Larynx-Tubus

Abstract

Laryngeal tube (10) for ventilating a patient, with special geometry and a ventilation channel (18) through which both cuffs can be inflated and / or deflated.

Description

[0001] The invention relates to a laryngeal tube.

[0002] The laryngeal tube is a supraglottic airway (above the vocal cords (glottis)) used for temporary airway provision or securing. In emergency situations, the laryngeal tube serves as an aid for airway management, as an alternative technique to mask ventilation and endotracheal intubation.

[0003] A laryngeal tube typically consists of a tube body with a ventilation lumen. Attached to the tube body is an inflatable esophageal cuff, also known as the distal cuff, for inflating the esophagus. A pharyngeal cuff is also attached to the tube body for inflating the pharynx. This pharyngeal cuff is also known as the proximal cuff. A ventilation port is located between the two cuffs.

[0004] To secure the airway, the laryngeal tube is inserted from the mouth into the pharynx (throat) until the breathing port of the tube body is positioned in front of the laryngeal inlet of the patient. The two cuffs are then inflated so that the distal esophageal cuff seals the esophagus and the proximal pharyngeal cuff seals the oropharynx.

[0005] To relieve pressure on the stomach, i.e., to drain stomach contents, laryngeal tubes sometimes have an additional drainage channel. This drainage channel has a drainage opening located distal to the esophageal cuff. This helps to counteract both the risk of aspiration (entry of a liquid or solid substance or mixture into the trachea and lower respiratory tract) and the risk of esophageal injury (rupture) associated with vomiting.

[0006] Laryngeal tubes are known, for example, from DE 10 2011 001 325 B4 and US 4,231,365.

[0007] WO 2011 / 106754 A1 describes a multi-section laryngeal tube in which the tube body has a proximal and a distal longitudinal shaft section that are connected to each other. The ventilation lumen has a circular cross-section and a ventilation opening located laterally on the distal longitudinal shaft section of the tube body. Another laryngeal tube is known from US 2005 / 0229933 A1.

[0008] EP 0 665 029 A2 describes an airway device for both esophageal obturator ventilation alone and combined endotracheal and esophageal obturator ventilation.

[0009] 15 US 2024_0226479_A1 describes a laryngeal tube in which a separate ventilation lumen is used.

[0010] The present invention is based on the objective of providing a laryngeal tube which has improved properties with regard to its use and preferably also offers improved manufacturability.

[0011] The invention is defined in claim 1. Further advantageous embodiments of the laryngeal tube are described in the following aspects, each of which offers advantages over known tubes. The features that characterize a laryngeal tube of one aspect are also to be understood as possible further developments of the laryngeal tube according to the invention from claim 1 as well as the other aspects.

[0012] The present invention relates to a laryngeal tube with the following features: A laryngeal tube is used for ventilating a patient. The laryngeal tube consists of a tube body with a breathing channel, a drainage channel, and a ventilation channel. An esophageal cuff is attached to the tube body to block the esophagus. A pharyngeal cuff is also attached to the tube body to block the pharynx. The drainage channel has a drainage port located distal to the pharyngeal cuff, and the breathing channel has a breathing port located between the pharyngeal and esophageal cuffs. The esophageal and / or pharyngeal cuffs can be inflated and / or deflated via the ventilation channel.

[0013] The tube body is elongated and extends along a central longitudinal line. Typically, the tube body, or at least its central longitudinal line, is curved in at least some sections. The curvature of the tube body is specifically such that the center(s) of curvature lie on one side of the tube body. Thus, the tube body is curved in only one direction.

[0014] The tube body is designed to be particularly flexible, and in particular, it is (predominantly) made of or composed of an elastic material. This makes the laryngeal tube easy to insert and minimizes the risk of injury when inserting it into the patient's pharynx.

[0015] According to the invention, such a laryngeal tube is characterized by the fact that the tube body has a tube shaft. The tube shaft refers to a section of the tube body excluding its tip. The ventilation channel is arranged centrally within the tube shaft, and the drainage channel is located on one side of the ventilation channel and the ventilation channel on a second side opposite the first, such that the tube shaft has a flattened cross-sectional shape. The channels thus lie, as it were, in a single plane. The flattened cross-sectional shape results in a tube shaft that has narrow sides and wide sides. Within the tube shaft, the ventilation channel, the ventilation channel, and the drainage channel run parallel to each other.The tube shaft typically ends at the distal end of the ventilation opening, since the ventilation channel typically extends distally only as far as the ventilation opening, or opens into the surface of the tube body via the ventilation opening.

