the patient, if desired. Thus, the oral airway appliance 700 may be used with or without an endotracheal tube to manage the airway.

[0362] The central lumen 704 is hollow and has a distal opening 704A and a proximal opening 704B. The proximal opening 704B opens at the proximal end 702B of the curved tubular body 702. The distal opening 704A leads to the ventral side 716 of the tongue 703.

[0363] like Fig.9A As shown, the central lumen 704 may be completely surrounded by the wall 702, or the wall 702 may have a slit 706. Fig.9A In the embodiment of FIG. 7 , the slit 706 extends along the distal-proximal 702A-702B axis on the ventral side 702D of the wall 702. Fig.9A As shown, in addition to or in lieu of the slits 706, some proximal portions on the ventral side 702D may not exist, such that some proximal portions of the central lumen 704 are open on the ventral side 702D and not covered by the wall 702. In other words, the curved tube 701 may have a proximal recess 708 leading to the central lumen 704. In other embodiments, the instrument 700 does not have the slits 706 or the slits 706 are located on the dorsal side 702C instead of the ventral side 702D.

[0364] A medical device, such as an endotracheal tube or any other tool or instrument suitable for managing a patient's airway or a camera, can be placed in central lumen 704 or removed from central lumen 704 by pushing the edges of wall 702 apart along slit 706.

[0365] exist Fig.9A In the embodiment of the present invention, the wall 702 has a slit 706 extending longitudinally along the distal-proximal axis 702A-702B on the ventral side 702D. In other embodiments, the slit 706 can be placed on other surfaces, such as on the dorsal side 702C of the wall 702, and the slit is set so long that the doctor can enter the central lumen 704 through the slit 706 by pushing the wall 702 at the slit 706.

[0366] In some embodiments, the slit 706 can be narrow so that the edges of the walls 702 touch or nearly touch along the length of the slit 706. In some embodiments, the slit is sealable. In these embodiments, one of the edges of the walls 702 along the slit 706 includes a groove, and the other edge of the wall 702 includes a ridge that interlocks with the groove, thereby forming a seal through the slit 706. The seal is reopened as needed.

[0367] In some embodiments, the slit 706 is a perforation line in the wall 702 that can be converted into an opening to the central lumen 704 by opening the wall along the perforation line. In other embodiments, the slit 706 is a gap such that there is always a gap between the edges of the wall 702 along the slit 706, and the edges of the wall 702 do not touch along the length of the slit 706. In at least other embodiments, the wall 702 does not include a slit 706.

[0368] Reference Fig. 9B , which is a longitudinal cross-sectional view of the central lumen 704 of the oral airway appliance 700 along the distal-proximal axis 702A-702B, showing the central lumen 704 within the wall 702. Fig.9A All elements are labeled. A cross section of tongue 703 is shown, including its distal tip 703A, ventral side 716 and dorsal side 703C.

[0369] The curved tube body 701 is curved forward. Therefore, the central lumen 704, which is a passage inside the wall 702, is also curved forward.

[0370] Additionally, some distal portions 702I of the wall 702 are angled within the central lumen 704 near the tongue 703. This configuration of the central lumen 704 defines an angle above the tongue 703 at which the endotracheal tube (or any instrument or tool received in the central lumen) protrudes from the distal opening 704A of the central lumen 704.

[0371] The central lumen 704 is inclined at a predetermined angle so that the central lumen 704 extends from the distal opening 704A at an angle of at least 30 degrees to the dorsal side 703C of the tongue 703 to the endotracheal tube accommodated therein. In some embodiments, the angle is in the range of 30 to 80 degrees. More preferably, the central lumen 704 is inclined at 50 to 80 degrees, and the central lumen 704 extends from the distal opening 704A to the endotracheal tube at an angle in the range of 50 to 80 degrees to the dorsal side of the tongue 703. Most preferably, the central lumen 704 is inclined at an angle in the range of 60 to 70 degrees to the dorsal side 703C of the tongue 703. Those skilled in the art will appreciate that in some other embodiments, such as in pediatric applications, the angle may be different and may be adjusted as desired.

[0372] Refer again Fig.9A , in addition to the central lumen 704, the wall 702 includes at least two peripheral hollow passages 718 and 720. See also Figure 9W In some embodiments, as described in detail below, channel 720 may not be present.

[0373] Channel 718 is a hollow passage in wall 702. Fig.9A as well as Figure 9W .

[0374] like Fig.9A As shown, channel 718 can be used to insert a camera and / or other tools, such as a bougie, or an instrument with cable 16. Channel 718 may be referred to as camera channel 718 in the present disclosure. It should be understood that channel 718 can be used to insert other tools and / or devices, and that the camera can be inserted into other channels, such as channel 704 and / or channel 720. Camera channel 718 can also be used to spray medication and / or aspirate secretions to the patient's tissue.

[0375] The camera channel 718 has a proximal opening 718B that is an entrance to the camera channel 718 and is located at the proximal end 702B of the wall 702. The camera channel 718 extends along the distal-proximal end 702A-702B axis. The camera channel 718 ends at a distal opening 718A that is an exit from the camera channel 718. The camera channel 718 is a peripheral channel. Compared to Fig.9A and Figure 9W The proximal opening 704B of the central lumen 704 is centrally positioned to view the peripheral position of the proximal opening 718B.

[0376] The camera 12 with the cable 16 may be inserted through the proximal opening 718B in the camera channel 718. Any camera suitable for viewing the patient's organs may be used with the oral airway appliance 700. The camera 12 may be inserted into and removed from the camera channel 718. The position of the camera 12 at the distal opening 718A of the camera channel 718 may be adjusted as needed to monitor the patient's tissues and the passage of the oral airway appliance 700 through the patient's mouth and into the pharynx during placement.

[0377] When the oral airway device 700 is equipped with a camera, it can continuously visualize the patient's larynx and vocal cords. This facilitates accurate and rapid placement of an endotracheal tube without requiring multiple lengthy insertion attempts. The device 700 can include more than one camera. For example, one camera can be inserted into the camera channel 718, while another camera can be placed in the central lumen 704 along with the bougie and / or endotracheal tube.

[0378] exist Fig.9AIn the embodiment, the distal opening 718A is disposed near the distal opening 704A of the central lumen 704, so that when the camera is inserted into the channel 718 and extended through the distal opening 718A, the camera can see the distal end of the instrument 700 and the insertion process of the instrument, and can guide the placement of the endotracheal tube under the continuous visualization of the camera. The distal opening 718A of the camera channel 718 is preferably not sealed so that the camera can extend distally from the camera channel 718. However, in some embodiments ( Fig.9A ), the distal opening 718A of the camera channel 718 may not be sealed by a window.

[0379] In some embodiments, the camera channel 718 is a hollow channel in the wall 702, and the camera channel 718 is completely separated from the ETT lumen 704, as shown in FIG. Figure 9W shown.

[0380] In other embodiments, the camera channel 718 is a semi-lumen that is connected to the ETT lumen 704 with a gap or slit. In other embodiments, there is a slit that is formed on one surface of the wall 702 ( Fig.9A 718). In these embodiments, the camera can be inserted into or removed from the camera channel 718 by pulling the slit.

[0381] Reference Fig. 9C , which is a longitudinal cross-sectional view of the camera channel 718, showing that the camera channel 718 is a hollow channel in the wall 702. The camera channel 718 is bent forward. The camera channel 718 is also inclined at its distal portion 718S from the dorsal side 703C of the tongue 703 at the distal opening 718A. The camera (or any other instrument) placed in the camera channel 718 protrudes from the camera channel 718 at a predetermined angle due to the inclined structure of the camera channel 718.

[0382] When a device such as a camera is accommodated in the camera channel 718 and the distal end of the camera extends distally from the camera channel opening 718A, the device / camera extends from the camera channel at a predetermined distance, and the predetermined angle is defined by the slope of the camera channel 718. The extended device / camera is then supported by the camera ramp 724 at the above-mentioned angle.

[0383] In some embodiments, the predetermined angle of the camera channel is 30 to 80 degrees with respect to the dorsal side 703C of the tongue 703. More preferably, the angle is in the range of 50 to 70 degrees. Most preferably, the angle is in the range of 55 to 65 degrees. However, in other applications, such as in pediatric applications, the camera may extend from the camera channel 718 at some other angle, such as 10 to 40 degrees, with respect to the dorsal side 703C of the tongue 703.

