Laryngeal mask airway

Abstract

A laryngeal mask apparatus (LMA) is disclosed that includes an airway conduit having a steerable upper end and a steerable lower end, and a mask at the steerable lower end of the airway conduit. The mask has an inner surface defining a receptacle in fluid communication with the airway conduit and an outer oropharyngeal surface facing away from the receptacle. The apparatus includes a separate oropharyngeal suction conduit having a steerable lower end that forms a collector defining a plurality of suction openings spanning the oropharyngeal surface of the mask. In use, secretions can be drawn into the oropharyngeal suction conduit through the suction openings for removal from the patient via the oropharyngeal suction conduit.

Description

[Technical field]

[0001] The present invention relates to laryngeal mask airway devices (LMAs) and also extends to methods of treating a patient with an LMA device.

[0002] (definition) In this specification, the term "comprising" is intended to mean the inclusion of a stated integer or integers, but not necessarily the exclusion of any other integers, depending on the context in which the term is used. This also applies to variations of the term such as "comprise" or "comprises."

[0003] In this specification, the terms "secretion" and "gastric matter" should be interpreted broadly. The term "gastric matter" should be interpreted to include stomach contents, gastric reflux and gastric secretions.

[0004] Furthermore, in this specification, the term "cuff" should be interpreted broadly and not limited to inflatable cuffs. Specifically, the term "cuff" should be interpreted to cover both inflatable and non-inflatable cuffs. [Background technology]

[0005] A laryngeal mask airway device (LMA) is a medical device that keeps a patient's airway open during anesthesia or while the patient is unconscious. Another term for an LMA device is a supraglottic appliance, which term can be used interchangeably with LMA device both in the prior art and in this specification.

[0006] The LMA was invented by British anaesthesiologist Archibald Brain and commercialised in 1987. Since then, the LMA has been widely used worldwide in anaesthesia care. The LMA device offers a therapy somewhere between a face mask and endotracheal intubation (where an endotracheal tube is inserted into the patient's trachea). The advantage of the LMA device is that it directs the artificial air supply directly into the respiratory tree with an end-to-end connection. The LMA device provides an effective artificial air supply delivered directly to the ventilator without the trauma of full intubation.

[0007] A basic conventional LMA device is shown in Figure 1. The device includes an air tube or ventilation conduit with an oval mask that, once deployed, forms a receptacle at its operable lower end that forms an airtight seal above the patient's glottis. The tube has an operable upper end that protrudes from the patient's mouth and terminates in an airway connector that is connected to an external air supply. As shown in Figure 1, the air tube or ventilation conduit opens into the receptacle formed by the mask that places the receptacle in communication with the air tube. When the LMA device is properly in place on a patient, the lower or tip of the mask is located at the upper part of the esophagus. Figure 2A shows the LMA device in place within the patient's throat and pharynx.

[0008] The oval mask has a cuff that is configured to seal against the patient's anatomy to form an airtight seal, so that air is directed from the air tube or ventilation conduit into the patient's respiratory tract and does not leak around the periphery of the mask.

[0009] In one form, the cuff is in the form of an inflatable cuff that is inflated to seal against the patient's glottis and form an airtight connection. The inflatable cuff has an inflation line that extends away from the cuff in parallel with the airway line exiting through the patient's mouth. The inflation line has a valve outside the patient's mouth that the clinician uses to inflate the cuff. The inflation line may also have an inflation indicator to indicate to the clinician when the cuff is properly inflated, recognizing that the clinician cannot directly view the cuff contained within the patient's body. In another form, the cuff can be formed of a compliant material, such as a soft cushioning material, that is configured to seal against the patient's tissue adjacent the glottis.

[0010] Another example of a previously known LMA device has an orogastric port (or gastric drain) that opens into the patient's esophagus when the LMA is in place in the patient. The orogastric port has an open lower end opposite the esophagus and an upper end that is positioned outside the patient's mouth. The orogastric port runs parallel to the ventilation conduit and does not open into the ventilation conduit.

[0011] The orogastric port broadly forms a basic conduit through which a catheter can be inserted, parallel to the vent conduit, to facilitate removal of gastric contents or secretions from the patient.

[0012] The catheter is inserted through the orogastric port, which acts as a guide conduit, through the operative lower end of the orogastric port, down the esophagus and into the patient's stomach Suction can be applied to the catheter to draw secretions up through the orogastric port and remove them from the body.

[0013] The catheter in the orogastric port facilitates the removal of gastric secretions and / or gastric reflux from the patient's esophagus and stomach while the LMA device is in use with the mask placed over the glottis. The catheter draws this material from a location spaced beneath the mask of the LMA device.

[0014] Another LMA device known in the art has a bite block and a tab toward its operable upper end adjacent the airway connector that allows the patient to bite down on the bite block when the LMA is in place on the patient.