[0016] When viewing a cross-section of the tube shaft along the central longitudinal line, which runs orthogonally to the cross-sectional area, the openings of the drainage channel, the ventilation channel, and the airway channel lie, in particular, on a straight line, or rather, a straight line can be drawn through the openings of all three channels in the cross-sectional area. Specifically, the centers of the openings of all three channels lie on a line in the cross-sectional area.

[0017] The ventilation channel has, in particular, the largest clear cross-sectional area, and especially the largest diameter, of the three channels. The ventilation channel has, in particular, the smallest clear cross-sectional area, and especially the smallest diameter. The drainage channel has, in particular, a clear cross-sectional area, and especially a diameter, that lies between the clear cross-sectional area (or diameter) of the ventilation channel and the ventilation channel.

[0018] The cross-section of the tube shaft can have a symmetrical shape, at least in areas of its longitudinal extent, with respect to a line running in the direction of the extension of the broad sides of the tube shaft, in particular the line on which the openings of the channels, in particular their surface centers, lie.

[0019] The cross-section of the tube shaft can have an asymmetrical shape with respect to a line running in the direction of the narrow sides of the tube shaft. In particular, the tube shaft is thicker on the side of the drainage channel in a direction perpendicular to the direction of the broad sides. Roughly speaking, the cross-section can be symmetrical with respect to the "plane" in which the channels lie, and asymmetrical with respect to a plane extending perpendicular to the previous plane.

[0020] The cross-section of the endotracheal tube shaft can be more elongated on the drainage channel side than on the ventilation channel side, relative to the center of the ventilation channel. Put simply, the tube shaft is thicker towards the drainage channel than towards the ventilation channel when viewed from the ventilation channel.

[0021] The shape of the tube shaft, due to the described asymmetry and the curvature explained in more detail below, is designed to facilitate easy and minimally invasive insertion. This shape is adapted to the slightly lateral position of the esophageal inlet (esaphagus) in the human body.

[0022] The previously mentioned curvature of the tube body is visible when viewing the narrow sides of the tube shaft's cross-section. When viewed from the broad sides, the laryngeal tube appears straight. This curvature, along with the flat shape and asymmetry, facilitates insertion of the laryngeal tube. Furthermore, it helps the laryngeal tube maintain its position and orientation once inserted, thus increasing the reliability of ventilation.

[0023] The breathing port is typically located on one of the broad sides of the tube shaft. If the tube body is curved, the breathing port is located on the broad side of the tube shaft facing the center(s) of the curve. The breathing port is therefore located on the inside of the curve (the curved arc).

[0024] The ventilation opening can extend essentially across the width of the ventilation channel. The width of the ventilation channel is defined as its extent perpendicular to the midline when viewed from a broad side of the tube shaft. In other words, the ventilation opening, at its widest point perpendicular to the midline, can extend as far as the ventilation channel itself.

[0025] The tube shaft, in which the drainage channel, the breathing channel and the ventilation channel run side by side, especially parallel to each other, is particularly asymmetrical when viewed along the midline.

[0026] According to a second aspect (claim 2), a laryngeal tube according to the invention is characterized by a tube body that is formed in one piece as an injection-molded part and is free of any adhesive joints. In particular, the tube body can be free of any joining points. These characterizing features and the following features also represent an advantageous further development of the laryngeal tube according to the first aspect.

[0027] In this variant, the drainage channel, the ventilation channel, and the airway channel are formed as lumens within the tube body material. They extend throughout the solid material of the tube body and are bounded by it. At their proximal ends, the channels may each have inserts, connectors, fittings, or similar components made of a material different from the tube body, which may extend, for example, into the channel near its proximal end. The ventilation channel terminates at the airway port. The airway channel ends after connecting to the esophageal cuff, allowing for its ventilation. The drainage channel typically extends to the distal end and opens into it. The aforementioned additional elements located at the proximal end of the channels may be held in place by a force-fit, for example, by being press-fitted into the channel.The other elements can also be positively connected to the material of the tube body, for example, the tube body can be injection-molded onto them. A material-bonded connection is also possible, for example, via an adhesive bond (the tube body itself is free of adhesive joints, in particular joints, which rules out the possibility that it is glued together from several parts but does not rule out the possibility that something that is not part of the tube body is glued to it).

[0028] The term "one-piece and internally bonded" refers specifically to a design in which the entirety of the material forming (or defining) the drainage channel, breathing channel, and ventilation channel is a continuous, and in particular homogeneous, material. The laryngeal tube may include components that are attached to the tube body, for example, via an adhesive bond. Typically, such additional components are the esophageal cuff and the pharyngeal cuff. These are typically made of a thin-walled plastic material, which is bonded to the one-piece, internally bonded tube body, particularly by means of an adhesive bond. Thus, the tube body forms the drainage channel, breathing channel, and ventilation channel and, in this variant, is made of a single, solid material.Additional components, in particular the esophageal cuff and the pharyngeal cuff, of the laryngeal tube may be attached, especially glued, to the solid material of the tube body.