[0384] The predetermined angle of the camera channel 718 is optimized so that the camera channel extends out of the camera at an angle that allows the camera to see the tip of the endotracheal tube housed in the central lumen 704. It should be noted that the camera channel 718 and the central lumen 704 can be designed to have different inclinations from the dorsal side 703C of the tongue 70s, so that the camera housed in the camera channel 718 extends out at an angle that is different from the angle at which the endotracheal tube extends out of the central lumen 704.

[0385] In some embodiments, the extension angle of the central lumen 704 can be greater than the extension angle of the camera channel 718, and both angles are calculated based on the dorsal side 703C of the tongue 703. In some embodiments, the extension angle of the central lumen 704 can be 5 to 10 degrees greater than the extension angle of the camera channel 718. In other embodiments, the extension angle of the central lumen 704 can be less than the extension angle of the camera channel 718. In some embodiments, the extension angle of the central lumen 7004 can be 5 to 10 degrees less than the extension angle of the camera channel 718. In other embodiments, the two extension angles are the same or substantially the same.

[0386] In some embodiments, the central lumen 704 is inclined at 55 to 75 degrees relative to the dorsal side 703C of the tongue 703 , and the camera lumen 718 is inclined at 50 to 70 degrees relative to the dorsal side 703C of the tongue 703 .

[0387] Because the camera can be manipulated to slide along the camera channel 718 independently of the endotracheal tube, the position of the camera can be adjusted as desired relative to the distal tip of the endotracheal tube housed in the central lumen 704. For example, the camera can be positioned closer to or farther from the distal end of the endotracheal tube that extends distally from the distal opening 704A of the central lumen 704. One of the technical advantages provided by the present oral airway appliance is that the camera can be placed near the tip of the endotracheal tube.

[0388] Refer again Fig.9A, the oral airway appliance 700 may also include one or more camera channel guide instruments for raising the exposed camera or any other tool above the ventral side 716. The guide instrument may also guide the exposed tip of an instrument or tool (e.g., a camera and / or a bougie) (where the tip emerges from the distal opening 718A) toward the centerline of the ventral side 716, whereby the tip of the camera and / or bougie or any other instrument or tool housed in the channel 718 may be better aligned with the distal end of the endotracheal tube emerging from the distal opening 704A of the central lumen 704.

[0389] The guiding device may include one or more of the following: 1) a ledge, Fig.9A 1) a wall shield which guides the emerging tip toward the centerline of the ventral side 716, and 2) a wall shield which guides the emerging tip toward the centerline of the ventral side 716, and 3) a wall shield which guides the distal tip of the camera toward the centerline of the ventral side 716, and 4) a wall shield which guides the emerging tip toward the centerline of the ventral side 716, and 5) a wall shield which guides the distal tip Fig.9A 3) a slope located in front of the distal opening 718A and / or inside the distal opening 718A, in Fig.9A Shown in FIG. 7 is a camera channel ramp 724; 4) any combination thereof.

[0390] The camera channel 718 is typically a hollow passage or tunnel in the wall 702 that is separated from the central lumen 704 by the wall material, but the camera lumen 718 may have a ledge 718L. Thus, the distal opening 718A and the distal opening 704A may be aligned so that the exposed tip of an instrument or tool placed in the camera lumen 718 is aligned with the tip of the endotracheal tube emerging from the distal opening 704A.

[0391] The oral airway appliance 700 can include a wall shield 718G that is configured so that when the tip of the camera emerges from the distal opening 718A, the wall shield 718G guides the tip of the camera and / or any other instrument (e.g., a bougie) toward the centerline of the ventral side 716 so that the camera and / or bougie can be aligned with the distal end of the endotracheal tube emerging from the distal opening 704A of the central lumen 704. The wall shield 718G can be a folded portion that hangs forward of a portion of the distal opening 718A.

[0392] The oral airway appliance 700 can include a camera channel ramp 724 located distally and in front of the camera channel distal opening 718A. The camera channel ramp 724 supports the camera extending from the angled camera channel 718.

[0393] In some other embodiments, the oral airway appliance 700 can include at least one camera (not shown), which can be built into the wall 702, sealed to the wall 702, or slidably connected along the wall 702. In other embodiments, the oral airway appliance 700 can include multiple cameras. The oral airway appliance 700 can also include a sound and / or heart sound sensor, which can be combined with the camera or it can also be a separate device. One or more cameras can include a built-in light source. Alternatively, the wall 702 can have a built-in light source independent of the camera.

[0394] In other embodiments, the oral airway appliance 700 can include an esophageal stethoscope (not shown) that can be built into the wall 702 or the esophageal stethoscope can be inserted into the passage 718, the ETT lumen, and / or the passage 720. In further embodiments, the oral airway appliance 700 can include a temperature probe (not shown) that can be combined with the esophageal stethoscope (not shown) or the temperature probe can be built into the wall 702 or the temperature probe can be inserted into the passage 718, the ETT lumen, and / or the passage 720.

[0395] The central ramp 714 is disposed on and rises above the ventral side 716. The central ramp 714 is located distally and forwardly of the opening 704A of the central lumen 704. The central ramp 714 includes a distal wall 714W supporting a ramp 714S having a proximal edge 714B and a distal edge 714A.

[0396] The central ramp 714 facilitates and guides the insertion of an endotracheal tube or other medical device or tool. When the endotracheal tube (or any other device or tool) is received in the central lumen 704 and the distal end of the endotracheal tube (or any other device or tool) extends distally from the distal opening 704A of the central lumen 704, the central ramp 714 supports and raises the extended distal tip above the ventral side 716 of the tongue 703.

[0397] Now refer to Fig.9E Describe the structure of the central ramp 714, Fig.9E A portion of the ventral side 716 is shown to which the central ramp 714 is attached. The central ramp 714 is located distally of the distal opening 704A of the central lumen 704 in the wall 702 and is located forwardly thereof.

[0398] The height of the slope 714 (at Fig.9E The central ramp 714 is shown as h) and is designed so that during insertion of the oral airway appliance 700, the central ramp 714 contacts the arytenoid cartilages and the lower portion of the larynx. The central ramp 714 prevents the oral airway appliance 700 from entering the upper esophagus.

[0399] When an instrument or tool such as an endotracheal tube is inserted into the central lumen 704 and the distal tip of the instrument or tool extends distally from the opening 704A of the central lumen 704, the central ramp 714 raises and supports the tip of the instrument or tool to above the ventral side 716 at a predetermined angle, and the predetermined angle is in the range of 50 to 80 degrees with the distal surface 703C of the tongue 703, preferably in the range of 60 to 70 degrees.

[0400] The oral airway device 700 guides the endotracheal tube and / or any other instrument or tool at an optimal angle to guide the endotracheal tube between the vocal cords. Thus, the central ramp 714, the arcuate bend of the wall 702 and the angled central lumen 704 minimize the risk of esophageal intubation or entanglement on the arytenoid cartilages.

[0401] exist Fig.9E , the distal opening 718A from the camera channel 718 is also shown, as well as the camera channel ramp 724 and the camera channel ledge 718L. The camera channel shield 718G is also shown.

[0402] return Fig.9A ,exist Fig.9A In some embodiments, the oral airway appliance 700 includes a second peripheral channel 720, which may be referred to in the present disclosure as a stomach channel 720. In other embodiments, the stomach channel 720 may not be present. In some other embodiments, the oral airway appliance 700 may include additional channels.

[0403] The stomach passage 720 is a hollow passage in the wall 702 that extends along the distal-proximal 702A-702B axis of the wall 702. The stomach passage 720 opens at a proximal opening 720B at the proximal end 702B of the wall 702. The stomach passage 720 may have a slit 722 that extends along at least a portion of the length of the stomach passage 720 and opens the stomach passage 720 on one of the surfaces of the wall 702. Fig.9A In the embodiment of the present invention, the slit 722 opens to the right side 702R. In an alternative embodiment, the slit 722 may open on the back side 702C of the wall 702. In a further embodiment, the slit 722 may not exist.