[0015] However, although there have been many improvements in the use of LMAs since they first appeared, they still have drawbacks. For example, there is a risk of aspiration of secretions from the nasal or oropharyngeal region or blood from the surgical field into the lungs in saliva when the LMA is removed. Secretions can accumulate on the upper side of the LMA (the sides or surfaces of the oropharynx) which ends up above the glottis when the LMA is removed. Secretions dropping into the glottis, especially during emergence (i.e., during light anesthesia), can cause airway crisis such as laryngospasm and / or bronchospasm.

[0016] These drawbacks lead to increased risk, and if the risk is assessed as unacceptable, the clinician may decide to use endotracheal intubation instead. However, intubation is more traumatic than the use of the LMA device and typically involves the use of muscle relaxants, which increase the risk of anaphylaxis, inadequate reversal, and emergence under anesthesia. Muscle relaxants were commonly used in people weighing 30 kg or more.

[0017] References to prior art in the above background are not, and should not be understood as, an admission or any form of suggestion that the prior art referred to forms part of the common general knowledge of a person skilled in the art in Australia or any other country. Summary of the Invention [Problem to be solved by the invention]

[0018] Applicant has recognized that it would be beneficial to devise a laryngeal mask airway device that ameliorates at least some of the shortcomings of conventional LMA devices. It would be particularly advantageous for the LMA device to facilitate the removal of secretions that accumulate on the oropharyngeal surface of the mask in order to reduce the risk of the patient experiencing an airway crisis. An airway crisis can be life-threatening and can lead to death or ICU admission. Furthermore, Applicant believes that it would be advantageous for the LMA device to be easy for clinicians to use, as this would enable the clinician to respond more quickly in an emergency. [Means for solving the problem]

[0019] According to one aspect of the present invention, a vent conduit having an operable upper end and an operable lower end; a mask at the operable lower end of the ventilation conduit, the mask having an inner surface defining a receptacle in fluid communication with the ventilation conduit, and an outer oropharyngeal (or posterior) surface opposite the inner surface and facing away from the receptacle; an independent oropharyngeal suction conduit having a maneuverable upper end and a maneuverable lower end forming a collector defining a plurality of suction openings spanning the oropharyngeal surface of the mask, wherein in use secretions are drawn through the suction openings and into the oropharyngeal suction conduit for removal from the patient via the oropharyngeal suction conduit; A laryngeal mask apparatus (LMA) is provided comprising:

[0020] By using suction to remove these secretions, aspiration of the secretions into the lower airways and the complications caused by aspiration can be resisted. Some potential complications related to the lower airways include laryngospasm and bronchospasm, which are especially prevalent when patients emerge from anesthesia.

[0021] The collector may extend over substantially the entire oropharyngeal surface of the mask and the suction openings may be spaced apart from one another over the oropharyngeal surface, i.e., the collector may extend over the entire oropharyngeal surface to collect secretions from the entire oropharyngeal surface of the mask.

[0022] The mask may be configured in an elliptical shape and may be referred to as an elliptical mask.

[0023] The LMA device may include a cuff that spans the periphery of the mask to seal the mask against the patient, eg, the patient's glottis.

[0024] The collector may have a peripheral region extending along at least a portion of the periphery of the collector and a raised inner region inward of the peripheral region, the raised inner region may be slanted towards the peripheral region on each side of a raised line.

[0025] The collector may include a first plurality of suction openings spaced apart from one another along the circumferential region. Conveniently, the first plurality of suction openings may be arranged in a row along the circumferential region.

[0026] The collector may also include a further plurality of suction openings in the raised inner region, for example on either side of the raised line, running substantially the entire length of the collector.

[0027] The suction openings may, for example, be aligned and positioned relative to one another on the collector to provide sufficient structural integrity to the collector.

[0028] The collector may further include a recess extending along part of the length of the peripheral region for collecting and / or directing secretions towards the suction opening of the peripheral region.

[0029] In particular, the recess may define an open channel that extends along substantially the entire length of the peripheral region, and in particular, the open channel may be provided with curved surfaces and rounded edges (without squared or protruding edges).

[0030] The oropharyngeal suction conduit may include a suction control for allowing a clinician to selectively apply suction to the oropharyngeal suction conduit.

[0031] The operable upper end of the oropharyngeal suction conduit may include a pipe coupling structure for releasable coupling to an external suction conduit.

[0032] In one form, the suction control may be in the form of a branch tube on the pipe connection structure having an open end that is normally open to the outside atmosphere for drawing outside air into the oropharyngeal suction conduit.

[0033] The open end of the branch tube can be closed, for example, by a clinician placing a finger over the open end to apply suction to the oropharyngeal suction conduit and drawing fluids and secretions through the collector at the operable lower end of the oropharyngeal suction conduit.

[0034] The pipe coupling structure may comprise a male pipe coupling structure for releasable connection to a complementary female pipe coupling structure on the external suction conduit.