[0029] According to a third aspect (claim 3), a laryngeal tube according to the invention is characterized in that the pharyngeal cuff is glued to the tube body, and the tube body, in the area of ​​the glued connection with the pharyngeal cuff, has a graspable collar into which the esophageal cuff is glued. The graspable collar can also be defined as a hook-shaped grasping section. These characterizing features and the following features also represent an advantageous further development of the laryngeal tube according to the preceding aspects.

[0030] The interlocking collar allows for efficient bonding over a small area. Specifically, the pharyngeal cuff, or rather its material, can be bonded to the tube body material on both sides. In simpler terms, the pharyngeal cuff can be bonded to the tube body with part of its inner surface and to the interlocking collar, which extends from the tube body, with part of its outer surface. A slot can be formed between the collar and the solid tube body material, into which the pharyngeal cuff is bonded. The interlocking collar offers further advantages in positioning the cuff during bonding. The cuff can be positioned more easily and precisely. Using the collar, the cuff can be positioned and bonded close to the airway opening. Post-processing is usually unnecessary.The collar simplifies the manufacturing process and has a positive effect on the finished laryngeal tube.

[0031] The surface of the tube body can be recessed in the area of ​​the adhesive connection with the pharyngeal cuff and / or the esophageal cuff by the wall thickness of the respective cuff, so that the surface of the laryngeal tube at the edge of the adhesive point of the respective cuff is essentially step-free.

[0032] The ventilation channel can have a ventilation opening in the region of each of the two cuffs, extending in particular transversely to the midline of the laryngeal tube, through which the cuffs can be inflated and / or deflated. The ventilation openings can extend in particular along the broad sides, which facilitates the production of the tube body by injection molding. The ventilation channel is closed at the distal end of the laryngeal tube, in particular by the solid material of the tube body. The ventilation openings can be formed in particular by recesses in the core of an injection mold used to produce the tube body. The ventilation openings are thus formed during the injection molding process and do not need to be subsequently incorporated into the material.

[0033] According to a fourth aspect (claim 4), a laryngeal tube according to the invention is characterized in that the esophageal cuff has, firstly, a shape that tapers towards the drainage opening, and this taper is more pronounced than the shape of the esophageal cuff on the side facing away from the drainage opening. Secondly, in this embodiment, the esophageal cuff has a width transverse to the longitudinal extent of the tube that is greater than the depth of the esophageal cuff transverse to the longitudinal extent of the tube and to the width of the esophageal cuff. These characterizing features and the following features also represent an advantageous further development of the laryngeal tube according to the preceding aspects.

[0034] The esophageal cuff thus has a shape that extends flatly in the same plane as the tube body itself. Furthermore, the esophageal cuff tapers towards its distal end in an almost arrow-like shape. This arrow-like taper is visible both when viewing the broad side of the tube body and when viewing its narrow side. The esophageal cuff can therefore close or block the esophageal inlet particularly reliably, as it adapts very well to the patient's anatomy. The advantageous fit of the esophageal cuff also results in less wrinkling, since the cuff has a basic shape that corresponds to the anatomically required form.A cuff shape that deviates from the anatomically required form tends to wrinkle during use, which can negatively affect its seal and cause irritation. The described cuff shape is also size-optimized. Cuffs with a different shape are often larger and, when deflated or uninflated, are slack and wrinkled upon insertion. These wrinkles and the slack cuff lead to increased irritation during insertion and pose a potential risk of injury. This is reduced or avoided by the described shape.

[0035] According to a fifth aspect (claim 5), a laryngeal tube according to the invention is characterized in that the pharyngeal cuff is designed such that it follows the course of the proximal edge of the ventilation opening and extends along the ventilation opening to a region of the ventilation opening where the ventilation opening tapers laterally. The pharyngeal cuff extends along the longitudinal length of the tube distally to a region where the ventilation opening narrows in its clear diameter or decreases in width. These characterizing features and the following features also represent an advantageous further development of the laryngeal tube according to the preceding aspects.