[0404] The stomach passage 720 is formed on the dorsal side 702C of the wall 702 with a distal opening 720A ( Fig.9A ), or the distal opening 720A may open on the dorsal side of the tongue 703 (not shown). Fig.9A (not visible in the image).

[0405] The stomach passage 720 can be used to suction fluid and stomach contents by inserting a suction tube into the stomach passage 720. In the present disclosure, the stomach passage 720 may be referred to as the esophageal passage 720. The stomach passage 720 can be used to suction stomach contents to prevent vomiting.

[0406] Reference Fig.9D , which is a longitudinal cross-sectional view of the esophagus 720, showing its relative position in the wall 702. Fig.9A All components are labeled. See also Figure 9W .

[0407] Gastric passage 720 may also be used to insert other tools including, but not limited to, a bougie, a stylet, forceps, an esophageal stethoscope, and / or a camera.

[0408] In other embodiments, the gastric passage 720 is a semi-lumen that is opened through a slit (not in the Fig.9A ) connected to the ETT lumen 704.

[0409] Because the oral airway appliance 700 is assembled from several components, the physician can manipulate all of these tools and perform placement of the oral airway appliance 700 as needed.

[0410] As will be appreciated by those skilled in the art, in some embodiments, channels 718 and 720 may be interchangeable, i.e., a camera may be inserted into either channel, as desired. In other embodiments, the oral airway appliance 700 may have more than two channels in the wall 702. These additional channels may be located at the periphery of the ETT lumen 704. In some procedures, a camera may also be placed in the ETT lumen 704, if desired.

[0411] Reference Fig.9A , a non-inflatable laryngeal cuff 710 is formed and attached around the ventral side 716 of the tongue 703, including the tongue tip 703A. The laryngeal cuff 710 is also attached to the wall 702 at the sides 702L, 702R and at the ventral side 702D. Thus, the laryngeal cuff 710 forms a donut-shaped cushion for the oral airway appliance 700.

[0412] The laryngeal cuff 710 is shaped so that it conforms to the contour of the patient's laryngeal inlet region. Thus, the laryngeal cuff 710 can form a seal at the laryngeal inlet region so that the lungs can be inflated during artificial ventilation through the central lumen 704, as discussed in more detail below.

[0413] exist Fig.9AIn an embodiment of the present invention, the laryngeal cuff 710 is non-inflatable and sufficiently flexible to prevent or minimize trauma to patient tissue during insertion. The laryngeal cuff 710 can also conform to the curvature of the patient's airway. The non-inflatable laryngeal cuff 710 can be made of silicone rubber or any other polymeric material that will provide the laryngeal cuff 710 with a rubber-like texture.

[0414] exist Fig.9A In the embodiment, the laryngeal cuff 710 circumferentially covers the ventral side 716 of the tongue 703, so that some central portion of the interior 716 is not covered by the laryngeal cuff 710. In other embodiments, the laryngeal cuff 710 may cover all or substantially all of the ventral side 716 except the central ramp 714.

[0415] In other embodiments, the laryngeal cuff 710 can be made inflatable so that after the device 700 is placed in the patient, the laryngeal cuff 710 is inflated. In other embodiments, the laryngeal cuff 710 is non-inflatable and is made as a shell of silicone rubber or any other polymeric material. During the manufacturing process, the shell is filled with a suitable liquid, gel or gas.

[0416] In other embodiments, only a portion of the laryngeal cuff is inflatable, while other portions are non-inflatable. In some embodiments, the distal portion of the laryngeal cuff 710 may be non-inflatable, while the side portions and / or the proximal portions may be inflatable.

[0417] The laryngeal cuff 710 absorbs and softens impact to the patient's tissue during insertion and also improves the seal once the device 700 is placed.

[0418] exist Fig.9A In some embodiments, the laryngeal cuff 710 has a slit 712 that is aligned with the slit 706 of the wall 702 so that when the edge of the wall 702 is pushed apart at the slit 706, the laryngeal cuff 712 can also be pushed apart to facilitate the insertion or removal of an endotracheal tube or any other instrument into or from the central lumen 704. In other embodiments, the laryngeal cuff 710 does not include the slit 712. The slit 712 can be sealable like the slit 706. If the laryngeal cuff 710 is inflatable, the slit 712 does not cut through the outer shell of the laryngeal cuff 710, and the outer shell remains intact and still contains air, gas, or liquid.

[0419] One of the purposes of the central lumen 704 is to deliver an endotracheal tube and facilitate proper placement of the endotracheal tube. Due to the slits 706 and 712, the endotracheal tube can be easily separated from and removed from the central lumen 704 while the oral airway appliance 700 remains inserted into the patient. In addition, the oral airway appliance 700 can be separated and removed from the patient after the endotracheal tube is placed in the patient and while the endotracheal tube remains inserted and placed in place in the patient, without having to remove the entire assembly from the patient.

[0420] If the oral airway appliance 700 has a slit 706 through the wall 702, one or more accessories may be used to establish a closed system through the central lumen 704. Thus, the oral airway appliance 700 may be used to ventilate a patient through the central lumen 704.

[0421] like Figure 1T , 1U and 1V, the oral airway device 700 can be used with a ventilator adapter 507. In an alternative embodiment, the device 500 can be inserted into the central lumen 704. In further embodiments, as shown in Figure 9N As shown and described in FIGS. 9O, 9P and 9Q, an accessory cover 770 may be used to establish a closed system for ventilation through the central lumen 704.

[0422] The oral airway appliance 700 can be manufactured in different sizes to accommodate the weight of pediatric and adult patients.

[0423] Reference Fig.9F , which shows Fig.9A How the oral airway device 700 is assembled with the endotracheal tube 480, which is inserted into the central lumen 704 through the proximal opening 704B. The suction tube 482 can be placed in the channel 720 by inserting it through the proximal opening 720B of the channel 720. The camera 12 with the cable 16 can be inserted into the camera channel 718 through the proximal opening 718B of the camera. In the device 700, all components are as combined Fig.9A As described.

[0424] Reference Figure 9G , which shows Fig.9A The oral airway device 700 is assembled with an endotracheal tube 480, which is accommodated in a central lumen 704, and the distal end 480A of the endotracheal tube 480 extends distally from the oral airway device 700. The endotracheal tube 480 extends from the central lumen 704 at a predetermined angle to above the tongue 703. The endotracheal tube is supported at this angle by a central ramp 714.

[0425] The suction tube 482 is located in the gastric passage 720. The distal end 482A of the suction tube 482 extends distally from the oral airway appliance 700 on the dorsal side 702C of the oral airway appliance 700 such that the distal end 482A of the suction tube 482 is located outside of the laryngeal cuff 710.

[0426] After insertion, the laryngeal cuff 710 seals the larynx, and the suction tube 482 can be used to aspirate fluids in the stomach. Figure 9G The camera 12 is not visible in the insertion, and the cable 16 is inserted into the camera channel 718 to keep the portion of the camera cable 16 outside the camera channel 718. The camera 12 can capture images of the distal tip of the assembly and provide continuous visualization during and after insertion. The camera can remotely transmit captured information, such as images and sounds.

[0427] Reference Figure 9H , which shows the endotracheal tube 480 being separated from the oral airway appliance 700 through slit 706 and then through slit 712. While the endotracheal tube 480 is removed, the camera 12 and suction tube 482 may remain inserted as desired.

[0428] Reference Fig.9I , which provides another embodiment of an oral airway appliance generally designated 730. All elements of the oral airway appliance 730 are similar to Figures 9A-9H All elements of the illustrated oral airway appliance 700 are identical, except that the oral airway appliance 730 includes an additional element, a dorsal inflatable cuff 734, as described in more detail below.

[0429] The dorsal inflatable cuff 734 is located on the dorsal side of the tongue 703A, near the tongue tip 703A. The inflatable cuff 734 can be inflated with the device 736. When the cuff 734 is inflated, the cuff 734 provides an additional seal. It supports the seal created by the laryngeal cuff 710. Because the inflatable cuff 734 can be inflated on demand, the inflatable cuff 734 can be used to fine-tune and adjust the seal and conform the seal to the patient's anatomy. Therefore, the device 730 can be used in patients in which the seal with the laryngeal cuff 710 is not complete.