[0035] The male pipe coupling structure may be in the form of a plug having one or more transverse rib structures or gripping structures and the female pipe coupling structure on the external suction conduit may be in the form of a complementary socket, the rib structures or gripping structures may be configured to releasably engage the female pipe coupling structure.

[0036] In use, this facilitates removal and reattachment of the pipe coupling from the external aspiration conduit, allowing a clinician to manually connect the coupling structures together during operation of the LMA device.

[0037] The external suction conduit may be operably coupled to a suction pump.

[0038] The laryngeal mask may further include an orogastric conduit having a maneuverable upper end and a maneuverable lower end for removing stomach material from the patient.

[0039] The orogastric conduit or orogastric port (or gastric tube) facilitates removal of gastric material from the patient's stomach or esophagus during use of the LMA device.

[0040] The orogastric conduit is separate from the oropharyngeal suction conduit and does not open into or communicate with the oropharyngeal suction conduit along its length. Specifically, the orogastric conduit has no opening intermediate its upper and lower ends that would allow stomach matter or secretions to be discharged from the orogastric conduit adjacent the collector on the mask. This keeps any stomach contents drawn up through the orogastric conduit completely separate from secretions drawn up through the oropharyngeal suction conduit.

[0041] The orogastric conduit may include an orogastric pipe attachment structure for releasable attachment to an external suction conduit.

[0042] For example, the oral gastric pipe connection structure may include a male pipe connection structure for releasable connection to a complementary female pipe connection structure on the external suction conduit to facilitate removal of the oral gastric pipe connection structure from, and reattachment of the oral gastric pipe connection structure to, the external suction conduit during use.

[0043] The orogastric pipe connection structure may include a suction control to allow a clinician to selectively apply suction to the orogastric conduit. The suction control may be similar to that described above for the suction control for the oropharyngeal suction conduit.

[0044] The oropharyngeal suction conduit and the orogastric port are interchangeably connectable to the external suction conduit during use, i.e., so that a single external suction line can be used to provide suction for both.

[0045] Thus, the external suction conduit is capable of providing suction to both the oropharyngeal suction conduit and the orogastric port, recognizing that suction is only applied intermittently by the clinician to each of the oropharyngeal suction conduit and the orogastric port.

[0046] Additionally, the orogastric conduit can be configured to form a port for receiving a catheter therethrough for withdrawing gastric material from the patient. That is, in addition to acting as a conduit for gastric material, the conduit can also receive a small catheter therein that is fed therein through the port. Such a catheter can be a small catheter, for example, an 8Fr catheter to a 12Fr port.

[0047] The cuff may be an inflatable cuff that is inflated to seal the mask against the patient's body, and may further include an inflation line extending away from the cuff for inflating the cuff.

[0048] The cuff may further include a valve on the inflation line that can be operated to introduce air under pressure into the cuff to inflate the cuff, and the inflation line may also include an inflation indicator to indicate to a clinician that the cuff is properly inflated.

[0049] Alternatively, the cuff may be a conformable cuff or seal formed of a conformable cuff material that conforms and seals against the patient's body without being inflated.

[0050] That is, the cuff material conforms and adapts to the shape of the surfaces of the patient's anatomy against which it abuts and seals against the body. The properties of the cuff material allow it to conform and seal against the patient's anatomy.

[0051] The oropharyngeal suction conduit may extend external to and parallel to the ventilation conduit. If desired, the ventilation conduit and the oropharyngeal suction conduit may be contained within a common housing along their lengths.

[0052] The common housing can have a smooth curved surface without any protruding surfaces that would interfere with any tissue of the patient's body. Optionally, the common housing can have an oval or circular cross-sectional shape.

[0053] In embodiments in which the LMA device includes an orogastric conduit, the orogastric conduit may extend external to and parallel to the ventilation conduit and may be contained within the common housing that contains the ventilation conduit and the oropharyngeal suction conduit.

[0054] The ventilation conduit and the oropharyngeal suction conduit, and optionally the orogastric conduit, may each be formed by a tube.

[0055] Additionally, the ventilation conduit, the oropharyngeal suction conduit, and the orogastric conduit may each have some flexibility or bendability.

[0056] The ventilation conduit and the oropharyngeal suction conduit, and optionally the orogastric conduit, may be formed from any suitable medical grade material, such as PVC, silicone rubber, thermoplastic polymers and / or bioplastics.

[0057] The LMA device may further include a bite block adjacent the upper end of the ventilation conduit that provides a rigid member for the patient to bite upon when the LMA device is inserted into the patient.

[0058] The laryngeal mask may include any one or more of the features or combinations of features of the laryngeal mask in any other aspect of the invention in the Summary section.