[0036] The pharyngeal cuff can thus efficiently and safely elevate the breathing opening from the surrounding tissue. With this design, the pharyngeal cuff can also reliably and securely close or block the pharynx. Simultaneously, it ensures that the breathing opening is not accidentally blocked. The breathing opening can have a proximal rim that is essentially semicircular or segment-shaped and a distal rim that tapers elongated and becomes pointed. In the distal half of the breathing opening, it can transition into a distal groove-like extension. This groove-like extension further reduces the risk of blockage and can also serve as a guide when inserting instruments or as an orientation aid when inserting an endoscope.

[0037] According to a sixth aspect (claim 6), a laryngeal tube according to the invention is characterized in that the ventilation opening has a proximal rim, in particular a rounded one, a central section of the rim extending in a longitudinal direction of the tube, and a distal rim with converging edges. The ventilation opening further comprises a support structure, in particular with two support ribs, extending from the rim of the ventilation opening into the opening itself. The support structure serves to prevent the patient's epiglottis from folding into the ventilation opening by providing support for the epiglottis, if necessary, and the support structure extends from the proximal rim in the longitudinal direction of the tube into the central section. These characterizing features and the following features also represent an advantageous further development of the laryngeal tube according to the preceding aspects.

[0038] The tube body can be reinforced in the proximal area, which lies in the patient's bite area when the tube is inserted, in such a way as to counteract, and in particular prevent, the closure of the ventilation channel by a bite from the patient.

[0039] Further features, details and advantages of the invention will become apparent from the wording of the claims and from the following description of exemplary embodiments with reference to the drawings. The drawings show: Fig. 1 a view of a laryngeal tube according to the invention; Fig. 2 another view of the laryngeal tube from Fig. 1; Fig. 3 a view of a tube body of the laryngeal tube from Fig. 1; Fig. 4 a section of the tube body made of Fig. 4 in perspective view; Fig. 5 a distal end of the tube body Fig. 4 in perspective view; Fig. 6 a sectional view along line AA from Fig. 5; Fig. 7 a view of the proximal end of the tube body Fig. 3; Fig. 8 the application range of the laryngeal tube; and Fig. 9 a section of an alternative laryngeal tube.

[0040] In the following description and in the figures, corresponding components and elements bear the same reference symbols. For the sake of clarity, not all reference symbols are shown in every figure.

[0041] Fig. 1 and Fig. Figure 2 shows a laryngeal tube 10 according to the invention in a top view and a side view.

[0042] The laryngeal tube 10 is formed with a tube body 12 which includes a ventilation channel 14, a drainage channel 16 and a ventilation channel 18.

[0043] An esophageal cuff 20 is attached to the tube body 12 to block the esophagus 24, and a pharyngeal cuff 22 is attached to the tube body 12 to block the pharynx 26. The esophageal cuff 20 and the pharyngeal cuff 22 can be inflated and deflated via the ventilation channel 18. When inserted into the patient's pharynx, the cuffs 20 and 22 are deflated and are inflated once in place to block the esophagus 24 and pharynx 26 and to correctly position the laryngeal tube 10.

[0044] The anatomical application area of ​​the Laryngeal Tube 10 is in Fig. 8 illustrated. The Fig. Figure 8 shows a cross-sectional view of a patient's pharynx, and the esophagus (24), epiglottis (33), trachea (28), and pharynx (26) are each labeled with reference symbols. The pharynx (26) extends from the hyperpharynx (30) to the nasopharynx (32). Air must be supplied to the patient via the trachea (28). The placed laryngeal tube (10) is in Fig. Figure 8 also shows this. The esophageal cuff 20 closes the esophagus 24 and the pharyngeal cuff 22 the pharynx 26.

[0045] The drainage channel 16 has a drainage opening 34 located distal to the esophageal cuff 20, which blocks and seals the patient's esophagus 24. When in place, the drainage opening 34 is positioned within the patient's esophagus 24 to allow for the drainage of any gastric contents that may leak.

[0046] The ventilation channel 14 has a ventilation opening 36 located between the pharyngeal cuff 22 and the esophageal cuff 20. When in place, the ventilation opening 36 is positioned approximately at the level of the epiglottis 33 and at the entrance to the trachea 28. Since the esophageal cuff 20 seals the esophagus 24 distally from the ventilation opening 36, and the pharyngeal cuff 22 seals the pharynx 26 proximally, air supplied via the ventilation channel 14 is introduced into the trachea 28. The patient can thus be ventilated.

[0047] The laryngeal tube 10 according to the invention has a shape that facilitates easy insertion and minimizes the risk of injury. The tube body 12 is elongated and extends along a central longitudinal line 40. The tube body 12 comprises a tube shaft 38 in which the ventilation channel 14, the drainage channel 16, and the ventilation channel 18 run parallel to each other. The course of the ventilation channel 14, drainage channel 16, and ventilation channel 18 is Fig. 3 represented by dotted lines. In the Fig. 1 and Fig. Figure 3 shows the longitudinal extent of the tube shaft 38 marked by curved clips. Distal to the ventilation opening 36, the ventilation channel 14 does not extend further, and the drainage channel 16 and the ventilation channel 18 converge.