[0430] As with other oral airway appliances (including oral airway appliance 700), oral airway appliance 730 is equipped with one or more cameras. The inflation of inflatable cuff 734 can be adjusted while continuously viewing through the camera. All other components and their functions are described in conjunction with oral airway appliance 700.

[0431] Briefly, the oral airway appliance 730 includes a tubular body 702 having a certain length between a proximal end 702B and a distal end 702A. The tubular body 702 has a slit 706 that opens the wall 702 to a central lumen 704. Fig.9A As described above, a laryngeal cuff 710 having a slit 712 is formed and attached to the tongue 703 and the wall 702. A ramp 714 is located in front of the central lumen 704 to the distal opening 704A. A camera channel 718 having a proximal opening 718B and a distal opening 718A is located on the periphery of the central lumen 704 at the side 702L. Another peripheral channel 720 is located in the other side 702R. The channel 720 opens on the dorsal side 702C and can be used to guide a suction tube.

[0432] Reference Figure 9J , which shows the oral airway appliance 730 from the ventral side (702D). All elements and combinations Fig.9A and 9I The elements discussed are the same. This view shows the position of the distal opening 720A of the channel 720 relative to the tongue 703. This view also shows the position of the inflatable cuff 734 relative to the tongue 703. Figure 9J In some embodiments, the inflatable cuff 734 is shown, while in other embodiments, the inflatable cuff 734 is not present.

[0433] Reference Figure 9K , which shows the oral airway appliance 730 from the dorsal side (702C). All elements and combinations Fig.9A , the elements discussed in 9I and 9J are the same. This view shows the position of the distal opening 720A of the channel 720 relative to the tongue 703. This view also shows the position of the inflatable cuff 734 relative to the laryngeal cuff 710.

[0434] Reference Figure 9L , which shows another embodiment of an oral airway appliance, generally 740. The oral airway appliance 740 is a curved and forward curved tube so that the oral airway appliance 740 follows the contour of the roof of the patient's mouth during insertion. The curved tube of the oral airway appliance 740 is made of a wall 742 having a length between a distal end 742A and a proximal end 742B.

[0435] In oral airway appliance 740, wall 742 is curved along the distal-proximal 742A-742B axis so that wall 742 follows the contour of the roof of the patient's mouth. Wall 742 is similar to wall 700 and also includes a dorsal side 742C (at Figure 9L742C), the ventral side 742D opposite to the dorsal side 742C and the two sides connecting the ventral side 742D and the ventral side 742C into the tube body, the left side 742L (at Figure 9L Due to the arcuate curvature, the length of the wall 742 on the dorsal surface 742C is longer than the length on the ventral surface 742D.

[0436] When the instrument 740 is inserted into the oral cavity, the ventral side 742D contacts the patient's tongue. The dorsal side 742C is opposite to the ventral side 742D.

[0437] In FIG9 , the ventral side 742D and the right side 742R are shown. The left side 702L is opposite to the right side 702R and is Figure 9L Not visible in.

[0438] The wall 742 surrounds the central lumen 744. The central lumen 744 is hollow and has a distal opening 744A and a proximal opening 704B substantially as described in conjunction with the central lumen 704 of the oral airway appliance 700. The proximal opening 744B opens at the proximal end 742B of the wall 742. The distal opening 744A opens near the distal end 742A of the wall 742.

[0439] like Figure 9L As shown, the central lumen 744 can be completely surrounded by the wall 742, or the wall 742 can have a slit 746. The slit 746 extends along the distal-proximal axis 742A-742B on the ventral side 742D. In addition to the slit 746, or in place of the slit 746, as shown in FIG. Figure 9L As shown, some proximal portions of the wall 742 on the ventral side 742D may not be present, such that some proximal portions of the central lumen 744 may be open on the ventral side 742D.

[0440] A medical device, such as an endotracheal tube or any other tool or instrument suitable for managing the airway of a patient, or a camera, may be placed in central lumen 744 or removed from central lumen 744 by opening wall 742 along slit 746 .

[0441] exist Figure 9L In the embodiment of the present invention, the wall 742 has a slit 746 extending along the distal-lateral 742A-742B axis on the ventral side 742D. In other embodiments, the slit 746 can be placed on other surfaces, such as one of the lateral or dorsal sides 742C of the wall 746, so that the position of the slit 746 should be set so that the physician can enter the central lumen 744 through the slit 746 by pushing the wall 742 at the slit 746. The function of the slit 746 is the same as that described in conjunction with the slit 706 in the oral airway appliance 700.

[0442] Wall 742 terminates at distal end 742A with tongue 743. Oral airway appliance 740 also includes laryngeal cuff 750 which is positioned in the same manner and functions in the same manner as laryngeal cuff 710, except that laryngeal cuff 750 is inflatable using appliance 754.

[0443] exist Figure 9L In some embodiments, the laryngeal cuff 750 is inflatable and can be inflated with an instrument 754 that remains outside the patient's body after the device 740 is placed inside the patient. In other embodiments, the laryngeal cuff 750 can be non-inflatable, as described in conjunction with the laryngeal cuff 710 of the oral airway device 700. The laryngeal cuff 750 includes a slit 752 that is aligned with the slit 746. The function of the slit 752 is the same as the function of the slit 712 of the cuff 750.

[0444] The oral airway appliance 740 includes a central ramp 756 having the same structure and the same function as the central ramp 714 of the oral airway appliance 700. In short, as described in conjunction with the central ramp 714, the central ramp 756 raises the extended tip of an endotracheal tube or other appliance received in the central lumen 744 above the ventral side 742I at an angle.

[0445] The oral airway appliance 740 also includes a camera channel ramp 764 located distally and forwardly of the distal opening 758A of the camera channel 758. The structure and function of the camera channel ramp 764 are as described in conjunction with the camera channel ramp 724 of the oral airway appliance 700.

[0446] Wall 742 has two peripheral hollow passages 758 and 760. Passage 758 is a hollow passage in wall 742. Passage 758 can be used to insert a camera or some other tool or instrument. The structure and function of passage 758 are as described in conjunction with camera passage 718 of oral airway appliance 700.

[0447] The camera channel 758 includes a proximal opening 758B at the proximal end 742B of the instrument 740 through which the camera (not shown) is inserted. Figure 9L 758B. The camera channel 758 terminates at a distal opening 758A through which the distal end of the camera housed in the channel 758 protrudes distally with the aid of the camera channel ramp 764 and the wall shield 758G. As discussed in conjunction with the central lumen 704 and the camera channel 718, the central lumen 744 and the camera channel 758 are inclined.

[0448] exist Figure 9LIn the embodiment of FIG. 7 , the oral airway appliance 740 includes a second peripheral channel 760 that is a hollow channel in the wall 742. The channel 760 has a proximal opening 760B located on the proximal end 742B of the wall 742.

[0449] The passage 760 is a hollow passage in the wall 742 that extends along the distal-proximal 742A-742B axis of the wall 742. The passage 760 has a distal opening 760A that opens proximally of the laryngeal cuff 750 on the ventral side 742I of the tongue 743.

[0450] exist Figure 9L In the embodiment of the present invention, the channel 760 has a slit 762 extending along at least a portion of the length of the channel 760, which opens the channel 760 on the right side 742R. In other embodiments, the slit 762 can open to the back side 702C of the wall 742.

[0451] Channel 760 can be used to aspirate fluid by inserting suction tube 766 into channel 760. Thus, when the tip of the suction tube is left in slit 762 to allow the tube to reach the esophagus, channel 760 can perform the function of an esophageal / gastric passage to aspirate the contents of the stomach, thereby preventing vomiting.

[0452] However, because the channel 760 is open at its distal end with a distal opening 760A, wherein the distal opening 760A is located on the ventral side 742I of the tongue 743, the channel 760 can be used to aspirate blood and / or slices in the laryngeal cavity. In addition, the channel 760 can be used to pass tools (including but not limited to a bougie, a stylet, forceps, and / or a camera) through the slit 762 to the esophageal cavity, or through the distal opening 760A to the laryngeal cavity.

[0453] Reference Figure 9M , which is an enlarged view of the distal portion of the oral airway appliance 740, showing the distal portion of the channel 760 having a portion of the slit 762 and the distal opening 760A of the channel 760. All reference numerals are the same as Figure 9L related.