[0059] According to another aspect of the present invention, a vent conduit having an operable upper end and an operable lower end; a mask at the operable lower end of the ventilation conduit, the mask having an inner surface defining a receptacle in fluid communication with the ventilation conduit, and an outer oropharyngeal surface opposite the inner surface and facing away from the receptacle; an independent oropharyngeal suction conduit having a maneuverable upper end and a maneuverable lower end forming a collector on the oropharyngeal surface of the mask to allow a clinician to remove secretions from the oropharyngeal surface, the maneuverable upper end comprising a pipe coupling structure for releasably coupling the suction conduit to an external suction conduit; A laryngeal mask device (LMA) is provided comprising:

[0060] The apparatus may include a cuff extending around a periphery of the mask for sealing the mask against the patient.

[0061] The pipe coupling structure may comprise a male pipe coupling structure for releasable connection to a female pipe coupling structure on the external suction conduit.

[0062] The oropharyngeal suction conduit may include a suction control on its operable upper end for allowing a clinician to selectively apply suction to the suction conduit.

[0063] The suction control may typically be in the form of a branch tube on the male pipe fitting having an open end open to the atmosphere to draw outside air into the oropharyngeal suction conduit, the open end of the branch tube being closable to apply suction to the oropharyngeal suction conduit and draw secretions into the collector.

[0064] The open end of the branch tube can be closed, in use, by a clinician placing a finger over the open end to apply suction to the oropharyngeal suction conduit and drawing secretions through the collector into the operable lower end of the oropharyngeal suction conduit.

[0065] The laryngeal mask may include any one or more of the features or combinations of features of the laryngeal mask in any other aspect of the invention in the Summary section.

[0066] According to yet another aspect of the present invention, a vent conduit having an operable upper end and an operable lower end; a mask at the operable lower end of the ventilation conduit, the mask having an inner surface defining a receptacle in fluid communication with the ventilation conduit, and an outer oropharyngeal surface opposite the inner surface and facing away from the receptacle; an independent oropharyngeal suction conduit having a maneuverable upper end and a maneuverable lower end forming a collector on the oropharyngeal surface of the mask to enable a clinician to remove secretions from the oropharyngeal surface, the maneuverable upper end comprising a pipe coupling structure for releasable coupling to a complementary pipe coupling structure on an external suction conduit; an independent orogastric conduit parallel to said oropharyngeal suction conduit, said orogastric conduit having a maneuverable upper end and a maneuverable lower end and an orogastric pipe coupling structure at said maneuverable upper end for releasable coupling to a complementary pipe coupling structure on an external suction conduit; Equipped with A laryngeal mask airway device (LMA) is provided, wherein the pipe connection structure of the oropharyngeal suction conduit and the pipe connection structure of the orogastric conduit are configured to engage with identical complementary pipe connection structures on an external suction conduit, thereby allowing the oropharyngeal suction conduit and the orogastric conduit to be interchangeably connected to a single external suction conduit.

[0067] The male and female coupling structures of the oropharyngeal suction conduit and orogastric conduit, respectively, may be configured so that they can be manually detached or separated from one another during operation of the LMA device, and so that they can be manually connected to one another by a clinician during use of the LMA device.

[0068] This interchangeability is useful because the anesthetic and surgical suction have a common connection or coupling configuration in the operating room and are merely different delivery devices, thereby allowing the clinician to selectively apply suction to each of the suction and orogastric conduits using existing external conduits.

[0069] The LMA device may further include an external suction conduit operably connectable to the pipe connection structures of each of the oropharyngeal suction conduit and the orogastric conduit, and the external or further suction conduit may likewise be operably connected to a suction pump.

[0070] The pipe connections of the oropharyngeal suction conduit and the orogastric conduit may be male pipe connections configured to be received within a standard female pipe connection of the external suction conduit.

[0071] The oropharyngeal suction conduit and the orogastric conduit may each have a suction control on their operable upper ends for enabling a clinician to selectively apply suction to the suction conduits.

[0072] In one form, the suction control can be in the form of a manifold on the male pipe coupling having an open end that is normally open to the outside atmosphere to draw outside air into the suction conduit, when open the control ceases the suction by balancing with atmospheric pressure.

[0073] The open end of the branch tube of each suction control can be closed, for example, by a clinician placing a finger over the open end and applying suction to either the oropharyngeal suction conduit or the orogastric conduit to draw fluids and secretions through the respective conduit.

[0074] The laryngeal mask device may include a cuff or seal that spans the periphery of the mask to seal the mask against the patient.

[0075] The laryngeal mask device may include any one or more features or combinations of features of the laryngeal mask devices described in any other aspect of the invention in the Summary section.

[0076] According to another aspect of the present invention, an airway wall for placement adjacent the glottis of a patient in use; an oropharyngeal wall spaced apart from and spanning the airway wall to define an oropharyngeal space therebetween, the oropharyngeal wall defining a plurality of suction openings forming a collector for receiving secretions through the suction openings into the oropharyngeal space; at least one internal support for supporting the oropharyngeal wall at a fixed distance from the airway wall; A mask for a laryngeal mask apparatus (LMA) is provided, comprising:

[0077] The plurality of suction openings may be distributed over the surface of the oropharyngeal wall to collect secretions from all sides of the oropharyngeal wall.