[0048] Typically, the tube body 12, or rather its midline 40, is curved, at least in sections. The curvature of the tube body 12 is specifically such that the center(s) of curvature lie on one side of the tube body 12. The tube body 12 is therefore curved in only one direction. The centers of curvature lie on the side of the ventilation port 36.

[0049] The tube body 12 is flexible and made of an elastic or plastic material. Therefore, the tube body 12 can deform when inserted into the patient's pharynx 26, allowing it to adapt to anatomical conditions and minimizing the risk of injury.

[0050] The laryngeal tube 10 is easy to insert due to its shape and material properties, minimizing the risk of injury during insertion into the patient's pharynx 26. The laryngeal tube 10 is also efficient to manufacture. The entire tube body 12, as it appears in Fig. Figure 3 shows a single-piece, injection-molded part without any glue joints. Further elements 68 can be connected to the tube body 12, which will be discussed in more detail below. The drainage channel 16, the ventilation channel 14, and the airway channel 18 are formed as lumens within the solid material of the tube body 12.

[0051] The advantageous shape of the laryngeal tube 10 or tube body 12 according to the invention is explained in more detail below. The individual aspects of the shape of the laryngeal tube 10 or its tube body 12 are also to be understood as independent inventions and are not only in their entirety incorporating the invention.

[0052] In the tube shaft 38, the ventilation channel 14 is arranged centrally, and the drainage channel 16 is arranged on a first side 42 of the ventilation channel 14, and the ventilation channel 18 is arranged on a second side 44 of the ventilation channel 14, which is located opposite the first side 42. The tube shaft 38 therefore has a flattened cross-sectional shape, which is particularly evident in the sectional view of Fig. 7 is clearly shown.

[0053] The flattened cross-sectional shape results in a tube shaft 38, which has narrow sides 46 and wide sides 48.

[0054] When looking along the central longitudinal line 40 at a cross-sectional area of ​​the tube shaft 38, where the cross-sectional area runs orthogonally to the central longitudinal line 40, the openings of the drainage channel 16, the ventilation channel 14 and the ventilation channel 18 lie in particular on a straight line 50 or a straight line 50 can be drawn through the openings of all three channels 14, 16, 18 in the cross-sectional area (see in particular Fig. 7).

[0055] In particular, the centers of the surfaces 52 of the openings of all three channels 14, 16, 18 lie on line 50 in the cross-sectional area. The three channels 14, 16, 18 have a circular cross-section.

[0056] The ventilation channel 14 has, in particular, the largest clear cross-section, especially diameter (in the case of a circular cross-section), of the three channels 14, 16, 18. The ventilation channel 18 has, in particular, the smallest clear cross-section, especially diameter. The drainage channel 16 has, in particular, a clear cross-section, especially a diameter, which lies between that of the ventilation channel 14 and the ventilation channel 18.

[0057] The cross-section of the tube shaft 38 can (when viewed along the central longitudinal line 40) have a symmetrical shape with respect to a line 51 which runs in the direction of the extension of the broad sides 48 of the tube shaft 38, in particular the line 50 on which the openings of the three channels 14, 16, 18, in particular their surface centers 52, are located, at least in areas of its longitudinal extension.

[0058] Orthogonally to this, the cross-section of the tube shaft 38 can, in particular, have an asymmetrical shape. Accordingly, the cross-section of the tube shaft 38 can have an asymmetrical shape with respect to a line 54 extending in the direction of the narrow sides 46 of the tube shaft 38. In particular, the tube shaft 38 is thicker on the side of the drainage channel 16 in a direction transverse to the extension of the broad sides 48 than on the side of the ventilation channel 18.

[0059] The cross-section of the tube shaft 38 can therefore have a lateral extent 54 (transverse to the narrow sides 46 and parallel to the broad sides 48) with respect to the center of the surface 52 of the ventilation channel 14 on the side of the drainage channel 16, which is larger than a lateral extent 56 (transverse to the narrow sides 46 and parallel to the broad sides) on the side of the ventilation channel 18 (see Fig. 7) The drainage channel 16 is located particularly on the right side of the ventilation channel 14 when viewed from the inner side of the curvature of the tube shaft 38 (from the side of the center of curvature).