[0454] Reference Figure 9N , which shows an accessory cover, generally 770. Figure 9N As shown, the accessory cap 770 may be inserted into the central lumen 704 of the oral airway appliance 700 , or the central lumen of any other oral airway appliance having a slit, to keep the slit closed and to establish ventilation through the central lumen 704 .

[0455] The attachment cap 770 is a tubular body made of a wall 772 surrounding a central lumen 774. The length of the wall 772 is between a distal end 772A and a proximal end 772B. The central lumen 774 includes a proximal opening 774B at the proximal end 772B and a distal opening 774A at the distal end 772A. The central lumen 774 is a hollow cylindrical passage with openings 774A and 774B at the ends.

[0456] The accessory cover 770 must fit into the central lumen 704, which is curved, as discussed in conjunction with the curvature of the wall 702 for the oral airway appliance 700. Thus, the accessory cover 770 can be made of a flexible material, taking on any shape, such that once the accessory cover 770 is inserted into the oral airway appliance 700, it will conform to the curvature of the central lumen 704. Alternatively, the accessory cover 770 can be made to have a curvature that matches the curvature of the central lumen 704.

[0457] The accessory cover 770 may include a clip 776 having a distal end 776A and a proximal end 776B. The clip 776 is externally attached to the wall 772 at the proximal end 776B. Fig.9O is a cross-sectional view of wall 772 showing clip 776 attached to wall 772 . Figure 9P is a side view of the clip 776 and also shows a portion of the wall 772 to which the proximal end 776B of the clip 776 is attached.

[0458] like Figure 9Q As shown, the accessory cover 770 can be placed in the central lumen 707 of the oral airway appliance 700. The width of the clip 776 and its position on the wall 772 are designed so that when the accessory cover 770 is placed in the central lumen 704, the clip 776 fits over the recess 708 and holds the edges of the wall 702 together at the slit 706. Therefore, the edges of the wall 702 will not separate at the slit 706 because the clip holds the edges together. A closed ventilation system can now be established through the central lumen 707 and the oral airway appliance 700 can be used for ventilation.

[0459] The oral airway appliance 700 may also include two retainers 778 located on each side of the slit 706 near the recess 708. These retainers 778 may be used to further hold the clip 776 in place on the wall 702 and to keep the slits apart during ventilation through the central lumen 704.

[0460] Figure 9RAn adapter 800 is shown, which is a hollow tube made of a wall 802 having a longitudinal slit 804 for holding the camera 12 with the cable 16. The adapter 800 is made of a sufficiently rigid polymer material so that if the camera 12 with the cable 16 is inserted into the adapter 800, the adapter 800 can maintain the predetermined shape of the camera 12 with the cable 16 and provide support for other flexible cables 16 when the cable cannot maintain a fixed shape, such as Figure 9S The camera 12 may then be placed near the distal end 802A of the wall 802. The adapter 800 may be used to accommodate other tools, such as a bougie or stylet.

[0461] Figure 9T Shows how to Figure 9S The components are placed in the central lumen 704 of the oral airway appliance 700. Figure 9T In combination with Fig.9A , Figure 9R and 9S All components are labeled in the other drawings including FIG. Figure 9U and 9V Shows the Figure 9S Components and oral airway device 700( Figure 9U ) and further with endotracheal tube 480 ( Figure 9V )combination.

[0462] Reference Figure 9X , which shows another embodiment of an oral airway appliance, generally 300, of the present disclosure.

[0463] Oral airway appliance 300 has the same elements and functions and structures as oral airway appliance 700, except that oral airway appliance 300 has a narrow central lumen 304 that can accommodate, for example, a bougie, but does not carry an endotracheal tube because the diameter of the central lumen 304 is smaller than the diameter of the endotracheal tube. Figure 9X As shown, the bougie 590 can be inserted into the central lumen 304 through the proximal opening 304B. The bougie 590 can extend distally from the central lumen 304 through the distal opening 304A of the central lumen 304.

[0464] 304 is narrow, the diameter of the body 301 with the wall 302 of the device 300 is smaller than the diameter of the wall 702 of the oral airway device 700. Therefore, the oral airway device 300 is easier to insert and remove and reduces burden on the patient's tissue. The oral airway device 300 can be used to ventilate the patient through a bag mask. The wall 302 includes a slit 706, which is the same as the slit described in conjunction with the wall 702. Like the oral airway device 700, the oral airway device 300 is shown from the ventral side 302D of the wall 302.

[0465] Reference Fig. 10A , which shows an oral airway appliance generally at 810. Oral airway appliance 810 does not include an endotracheal lumen. Like oral airway appliance 600, oral airway appliance 810 is a tubular body that curves forward. The tubular body of oral airway appliance 810 is formed by a wall 812 having a certain length between a distal end 812A and a proximal end 812B.

[0466] Wall 812 curves forward along distal-proximal axis 812A-812B and follows the contour of the roof of the patient's mouth when the instrument 810 is inserted into the patient. Wall 812 has a dorsal side 812C and a ventral side 812D. Fig. 10A In the figure, the dorsal side surface 812C is not shown. There are two side surfaces (side surfaces) 812L and 812R between the dorsal side surface 812C and the ventral side surface 812D. Looking at the ventral side surface 812D, the side surface 812L is the left side surface between the ventral side surface 812D and the dorsal side surface 812C. The side surface 812R is opposite to the side surface 812L. The side surface 812R is the right side surface between the ventral side surface 812D and the dorsal side surface 812C.

[0467] In some embodiments, the oral airway appliance 812 can include a handle 814 attached to the wall 812 on the dorsal side 812C to the proximal end 812B. The handle 812 helps the physician manipulate the appliance 810 during insertion and removal. The handle 814 can be removably attached so that after the oral airway appliance 812 has been placed, the handle 814 can be separated from the wall 812. In some embodiments, the oral airway appliance 810 does not include a handle.

[0468] Wall 812 forms an arc that follows the contour of the roof of the patient's mouth so that when the device 810 is inserted into the patient, the ventral side 812D contacts the patient's tongue. Oral airway device 810 has multiple channels. Fig. 10A , three channels 818, 820, and 822 are shown. In other embodiments, one or more additional channels may be added, or one or more channels 818, 820, and / or 822 may be lost.

[0469] Passageways 818, 820, and 822 are hollow passages in wall 812 along the distal-proximal 812A-812B axis.

[0470] Each of the channels 818, 820, and 822 opens at a proximal end 812B of the wall 812 with a proximal opening 818B, 820B, and 822B, respectively. Each of the channels 818, 820, and 822 opens at a distal end 812A of the wall 812 with a distal opening 818A, 820A, and 822A, respectively. Fig. 10A In the embodiment of the present invention, the oral airway appliance 810 includes 3 channels. In other embodiments, the oral airway appliance 810 may include more than 3 channels, i.e., 4 or 5 channels, or may include less than 3 channels, i.e., 2 or 1 channel.

[0471] Channel 818 is a peripheral channel because it is located on side 812L. It is a half cavity or groove. Channel 818 is not covered by wall 812 on at least a portion of ventral side 812D.

[0472] The channel 818 creates a groove into which the camera, bougie, tool or tube can be placed. Due to its groove-like shape, the channel 818 secures the camera, tool or tube in place and prevents it from becoming blocked or becoming separated from the oral airway appliance 810.

[0473] However, because the channel 818 is open along the distal-proximal axis 812A-812B, the camera, bougie, or tool or tube in the channel 818 may be easily manipulated and / or removed while the oral airway appliance 812 remains inserted in place within the patient.

[0474] exist Fig. 10A In the figure, the channel 818 opens on the outside of the ventral side 812D. In other embodiments, the channel 818 can lead to the left side 812L of the wall 818. In other embodiments, the channel 818 can be a lumen that is covered by all or nearly all of the surface of the wall.

[0475] The channel 820 is a hollow passage in the wall 812 of the oral airway appliance 810. The channel 820 can be used to accommodate a camera by placing the camera through a proximal opening 820B of the channel 820. The channel 820 is located in a central location in the appliance 812.