[0078] The airway wall and the oropharyngeal wall may each have a perimeter, and the internal support may be spaced inwardly from the perimeter of each of those walls.

[0079] The at least one internal support may, for example, comprise a single internal support substantially centrally within the oropharyngeal space.

[0080] Alternatively, the at least one internal support may comprise a plurality of internal supports.

[0081] The mask may further include a sidewall extending between and around the periphery of the airway wall and the oropharyngeal wall.

[0082] The airway wall, the oropharyngeal wall, and the at least one internal support may be integrally formed by a molding operation, such as, for example, an injection molding operation.

[0083] Optionally, the side walls may be integrally formed with the airway wall and the oropharyngeal wall.

[0084] The mask may further include a cuff extending around the periphery of the airway wall and the oropharyngeal wall.

[0085] The cuff may be a conformable cuff or seal, which may be integrally formed with the airway wall and the oropharyngeal wall.

[0086] In this configuration, the conformable cuff may be integrally formed with the airway wall and the oropharyngeal wall, for example by a molding operation such as an injection molding operation.

[0087] Alternatively, the cuff may be an inflatable cuff attached to the airway wall and the oropharyngeal wall which are separately formed into the cuff.

[0088] In this configuration, the inflatable cuff may be attached to the airway wall and the oropharyngeal wall, and optionally to the side walls.

[0089] The mask may include any one or more of the other features of the mask described in the LMA device described in any of the previous aspects of the invention.

[0090] According to another aspect of the present invention, an airway wall for, in use, being positioned adjacent the glottis of the patient; an oropharyngeal wall spaced apart from and spanning the airway wall to define an oropharyngeal space therebetween, the oropharyngeal wall defining a plurality of suction openings forming a collector for drawing secretions through the suction openings into the oropharyngeal space; at least one internal support for supporting the oropharyngeal wall at a constant distance from the airway wall; a conformable cuff or seal that extends around the airway wall and the oropharyngeal wall; A mask for a laryngeal mask apparatus (LMA) is provided, wherein the airway wall, the oropharyngeal wall, the at least one internal support, and the compliant cuff or seal are integrally formed.

[0091] The present invention also provides a method for producing a semiconductor device comprising the steps of: a vent conduit having an operable upper end and an operable lower end; A mask as defined in any of the preceding aspects of the invention; an oropharyngeal suction conduit having a steerable upper end and a steerable lower end communicating with said oropharyngeal wall; wherein, in use, secretions are drawn into the oropharyngeal space via the suction opening and thereafter sucked up into the oropharyngeal suction conduit for removal.

[0092] The LMA device may include any one or more of the other configurations of the LMA device described in any of the previous aspects of the invention.

[0093] According to yet another aspect of the present invention, there is provided a method of directly supplying intake air to a patient's respiratory tree, comprising attaching an LMA device as claimed in any one of the other statements of the present invention and directing air through the ventilation conduit to the patient's respiratory tree.

[0094] The method may include removing secretions from the oropharyngeal surface of the mask by intermittently applying suction to the oropharyngeal suction conduit to draw secretions up through the oropharyngeal suction conduit.

[0095] The clinician can apply the suction to the oropharyngeal suction conduit intermittently when their operation of the manual suction controls becomes necessary.

[0096] Directing air into the ventilation conduit may include introducing air under positive pressure into the operable upper end of the ventilation conduit.

[0097] The method may include attaching the LMA device to a patient to perform oral or upper airway surgery, and may also include attaching the LMA device to the patient in an emergency, for example when the patient is unconscious.

[0098] The method removes secretions, e.g., secretions secreted by the patient, from the oropharyngeal surface of the LMA device so that the secretions do not enter the patient's trachea, which reduces the risk of respiratory complications including bronchospasm and laryngospasm.

[0099] The LMA device may include any one or more of the other configurations of the LMA device described in any of the previous aspects of the invention.

[0100] For example, the LMA device may also include an orogastric conduit, and the method may include passing a catheter through the orogastric conduit to enable intermittent aspiration of stomach contents via the orogastric conduit. [Brief description of the drawings]