[0060] The tube shaft 38, due to the described asymmetry and curvature, has a shape that facilitates easy and low-trauma insertion. This shape is adapted to the slightly lateral position of the esophageal inlet (esaphagus 24) in the human body.

[0061] The curvature of the tube body 12, mentioned above, is designed such that it becomes apparent when viewing the narrow sides 46 of the cross-section of the tube shaft 38. When viewing the broad sides 48 of the tube shaft 38, the laryngeal tube 10 appears straight (see Fig. 1 and Fig. 2 in comparison).

[0062] The ventilation opening 36 is located on a broad side of the tube shaft 38. More precisely, the ventilation opening 36 is formed on the broad side of the tube shaft 38 that faces the center of curvature or centers of curvature. In the intended inserted state, the ventilation opening 36 is thus oriented towards the inlet of the trachea 28.

[0063] The ventilation opening 36 can extend, in particular, essentially across the width of the ventilation channel 14. The width of the ventilation channel 14 is its extent transverse to the midline 40 and, when viewed from a broad side 48 of the tube shaft 38. In other words, the ventilation opening 36, at its widest extent transverse to the midline 40, can extend as far as the ventilation channel 14. A ventilation opening 36 that is as wide as possible counteracts the risk of its closure.

[0064] Thin-walled support projections 58 can be arranged at the ventilation opening 36. These projections extend inwards from the lateral edge 60 of the ventilation opening 36 and form a support structure 59. The support projections 58 begin at the proximal edge 62 of the ventilation opening 36 and are separated from each other there by a central gap. From the proximal edge 62, the support projections 58 extend along the lateral edges 60 of the ventilation opening 36 into the distal half of the ventilation opening 36. In the region of the distal half of the ventilation opening 36, this transitions into a distal groove-like extension 64. Although the support projections 58 reduce the clear opening area of ​​the ventilation opening 36, they serve, in turn, to support the epiglottis if it has been bent towards the trachea 28, for example, during the insertion of the laryngeal tube 10. The support of the epiglottis prevents the respiratory channel 14 from being closed off by it.The support projections 58 are set back, particularly relative to the edge 60 of the ventilation opening 36, towards the interior of the ventilation channel 14. Even with the epiglottis supported, this ensures air escape routes from the ventilation opening 36. The groove-like extension 64 further reduces the risk of obstruction of the ventilation opening 36, as it ensures the escape of ventilation air even if the ventilation opening 36 is covered. Furthermore, the ventilation channel 14 features an internal ramp structure 66 extending from the channel floor to the groove-like extension 64. This allows, for example, an endoscope or other device inserted through the ventilation channel 14 to be guided out of the ventilation channel 14 and through the ventilation opening 36 via the ramp structure 66. The groove-like extension 64 can serve as a guide or orientation aid in this process.

[0065] As already mentioned, the tube body 12 is a single-piece, injection-molded part without any adhesive joints. In particular, the tube body 12 can be designed without any joints whatsoever, meaning it has not only no adhesive joints but no joints at all. The drainage channel 16, the ventilation channel 14, and the ventilation channel 18 are formed as lumens within the material of the tube body 12. They therefore extend throughout the solid material of the tube body 12 and are bounded by it. This contrasts with prior art tube bodies in which individual channels are bonded together.

[0066] In the present example, further elements 68 are attached to the tube body 12. For connection with other devices, e.g., a cannula for inflating the cuffs or a resuscitation bag for inflating the ventilation channel 14, the laryngeal tube 10 can have inserts, connectors, connecting pieces, or similar components at its proximal ends. These components are made of a material different from that of the tube body 12 and can extend, for example, into the respective channel 14, 16, 18 in the region of its proximal end. Such further elements 68, which are arranged at the proximal end of the channels 14, 16, 18, can be held there by frictional engagement, e.g., by being press-fitted into the channel 14, 16, 18. The other elements 68 can also be positively connected to the material of the tube body 12, e.g. the tube body 12 can be injection molded onto them.In the present example, the ventilation channel 14 has a connection adapter 70 for a ventilation bag (not shown) and the ventilation channel 18 has a connecting line 72 through which air can be supplied to the ventilation channel 18 in order to pressurize the cuffs 20, 22 with air.

[0067] A one-piece tube body 12, free of any adhesive joints, is therefore designed such that the entirety of the material forming (or defining) the drainage channel 16, ventilation channel 14, and airway 18 is a continuous, and in particular homogeneous, material. The laryngeal tube 10 may, in turn, include components that are attached to the tube body 12, for example, by means of an adhesive bond. Typically, such additional components are the esophageal cuff 20 and the pharyngeal cuff 22, as well as, if applicable, the aforementioned additional elements 68.