[0476] Channel 822 is located on the periphery of channel 820. Channel 822 is located in the right side 812R. Fig. 10AIn the embodiment, channel 822 is a lumen (hollow channel) extending along the distal-proximal axis 802A-802B. In other embodiments, channel 822 can be a semi-lumen (groove) that opens outward from the wall 812 on one of the wall surfaces 812D, 812R or 812C of the wall 812.

[0477] Channel 822 creates a hollow passageway into which a camera, tool, or tube may be placed. Any of the three channels 818, 820, and / or 822 may be used to insert a camera or tool, including, for example, forceps, aspiration tube, a stethoscope, a temperature probe, a bougie or stylet, and / or an instrument for monitoring respiration and heart sounds.

[0478] The oral airway appliance 810 is compatible with a laryngoscope, typically 830, which includes a blade 832 attached to a handle 834. The oral airway appliance 810 includes a holder (sheath) 816 attached to the ventral side 812D. The curvature of the holder 816 matches the curvature of the blade 832 so that the blade 832 can be inserted into the holder 816.

[0479] like Fig. 10B As shown, the laryngoscope 830 can be assembled with the oral airway appliance 810 by inserting the blade 832 into the holder 816. The holder 816 acts as a sheath and glove over at least a portion of the blade 832, and the distal end 832A of the blade 832 extends distally from the holder 816. The proximal end 832B of the blade 832 is attached to the handle 834. The physician can operate the laryngoscope 830 by manipulating the handle 834 held outside the patient's mouth. Because the laryngoscope 830 is combined with the oral airway appliance 810, the laryngoscope 830 can be operated under continuous visualization by inserting one or more cameras in one of the channels 818, 820, and / or 822.

[0480] Reference Fig. 10C and Fig. 10D , which show how the oral airway appliance 810 is combined with the camera 12 with the cable 16 which has been inserted into the channel 820 through the proximal opening 820B and the bougie 590 which has been inserted into the channel 818.

[0481] Reference Fig.11A, which shows another oral airway appliance, generally 830, in accordance with the present disclosure. The appliance 830 includes a laryngeal mask 833 attached to a handle 832. The handle 832 has a length between a distal end 832A and a proximal end 832B. The handle 832 is bent forward so that during insertion of the oral airway appliance 830, the oral airway appliance 830 follows the contour of the roof of the patient's mouth. The handle 832 is not a tube, but rather a chute-like groove that forms a half-cavity 844 into which the endotracheal tube 480 or any other tube or appliance or tool can be loaded. The handle 832 terminates at its distal end 832A in a tongue 834 with a ventral side 840. The tip 834A of the tongue 834 is tapered.

[0482] The laryngeal cuff 836 is formed and attached around the ventral side 840 of the tongue 834. The structure and attachment of the laryngeal cuff 836 are the same as those described in conjunction with the laryngeal cuff 710, for example, the laryngeal cuff 836 can be non-inflatable, inflatable, or some portions of the laryngeal cuff 836 are inflatable while other portions of the laryngeal cuff 836 are non-inflatable. The shape of the laryngeal cuff 836 is configured so that it conforms to the contour of the laryngeal entrance area of ​​the patient. Therefore, the laryngeal cuff 836 can form a seal at the laryngeal entrance area. In some embodiments, the laryngeal cuff 836 can cover less than the entire periphery of the tongue 834. In these embodiments, only the distal portion of the tongue 834 can be covered by the laryngeal cuff 836. In these embodiments, the laryngeal cuff 836 only partially blocks the laryngeal entrance. The laryngeal cuff 836 attached to the tongue 834 is referred to as a laryngeal mask 833.

[0483] The laryngeal cuff 836 has a slit 838 aligned with the half lumen 844 so that the oral airway device 830 can be separated from the endotracheal tube 480 through the slit after the endotracheal tube 480 is placed in the vocal cords, and the oral airway device 830 can be removed from the endotracheal tube while the endotracheal tube 480 is still properly placed in the patient's body.

[0484] The central ramp 714 is disposed on the ventral side 840 of the tongue 834. The location, structure, and function of the central ramp 714 are the same as those of the oral airway appliance 700. Because the handle 832 bends from the tongue 834 at a certain slope, the endotracheal tube 480 or any other instrument or tube or tool placed in the semi-lumen 844 protrudes from the ventral side 840 at a certain angle. The angle can be the same as that described in connection with the central lumen 704 of the oral airway appliance 700. The central lumen supports the protruding endotracheal tube 480 above the ventral side 840.

[0485] The oral airway appliance 830 includes a camera channel 842, which is a hollow channel extending along the length of the handle 832. The camera channel 842 can be a hollow channel carved into the handle 832, or the camera channel can be a tube that is attached to the handle 832, and in some embodiments, the tube is slidably attached to the handle 832. The camera channel 842 has a proximal opening 842B, which is the entrance to the camera channel 842. The proximal opening 842B is located at the proximal end 832B of the handle 832. The camera channel 842 has a distal opening 842A, which is the exit of the camera channel 842. The distal end 842A opens to the ventral side 840. The camera channel 842 is angled in the manner described in the camera channel 718. Therefore, as described in conjunction with the camera channel 718, the camera channel 842 extends out of the camera (or tool) placed in the camera channel 842 at a predetermined angle. A ramp is disposed in front of the distal opening 842A. The structure and function of the ramp 724 are the same as those described in connection with the oral airway appliance 700. The structure and function of the ledge 842 are the same as those described in connection with the camera channel 718. The camera 12 with the cable 16, which may be any camera described in connection with other embodiments, may be inserted into the camera channel 842 and provide continuous visualization of the endotracheal tube 480 and the patient's tissues.

[0486] Reference Fig. 11B , which shows an oral airway appliance 830 that houses an endotracheal tube 480 and a camera 12 (not shown). Fig.9A Discuss all components.

[0487] Reference Fig. 12A , which shows another embodiment of an oral airway appliance, generally 850, in accordance with the present disclosure. Unlike oral airway appliance 700 or oral airway appliance 830, oral airway appliance 850 does not completely obstruct the laryngeal entrance.

[0488] Oral airway appliance 850 includes a body 851 having the same structure and function as body 701. Specifically, body 851 is made of a wall 852 having the same structure and function as wall 702. Wall 852 has a length between a distal end 852A and a proximal end 852B. Like wall 702, wall 852 is also curved.

[0489] Wall 852 has the same surfaces as wall 700: the back side (at Fig. 12A ), ventral side 852D and two side surfaces 852R and 852L (not shown in Fig. 12A852). Wall 852 contains a central lumen 862 having a proximal opening 852B and a distal opening 852A. The structure and function of central lumen 862 are the same as the structure and function of central lumen 704 of oral airway appliance 700.

[0490] Wall 852 also houses camera channel 852, which is a hollow channel in wall 852. Camera channel 852 has a proximal opening 852B and a distal opening 852A. The location of camera channel 852 in wall 852, the structure and function of camera channel 852 are the same as camera channel 718.

[0491] Wall 852 also houses gastric passage 860, which is a hollow passage having a proximal opening 860B and a distal opening 860A. Gastric passage 860 is located in wall 852 and has the same structure and function as the corresponding portion of gastric passage 720.

[0492] Like wall 702, wall 852 includes a slit 864 on a ventral side 852D of wall 852. Slit 864 has the same structure and function as described in connection with slit 706 of oral airway appliance 700. Wall 852 also has a recess 866 that is the same as recess 708 described in connection with wall 702.

[0493] The wall 852 terminates at its distal end 852A in a tongue 854. The distal tip 854A of the tongue 854 is tapered. On the ventral side 856 of the tongue 854, a central ramp 714 is found, the structure and function of the central ramp 714 being the same as that described in conjunction with the oral airway appliance 700. As described in conjunction with the central lumen 704, an endotracheal tube or any other instrument or tool housed in the central lumen 862 protrudes from the central lumen 862 at a predetermined angle. As described in conjunction with the oral airway appliance 700, the central ramp 714 supports the protruding endotracheal tube. As described in conjunction with the wall 702, the wall 852 is made of a thermoplastic material and is curved. Accordingly, as described in conjunction with the central lumen 704, the central lumen 862 is inclined from the tongue 854.