[0101] The LMA device and method of treating a patient with the LMA device according to the present invention may manifest itself in a variety of forms. It will be convenient hereinafter to describe in detail some embodiments of the invention with reference to the accompanying drawings. The purpose of providing this detailed description is to teach those interested in the subject matter how to carry out the invention. It should be expressly understood, however, that the specificity of this detailed description does not supersede the generality of the preceding general description. [Figure 1] FIG. 1 is a perspective view of a known laryngeal mask device (LMA). [Figure 2A] FIG. 2 is a cross-sectional view of an LMA device such as that of FIG. 1 in place on a patient, showing the mask attached to the glottis. [Figure 2B] 1 is a set of schematic diagrams showing human anatomical structures near the entrance to the tracheal passageway. [Diagram 3] FIG. 1 is a top perspective view of an LMA device according to one embodiment of the present invention. [Figure 4] FIG. 4 is a bottom perspective view of the LMA device of FIG. [Diagram 5] FIG. 4 is a side view of the LMA device of FIG. [Figure 6] FIG. 4 is a front view of the LMA device of FIG. [Figure 7] FIG. 4 is a bottom view of the LMA device of FIG. 3. [Figure 8a] 4 includes three cross-sectional views through the mask of the LMA device of FIG. 3 taken at three different locations along the length of the mask. [Figure 8b] 4 includes three cross-sectional views through the mask of the LMA device of FIG. 3 taken at three different locations along the length of the mask. [Figure 8c] 4 includes three cross-sectional views through the mask of the LMA device of FIG. 3 taken at three different locations along the length of the mask. [Figure 9] FIG. 2 is a top perspective view of an LMA device according to a second embodiment of the present invention. [Figure 10]FIG. 10 is a bottom perspective view of the LMA device of FIG. [Figure 11] FIG. 10 is a side view of a portion of the LMA device of FIG. 9 showing a suction conduit and collector that allows secretions from the patient to be selectively drawn up by the LMA device. [Figure 12] FIG. 12 is a cross-sectional view of the portion of the LMA device of FIG. [Figure 13] FIG. 12 is a top perspective view of the portion of the LMA device of FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0102] Figures 1 and 2 show conventional LMA devices, already described in the Background section above, and therefore these figures will not be further described in the Detailed Description, which will focus on embodiments according to the invention.

[0103] 3-8 show an LMA device according to one embodiment of the present invention, which is just one implementation of the LMA having an inflatable cuff with a pressure indicator balloon to indicate the inflation pressure within the cuff.

[0104] The LMA device 10 generally comprises an airway line or airway tube or ventilation conduit 12 having a steerable upper end 14 and a steerable lower end 16, and an oval mask 20 at the steerable lower end 16 of the airway line 12. The oval mask 20 has an inner surface 22 forming a receptacle opening into the airway line 12, and an outer or oropharyngeal surface 24 opposite the inner surface 22 and facing away from the receptacle. The mask 20 has a cuff 30 extending about its periphery 31 for sealing the mask 20 against the steerable upper open end of the patient's airway, for example across the patient's glottis.

[0105] The LMA device 10 also includes a suction conduit 40 separate from and parallel to the ventilation conduit 12 that allows a clinician to apply intermittent suction to remove bodily secretions from the oropharyngeal surface 24 of the mask 20. The term "suction conduit" 40 may be used interchangeably herein with the term oropharyngeal suction conduit.

[0106] Each of these components of the LMA device 10 is now described in more detail below.

[0107] The ventilation conduit 12 is formed of a tubular material having a degree of bendability or flexibility, and is configured to be comfortably received in the patient's mouth and throat. The operable upper end 14 of the ventilation conduit 12 has an airway connector (such as that shown in FIG. 1) that facilitates its operable connection to an external air supply system. The structure and function of external air supply systems are known to those skilled in the art and will not be described in further detail herein.

[0108] The oval mask 20 is shaped and configured to fit the glottis of a patient and seal the mask 20 against the patient's anatomy around the glottis such that air traveling down through the ventilation conduit 12 is directed into the patient's respiratory tree and not into the esophagus along the path that leads to the stomach.

[0109] The inflatable cuff 30 extends around the periphery 31 of the mask 20 to seal against the patient's glottis and is inflated with air to bring it into sealing contact with the glottis. The inflatable cuff 30 includes an inflation line 32 extending away from the cuff 30 that typically has a valve (not shown) that can be operated to allow air under pressure to enter the inflation line 32 to inflate the cuff 30. The inflation line 32 also typically includes an inflation indicator balloon (not shown) to indicate to a clinician when the cuff 30 is properly inflated.

[0110] The suction conduit 40 has an operable upper end 60 which, in use, is positioned outside the patient's mouth and is operably coupled to an external suction conduit 70 (not shown in FIG. 3), and an operable lower end 61. A suction control is operated by a clinician generating suction within the suction tube 40. The suction devices used to generate the suction are well known and will not be described in detail herein.

[0111] As shown in the figures, the upper end 60 of the conduit 40 has a pipe coupling arrangement 90 that can be used to releasably couple the conduit 40 to the external conduit 70. Conveniently, the pipe coupling arrangement 90 comprises a male pipe coupling arrangement that is received, for example by friction fit, into a complementary female pipe coupling arrangement 92 on the external suction conduit 70. Furthermore, the suction control is effected by the male pipe coupling arrangement 90 having a branch line 94 with an open end that allows the clinician to apply suction intermittently when required. Conveniently, the male and female pipe coupling arrangements 90, 92 may be similar to those used in catheter technology.

[0112] The operable lower end 61 of the suction tube 40 defines a collector 62 that spans substantially the entire oropharyngeal or posterior surface 24 of the mask 20. The collector 62 has a peripheral region that extends to the periphery 31 of the mask 20 and a raised inner region that slopes downwardly toward the peripheral region on each side of the collector 62. The raised inner region has a ridge or highline or spine that extends along the length of the collector 62 and slopes downwardly toward the peripheral region on each side of the highline.