[0068] The cuffs, the esophageal cuff 20 and the pharyngeal cuff 22, are typically made of a thin-walled plastic material which is bonded to the one-piece tube body 12, which has no adhesive joints, in particular by means of an adhesive bond.

[0069] In the figure shown, the esophageal cuff 20 and / or the pharyngeal cuff 22 are glued to the tube body 12. The tube body 12 has a hook-shaped rear gripping section 74 or a gripping collar 74 around the ventilation opening 36 in the area of ​​the glued connection with the pharyngeal cuff 22.

[0070] The tube body 12 thus forms a posterior gripping section or grippable collar, which is gripped by the material of the pharyngeal cuff 22. The pharyngeal cuff 22 is glued into this posterior gripping collar 74. The effective adhesive surface is thereby provided on the upper and lower surfaces of the material of the pharyngeal cuff 22, so that a sufficient adhesive bond for fixation can be provided over a smaller overall area. Fig. 5 is a section of the tube body 12 shown in detail and in Fig. 6 is a section along line AA from Fig. 5 is sketched. In the sectional view, it is clearly visible that the rear gripping section 74 or the grippable collar 74 forms a slit 76 into which the pharyngeal cuff 22 can be inserted, so that it can be adhesively attached to both the underside 78 of the slit 76 and the top 80 of the slit 76.

[0071] As in the Fig. 3, Fig. 4 to Fig. Figure 5, in which the tube body 12 is shown without the cuffs 20, 22, is clearly visible. The surface of the tube body 12 in the area of ​​the adhesive connection with the pharyngeal cuff 22 and the esophageal cuff 20 is recessed by the wall thickness of the respective cuff 20, 22, or a region 81 to be bonded is recessed. This results in step-like transitions 83 on the tube body 12 ( Fig. 3 and Fig. 4) In this way, the surface of the laryngeal tube at the edge of the adhesive joint of the respective cuff 20, 22 can be formed essentially step-free when the cuff 20, 22 is glued in place, which is in the Fig. 1 and Fig. 2 is recognizable.

[0072] The esophageal cuff 20 has a shape that tapers towards the drainage opening 34, tapering more sharply than the shape of the esophageal cuff 20 on the side facing away from the drainage opening 34. The esophageal cuff 20 is therefore "pointed" distally and flattened proximally. Furthermore, the esophageal cuff 20 has a width (viewed from the Fig. 1) transverse to the tube's longitudinal extent (along the central longitudinal line 40) and when looking at the broad side 48, which is larger than a depth extent (viewing direction from Fig. 2) of the esophageal cuff 20 transversely to the longitudinal extension of the tube and when looking at the narrow side 46.

[0073] The esophageal cuff 20 thus has a shape that extends flat in the same plane as the tube body 12 itself. Furthermore, the esophageal cuff 20 tapers in an arrow-like shape towards its distal end. This arrow-shaped taper is visible both when viewing the broad side 48 of the tube body 12 and when viewing the narrow side 46. The esophageal cuff 20 can therefore close or block the esophageal inlet particularly reliably, as it adapts very well to the patient's anatomy.

[0074] The pharyngeal cuff 22 is designed to follow the course of the proximal rim 62 of the airway opening 36 and extends along the airway opening 36 to a distally tapering region of the airway opening 36, which transitions into the distal groove-like extension 64. With this design, the pharyngeal cuff 22 can close or block the pharynx 26 particularly reliably and securely. At the same time, it is ensured that the airway opening 36 is not accidentally blocked, as the pharyngeal cuff 22 extends distally around the airway opening 36. The proximal rim 62 of the airway opening 36 is essentially semicircular or segmental in shape. In contrast, a distal rim 82 is formed in a distally elongated tapering manner and transitions into the distal groove-like process 64 and tapers to a point.

[0075] The cuffs 20, 22 are connected via lateral outlets 84 on the ventilation duct 18, which are located in Fig. 4 are recognizable, inflated and deflated.

[0076] The ventilation opening 36, or rather its peripheral region, has a proximal edge 62, which is particularly rounded, a central section 88 extending in a longitudinal direction of the tube, and a distal peripheral region 82 with converging edges. The support structure 59 of the ventilation opening 36, which in this example is formed by the two support ribs 58, extends inwards from the proximal peripheral region 62 and from the central section 88 into the ventilation opening 36.

[0077] The tube body 12 is designed with reinforcing structures 92 in the proximal region, which lies in the patient's bite zone when the tube is inserted. The reinforcing structures 92 counteract occlusion of the ventilation channel 18 by a bite from the patient.