[0494] The camera channel 858 can accommodate the camera 12 with the cable 16 in the same manner as described in conjunction with the camera channel 718. As described in conjunction with the camera channel 718, the camera accommodated in the camera channel 858 extends at a predetermined angle from the distal end 858A of the camera channel 858. As described in conjunction with the elements 718G, 724 and 718L, the extended camera is aligned with the endotracheal tube with the aid of the shield 758G, the camera channel ramp 859 and the ledge 858L.

[0495] A non-inflatable partial laryngeal cuff 874 is formed around at least some distal portion of the periphery of the ventral side 856 of the tongue 854 .

[0496] The difference between the partial laryngeal cuff 874 and the laryngeal cuff 710 is that the partial laryngeal cuff 874 only covers a portion of the laryngeal entrance. Therefore, the partial laryngeal cuff 874 does not completely block the larynx. In some embodiments, the partial laryngeal cuff 874 only covers about 70% to 90% of the laryngeal entrance.

[0497] The oral airway device 850 includes an inflatable peripheral cuff 868 that can be inflated using a device 870. Fig. 12A In some embodiments, the peripheral cuff 868 is inflatable, but in other embodiments the peripheral cuff 868 is non-inflatable.

[0498] A peripheral cuff 868 is wrapped around the body 851 and attached to the wall 852. The peripheral cuff 868 is located proximal to the distal end 852A of the wall 852. The location of the peripheral cuff 868 on the wall 852 is arranged so that the peripheral cuff 852 can seal the area around the oral airway appliance 850. Thus, the oral cuff airway appliance 850 can be used to ventilate a patient through an endotracheal tube or through the central lumen 862. The peripheral cuff 868 has a slit 872 that is aligned over the slit 864. Thus, the endotracheal tube can be separated from the oral airway appliance 850 through the slits 872 and 864. Thus, the endotracheal tube remains in place, while the oral airway appliance 850 can be removed from the patient.

[0499] It should be noted that any other oral airway appliance provided in the present disclosure, including appliances 700 , 730 , 740 , and / or 300 , may also include a peripheral cuff 868 .

[0500] Reference Fig. 12B , which shows another embodiment of an oral airway appliance, generally 900, in accordance with the present disclosure. Unlike oral airway appliance 700 or oral airway appliance 830, oral airway appliance 900 does not include a laryngeal cuff and does not block the laryngeal entrance. Instead, as described in detail below, oral airway appliance 900 includes an upper esophageal cuff 906.

[0501] Unlike oral airway appliance 850, oral airway appliance 900 does not include cuff 874. Instead, oral airway appliance 900 includes upper esophageal cuff 906. All other components of oral airway appliance 900 are the same as all other components of oral airway appliance 850.

[0502] Oral airway appliance 900 includes a body 901 having the same structure and function as body 701. Specifically, body 901 is made of a wall 902 having the same structure and function as wall 702. Wall 902 has a length between a distal end 902A and a proximal end 902B. As described in connection with wall 702, wall 902 is curved.

[0503] Wall 902 has the same surfaces as wall 700: back side ( Fig. 12B ), ventral side 902D and two side surfaces 902R and 902L ( Fig. 12B 9). Wall 902 contains a central lumen 912 having a proximal opening 912B and a distal opening 912A. The structure and function of central lumen 912 are the same as those described in connection with central lumen 704 of oral airway appliance 700.

[0504] Wall 902 also houses camera channel 916, which is a hollow channel in wall 902. Camera channel 916 has a proximal opening 916B and a distal opening 916A. The location of the camera channel in wall 902, the structure and function of camera channel 916 are the same as those described in conjunction with camera channel 718.

[0505] Wall 902 also houses gastric passage 918, which is a hollow passage having a proximal opening 918B and a distal opening 918A. The location of gastric passage 918 in wall 902, the structure and function of gastric passage 918 is the same as that described in connection with gastric passage 720.

[0506] Like wall 702, wall 902 includes a slit 910 located on a ventral side 902D of wall 902. Slit 910 has the same structure and function as described in connection with slit 706 of oral airway appliance 700. Wall 902 has a recess 914 that is the same as recess 908 described in connection with wall 702 of appliance 700.

[0507] The wall 902 terminates at its distal end 902A in a tongue 904. The distal tip 904A of the tongue 904 is tapered. On the ventral side 908 of the tongue 904, a central ramp 714 is found, the structure and function of the central ramp 714 being the same as that described in conjunction with the oral airway appliance 700. As described in conjunction with the central lumen 704, an endotracheal tube or any other instrument or tool housed in the central lumen 912 protrudes from the central lumen 912 at a predetermined angle. As described in conjunction with the oral airway appliance 700, the central ramp 714 supports the protruding endotracheal tube. As described in conjunction with the wall 702, the wall 902 is made of a thermoplastic material and is curved. Accordingly, as described in conjunction with the central lumen 912, the central lumen 912 is inclined from the tongue 904.

[0508] The camera channel 916 can accommodate the camera 12 with the cable 16 in the same manner as described in conjunction with the camera channel 718. As described in conjunction with the camera channel 916, the camera accommodated in the camera channel 916 extends at a predetermined angle from the distal end 916A of the camera channel 916. As described in conjunction with the elements 718G, 724, and 718L, the extended camera is aligned with the endotracheal tube with the aid of the shield 916G, the camera channel ramp 926, and the ledge 916L.

[0509] No laryngeal cuff is formed around at least some distal portions of the perimeter of the ventral side 908 of the tongue 904. Thus, the oral airway appliance 900 does not block the laryngeal entrance. However, the distal tip of the tongue 904 is covered with an upper esophageal cuff 906 that can be used to block the esophagus. Fig. 12B In the embodiment, the upper esophageal cuff 906 is non-inflatable. In other embodiments, the upper esophageal cuff 906 can be inflatable.

[0510] The oral airway appliance 900 includes an inflatable peripheral cuff 920 that can be inflated using an appliance 924. Fig. 12B In some embodiments, the peripheral cuff 920 is inflatable, but in other embodiments, the peripheral cuff 920 is non-inflatable.

[0511] A peripheral cuff 920 is wrapped around the body 901 and attached to the wall 902. The peripheral cuff 920 is located proximal to the distal end 902A of the wall 902. The location of the peripheral cuff 920 on the wall 902 is arranged so that the peripheral cuff 920 can seal the area around the oral airway appliance 900. Thus, the oral airway appliance 900 can be used to ventilate a patient through an endotracheal tube or through the central lumen 912. The peripheral cuff 920 has a slit 922 that aligns over the slit 910. Thus, the endotracheal tube can be separated from the oral airway appliance 900 through the slits 922 and 910. Thus, the endotracheal tube can remain in place while the oral airway appliance 900 can be removed from the patient.

[0512] In other aspects, the present disclosure provides a kit or system for managing the airway of a patient. The kit / system may include at least one of the instruments described in the present disclosure and may also include additional tools and / or materials. The kits may include oral airway instruments 460, 510, 520, 530, 540, 560, 580, 600, 700, 730, 740, 810, 300, 830, 850, and / or 900 and one of the following components: adapter 500 and / or adapter 770, ventilator adapter 507, camera 12, plug 546, bougie 590, adapter 620, adapter 640, adapter 660, adapter 680, or any combination thereof. The kit / system may also include other tools and / or manuals. The kit / system may include any oral airway instrument of several different sizes, including oral airway instruments for pediatric patients. In order to accommodate pediatric patients and adult patients of different weights, any instrument described in the present disclosure may be made in different sizes.

[0513] In another aspect, the present disclosure provides methods for managing the airway of a patient, including ventilating and monitoring the patient. In these methods, at least one of the oral airway devices 460, 510, 520, 530, 540, 560, 580, 600, 700, 730, 740, and 810 is combined with at least one camera and preferably at least one camera and a tool such as a stylet or a bougie, which can help place the oral airway device 460, 510, 520, 530, 540, 560, 580, and / or 600 into the patient. The oral airway device can also be used in conjunction with a suction tube and / or the patient's heart sounds and sound monitor. Any of these components is then inserted into the patient's oral cavity, and the oral airway device is then placed in the patient's pharynx. If desired, any of the cuffs 476, 494, 542, 710 and / or adapters 500, 507, 770 and / or plugs 546 can be used to establish a closed system. The assembly is then connected to a ventilator to ventilate the patient through ETT lumen 468 or one of channels 584 , 586 , and / or 588 .