[0113] The collector 62 includes a plurality of suction openings 64 disposed on the oropharyngeal surface. Some of the suction openings 64 may be disposed around the periphery 31 and other suction openings 64 may be disposed in the raised inner region. In the illustrated embodiment, the collector 62 has at least eight suction openings 64 disposed in a row and spaced apart from one another along the periphery region.

[0114] Applicant points out that the number of suction openings 64 on the collector 62 in this embodiment is only one example of a configuration of suction openings 64. In some other configurations, there may be fewer suction openings 64 on the collector 62, and they may be positioned differently on the collector. In some other configurations, the collector 62 may have more suction openings 64 than those shown in Figures 3-8. For a given LMA device configuration, the number of suction openings 64 and the placement of those openings 64 will depend on the amount of secretions that will be flushed through the suction openings 64 during use and the structural strength required of the collector 62.

[0115] One factor in the placement of the suction openings 64 on the collector 62 is the desire to avoid suctioning mucosa directly into the suction openings 64, which would block or obstruct the openings 64 and potentially cause some degree of tissue damage to the patient.

[0116] Additionally, the peripheral region may include a recess or open channel 67 extending around a substantial portion of the periphery 31 of the mask 20. The channel 67 serves to collect and direct secretions toward and into the suction opening 64 formed in the peripheral region. The channel 67 may include only curved or rounded edges and not have any square edges. By forming the suction opening 64 in the recess 67, suction trauma to mucosal tissue extending across the collector 62 may be avoided. Although an open channel is not explicitly shown in Figures 3-8, one skilled in the art will appreciate that the oropharyngeal surface 24 may be configured with a more defined channel.

[0117] The collector 62 includes additional suction openings 64 in the raised inner region, for example, at least one suction opening 64 on each side of the highline. In the embodiment shown in Figures 3-8, the additional openings 64 include several suction openings on each side of the highline toward the end away from the air tube or vent conduit 12, i.e., distal from the operable upper end 14 of the vent conduit 12.

[0118] Thus, the collector 62 extends across the posterior or oropharyngeal surface 24 of the mask 20 and draws the patient's body secretions across the oropharyngeal surface 24 into the suction opening 64. After the body secretions are drawn through the suction opening 64, they are sucked up through the oropharyngeal suction conduit 40 and away from the glottis at the entrance to the trachea.

[0119] The collector 62 has a low profile as shown in the drawings and does not take up much space above the rest of the LMA device. Furthermore, because the collector 62 has only curved surfaces and rounded edges (no square edges or corners), it does not inflict any trauma on the patient's body tissue. This is especially true when the LMA device 10 is in place as well as when it is inserted into and withdrawn from the patient.

[0120] The oropharyngeal suction conduit 40 follows the curvature of the ventilation conduit or air tube 12 along its length and is typically made of a similar material as the ventilation conduit 12. As shown in the drawings, the suction conduit 40 has a much smaller diameter than the ventilation conduit 12. By way of example only, the air tube or ventilation conduit 12 may have a diameter of about 15 mm and the suction conduit 40 may have a diameter of about 5 mm. As a result, the ventilation conduit 12 and associated suction conduit 40 form a relatively streamlined body with a low profile as the conduits extend upward from the glottis through the oropharyngeal conduit in the patient. The LMA device 10 with its collector 62 and oropharyngeal suction conduit 40 fits without any problem within the interior space defined by the oropharyngeal conduit of the patient.

[0121] Those skilled in the art will appreciate that the size of the tubing used for both the ventilation conduit 12 and the suction conduit 40 will vary depending on the size of the LMA device 10, i.e., a larger sized LMA device 10 will generally have a larger ventilation conduit 12.

[0122] In the illustrated embodiment in Figures 3-8, the vent conduit 12 and the suction conduit 40 are held together along their lengths, however, one skilled in the art will readily recognize that the conduits 12 and 40 can also extend from their upper ends to their lower ends independently and without being attached to one another.

[0123] 3-8 does not have an orogastric port as described above with respect to conventional LMA devices in the Background section, i.e., the LMA device does not have a separate orogastric port parallel to the ventilation conduit 12 and the oropharyngeal suction conduit 40 that can be used to withdraw the patient's gastric contents and secretions from the stomach and / or esophagus.

[0124] In use, an LMA device 10, as shown in Figures 3 to 8, is attached to a patient to provide an air supply which is directed into the patient's respiratory tree. The glottis marks the entrance to the respiratory tree and where the passage of food from the mouth to the stomach branches off from the respiratory pathway. LMA devices are used by medical personnel with a wide range of backgrounds and specialities. For example, the LMA device may be used by a consultant anaesthetist and, in some cases, the LMA device may be removed by a recovery nurse.