[0078] In Fig. Figure 9 shows the distal end of an alternative laryngeal tube 10, with a tube body 12 that is formed as a single-piece, injection-molded part without any adhesive joints, as shown in the Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6 to Fig. Figure 7 illustrated laryngeal tube 10, but has a simplified area around the ventilation opening 36 without the support structure 59 and without the graspable collar 74. The cuffs 20 and 22, however, are as in the example of the Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6 to Fig. 7 glued to the tube body 12. QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] DE 10 2011 001 325 B4

[0006] US 4,231,365

[0006] WO 2011 / 106754 A1

[0007] US 2005 / 0229933 A1

[0007] EP 0 665 029 A2

[0008] US 0226479

[0009]

Claims

Laryngeal tube (10) for ventilating a patient, comprising an elongated tube body (12) formed with a ventilation channel (14), a drainage channel (16) and a ventilation channel (18), wherein an esophageal cuff (20) for blocking the esophagus (24) and a pharyngeal cuff (22) for blocking the pharynx (26) are arranged on the tube body, wherein the drainage channel (16) has a drainage opening (34) arranged distal to the esophageal cuff (20), and the ventilation channel (14) has a ventilation opening (36) arranged between the pharyngeal cuff (22) and the esophageal cuff (20), wherein the esophageal cuff (20) and the pharyngeal cuff (22) are connected via the ventilation channel (18). can be inflated and / or deflated, characterized in that the tube body (12) has a tube shaft (38),in which the ventilation channel (14) is arranged centrally and the drainage channel (16) is arranged on a first side of the ventilation channel (14) and the ventilation channel (18) is arranged on a second side of the ventilation channel (14) opposite the first side, so that the tube shaft (38) has a flattened cross-sectional shape. Laryngeal tube (10) according to claim 1, characterized in that the tube body (12) is formed in one piece and is free of adhesive joints, in particular free of joining joints, and is formed as an injection molded part, in particular wherein the esophageal cuff (20) and the pharyngeal cuff (22) are attached to the tube body (12) by adhesive bonding. Laryngeal tube (10) according to claim 1 or according to claim 2, characterized in that the pharyngeal cuff (22) is glued to the tube body (12) and the tube body (12) has a recessable collar (74) in the area of ​​the adhesive connection with the pharyngeal cuff (22), into which the pharyngeal cuff (22) is glued, wherein the recessable collar (74) forms a slot (76) in which the material of the pharyngeal cuff (22) is received and is contacted on both sides by the material of the tube body (12). Laryngeal tube (10) according to one of the preceding claims, characterized in that the esophageal cuff (20) has, firstly, a shape tapering towards the drainage opening (34), which tapers more sharply than the shape of the esophageal cuff (20) on the side facing away from the drainage opening, and secondly, that the esophageal cuff (20) has a width extent transverse to the longitudinal extent of the tube, which is greater than a depth extent of the esophageal cuff which runs transversely to the longitudinal extent of the tube and to the width extent of the esophageal cuff. Laryngeal tube (10) according to one of the preceding claims, characterized in that the pharyngeal cuff (22) is designed such that it follows the course of the proximal edge (62) of the ventilation opening (36) and extends distally along the edge of the ventilation opening (36) to a region of the ventilation opening (36) in which the ventilation opening (36) tapers in a lateral direction. Laryngeal tube (10) according to one of the preceding claims, characterized in that the ventilation opening (36) has a, in particular rounded, proximal edge region (62), a central section (88) of the edge extending in a longitudinal direction of the tube and a distal edge region (82) which is formed with converging edges (60), wherein the ventilation opening (36) has a support structure (59), in particular with two support projections (58), which extends from the edge (60) of the ventilation opening (36) into it in order to prevent the epiglottis (33) of the patient from folding into the ventilation opening (36) by optionally supporting the epiglottis (33), in particular wherein the support structure (59) extends from the proximal edge region (62) in the longitudinal direction of the tube at least as far as the central section (88). Laryngeal tube (10) for ventilating a patient, according to one of the preceding claims, characterized in that the tube body (12) in the proximal area, which lies in the bite area of ​​the patient when the laryngeal tube (10) is inserted, is reinforced in such a way that it counteracts a closure of the ventilation channel by a bite of the patient, in particular prevents a closure of the ventilation channel. Laryngeal tube (10) for ventilating a patient, according to one of the preceding claims, characterized in that the surface of the tube body (12) in the area of ​​the adhesive connection with the pharyngeal cuff (26) is recessed by the wall thickness of the pharyngeal cuff (26), so that the surface of the laryngeal tube (10) at the edge of the adhesive point of the pharyngeal cuff (26) is essentially step-free.

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