[0514] If the patient must be intubated, an endotracheal tube may be inserted into the ETT lumen of the oral airway appliance 460, 510, 520, 530, 540, 560, 700, 730, or 740. The assembly may then deliver the endotracheal tube to the patient's trachea and ensure that it is properly placed.

[0515] The oral airway device 460, 510, 520, 530, 540, 560, 580, 600, 700, 730, 740, and / or 810 can be inserted into the patient's oral cavity by a single physician under continuous visualization by one or more cameras, which ensures accurate and rapid placement of the device into the patient's pharynx. If the oral airway device 460, 510, 520, 530, 540, 560, 700, 730, or 740 is carried with an endotracheal tube, the oral airway device can be easily separated from the endotracheal tube through a slit in the endotracheal lumen and removed from the endotracheal tube while the endotracheal tube remains inserted in the correct position in the patient's body. These methods avoid repeated intubation / extubation.

[0516] Furthermore, because the oral airway devices 460, 510, 520, 530, 540, 560, 700, 730, and 740 include an endotracheal tube lumen that is bent forward at a predetermined angle, and because the device includes a ramp, the device extends the endotracheal tube and maintains the optimal angle for insertion into the vocal cords. This improves the efficiency of intubation, shortens the time required for intubation, and minimizes the risk of injury.

[0517] After intubation is complete, the intubated patient can be continuously monitored by a camera and, if desired, heart sounds, voices, and / or temperature.

[0518] The apparatus and method of the present invention can be used to intubate difficult to intubate patients, as well as to intubate patients with compromised airways. The apparatus and method are suitable for monitoring patients for adverse reactions, such as vomiting and / or obstruction.

[0519] Although certain medical devices have been described above, those skilled in the art will appreciate that the present invention also includes embodiments with various modifications that are obvious to those skilled in the art.

Claims

1. An oral airway device, characterized in that: The oral airway appliance comprises a curved tubular body formed by a wall surrounding an endotracheal tube lumen, wherein the endotracheal tube lumen has a distal opening and a proximal opening, The wall has a distal end and a proximal end, and the wall has a dorsal side and a ventral side, The wall further comprises two or more hollow passages in the wall, the two or more hollow passages extending at least a portion of the wall along a distal-proximal axis of the wall, and each passage having a distal opening and a proximal opening, the distal opening being an exit from the wall and the proximal opening being an entrance to the wall; One of the hollow passages is a gastric passage having a proximal opening at the proximal end of the wall and a distal opening opening on the dorsal side of the wall; and The curved tubular body is curved forwardly, and wherein the tubular body terminates at a tongue at the distal end, The tongue has a dorsal side and a ventral side, wherein the endotracheal tube lumen is a central lumen, the proximal opening of the endotracheal tube lumen is located at the proximal end of the wall, the distal opening of the endotracheal tube lumen is located at the distal end of the wall, the distal opening of the endotracheal tube lumen opens the endotracheal tube lumen onto the ventral side of the tongue, wherein the endotracheal tube lumen is inclined at a first predetermined angle to the dorsal side of the tongue, and when the endotracheal tube or tool is placed in the endotracheal tube lumen, the endotracheal tube lumen extends the endotracheal tube or tool above the ventral side of the tongue, wherein the central ramp is located on the ventral side of the tongue, the central ramp is located distally and in front of the distal opening of the endotracheal tube lumen, and when the endotracheal tube or tool is placed in the endotracheal tube lumen, the central ramp supports the endotracheal tube or tool above the ventral side of the tongue, One of the hollow channels is a camera channel, and a distal opening of the camera channel opens the camera channel to the ventral side of the tongue, wherein the camera channel is inclined at a second predetermined angle to the dorsal side of the tongue, and when the camera is accommodated in the camera channel, the camera channel extends the camera above the ventral side of the tongue, wherein the camera channel ramp is located in front of the distal opening of the camera channel and / or inside the distal opening of the camera channel; and the oral airway instrument further comprises a laryngeal cuff formed around the periphery of the ventral side of the tongue.

2. The oral airway device of claim 1, wherein: The oral airway appliance further comprises at least one camera, wherein the camera is insertable into the hollow passage and / or the lumen of the endotracheal tube, the camera is built into the wall, the camera is sealed to the wall, or the camera is slidably connected along the wall.

3. The oral airway device of claim 2, wherein: The camera wirelessly transmits one or more of images, heart sounds, and / or breathing sounds to one or more monitors located at one or more remote locations.

4. The oral airway device of claim 1, wherein: The wall has a slit on a ventral side of the wall, and the slit opens into the endotracheal tube lumen.

5. The oral airway device of claim 1, wherein: The oral airway appliance has a laryngeal cuff formed only about a distal portion of the periphery of the ventral side of the tongue, and the laryngeal cuff does not completely block the laryngeal inlet or the laryngeal cuff is absent and replaced by an upper esophageal cuff, and the oral airway appliance further includes a peripheral cuff with a slit, the peripheral cuff is wrapped around the wall, located near the distal end of the wall, and the slit of the peripheral cuff is aligned with the slit of the wall.

6. The oral airway device of claim 1, wherein: The first predetermined angle is greater than the second predetermined angle.

7. The oral airway device of claim 1, wherein: The laryngeal cuff is non-inflatable, only the sides of the laryngeal cuff are inflatable, or the laryngeal cuff is inflatable.

8. The oral airway device of claim 1, wherein: The central lumen has a diameter that is smaller than a diameter of an endotracheal tube and the central lumen does not carry the endotracheal tube, and wherein the oral airway appliance may be used in conjunction with a face mask to ventilate a patient.

9. The oral airway device of claim 1, wherein: The oral airway device further comprises one or more of the following: a bougie insertable into at least one of the hollow passages; a tongue located at the distal end of the wall; a ramp located proximal to the tongue; a camera built into the ramp; an esophageal stethoscope insertable into at least one of the passages, the esophageal stethoscope built into the wall; a temperature probe; an inflatable cuff wrapped around the wall proximal to the distal end of the wall; a non-inflatable cuff attached around the periphery of the distal end of the wall; a cushion located below the tongue; a plug insertable into the distal opening of at least one of the hollow passages, and the plug removable from at least one of the hollow passages; An accessory cover which is a hollow tube having a clip attached to the wall, the accessory cover being insertable into and removable from the lumen of the endotracheal tube and the clip being capable of holding the edges of the wall together at the slit; or a combination thereof.

10. The oral airway appliance of claim 1, wherein: The oral airway appliance includes two or more cameras, each camera: can be inserted into the hollow passage and the lumen of the endotracheal tube, Built into said wall, sealed to the wall, or Slidably connected along the wall.

11. The oral airway appliance of claim 1, wherein: The oral airway appliance includes three hollow channels, one of the hollow channels having a diameter suitable for receiving and retaining an endoscope.

12. The oral airway appliance of claim 1, wherein: At least one of the two or more hollow channels has a slit, wherein each of the channel slits opens into the endotracheal tube lumen or into a wall surface of the oral airway appliance.

13. The oral airway appliance of claim 1, wherein: The wall of the oral airway appliance has a recess on the ventral side that opens a portion of the endotracheal tube lumen on the ventral side.

14. The oral airway appliance of claim 1, wherein: One of the hollow passages is a camera passage, the camera passage is located near a centerline of the oral airway appliance, and the endotracheal tube lumen is located at a periphery of the camera passage.

15. The oral airway appliance of claim 1, wherein: The oral airway appliance also includes a dorsal inflatable cuff disposed on a dorsal side of the tongue.

16. The oral airway appliance of claim 1, wherein: The oral airway appliance further comprises a peripheral passage, the peripheral passage being one of the hollow passages in the wall, the peripheral passage having a proximal opening and a distal opening, the proximal opening being located at the proximal end of the wall, the distal opening opening on the ventral side of the tongue proximate to the laryngeal cuff, and wherein the peripheral passage has a slit opening the peripheral passage to the dorsal side and / or the side of the wall.

17. A system for managing the airway of a patient, characterized in that The system includes: The oral airway device of claim 1; a camera that is insertable into and removable from the hollow passage; and A ventilator adapter having at least one cover for establishing a closed system in the oral airway appliance.

Images