[0125] The LMA device 10 provides a direct end-to-end connection from the air supply (external to the patient) to the entrance of the respiratory tree. Figure 2B shows the relevant anatomical structure of the patient, including the pharyngeal cavity and the glottis to which the LMA device is attached. After the LMA device 10 is inserted through the patient's mouth and into the throat, it is moved downward until the front or cup-shaped inner surface 22 of the mask 20 (opposite the oropharyngeal surface 24) is positioned over the patient's glottis, opposite the patient's vocal cords. The cuff 30, which is by then positioned around the glottis, is inflated and urged into sealing contact against the glottis to form an airtight seal. In this way, air directed downward toward the air tube or ventilation conduit 12 passes directly through the respiratory tree and does not leak out of the mask 20 to oxygenate blood passing through the lungs.

[0126] During use of the LMA device 10, the suction conduit 40 can be used by a physician to aspirate upper airway secretions and blood that may collect in the body cavity or space around the oropharyngeal surface 24 of the mask 20. The physician can apply suction on an intermittent basis as needed, for example, by manual actuation of the suction control at the operable upper end 60 of the suction conduit 40 and external to the patient. The plurality of suction openings 64 of the collector 62 draw secretions from all areas of the oropharyngeal surface 24 into the suction conduit 40. When suction is applied, the secretions are drawn up through the suction conduit 40 and into an external suction conduit 70 from which they are flushed to a canister / reservoir.

[0127] After airway therapy, i.e., delivery of oxygen to the patient's lungs, is completed, the LMA device 10 can be moved up through the pharynx and throat and withdrawn through the mouth. This is done manually by fastening to the airway connector or the like. With current technology, the cuff is still inflated when the LMA device is withdrawn. This helps to avoid secretions dripping down into the larynx. Applicant believes that there is room to deflate the cuff for withdrawal as secretions are aspirated from the oropharyngeal surface, as disclosed herein.

[0128] Figures 9-13 show an LMA device according to another embodiment, which has some similarities to the LMA device shown in Figures 3-8 above, and therefore like reference numerals are used to refer to like components unless otherwise indicated, and the following description will focus on the differences between this embodiment and the embodiment of Figure 3.

[0129] The structure of the LMA device 10 shown in Figures 9 to 13 is similar to that of the 'i-gel' LMA device manufactured by Intersurgical Pty Ltd. In this embodiment, the basic 'i-gel' LMA product is already adapted with a suction conduit 40 running parallel to the air tube or ventilation conduit 12 to allow the clinician to remove body secretions and mucus adjacent the oropharyngeal surface 24 of the mask 20.

[0130] Generally, the LMA device 10 comprises an airway line or air tube or ventilation conduit 12 having an upper operable end 14 and a lower operable end 16, and an oval mask 20 at the lower operable end 16 of the ventilation conduit 12. The oval mask 20 has an inner surface 22 defining a receptacle that opens into the ventilation conduit 12, and an outer or oropharyngeal surface 24 opposite the inner surface 22 and facing away from the receptacle.

[0131] In this embodiment, the mask 20 has a conforming cuff or seal 30 extending around its periphery 31, e.g., across the glottis of the patient, for sealing the mask 20 to an operable upper open end of the patient's airway. The conforming cuff or seal 30 is formed of a flexible cuff material that bears against and seals against the patient's tissue. The properties of the cuff material allow it to conform and adapt to the shape of the internal anatomical surfaces that it abuts and seals the mask 30 against the patient. The cuff is not inflatable and therefore does not have a cuff inflation line.

[0132] The LMA device 10 also includes an oropharyngeal suction conduit 40 separate from (and parallel to) the ventilation conduit 12 that allows a clinician to apply intermittent suction to remove secretions from the oropharyngeal surface 24 of the mask 20. The oropharyngeal suction conduit 40 has a pipe fitting structure or connector 90 at its upper end as shown in the drawings. The connector 90 is a male pipe fitting structure for releasable connection to a complementary female pipe fitting structure 92 of an external suction conduit 70.

[0133] The male pipe fitting 90 includes a spigot having transverse ribs configured to be received within an industry standard female pipe fitting 92, e.g., a 50 mm diameter pipe fitting such as those used in the catheter art.

[0134] The LMA device 10 also has an orogastric conduit or port (gastric drain) 80 (not provided in the LMA device in Figures 3-8) for removing stomach related material including reflux from the esophagus. The orogastric conduit 80 helps to prevent stomach secretions from being aspirated or drawn into the lungs where they can cause complications well known and described above.

[0135] The orogastric conduit 80 has an operable lower end 81 with an opening that opens into the esophagus and is disposed external to the respiratory tree. It faces into the esophagus toward the stomach, beneath the mask of the LMA device. The orogastric conduit 80 is separate from both the ventilation conduit 12 and the oropharyngeal suction conduit 40 and is not in communication with either of those conduits 12 and 40 along their length.

[0136] The orogastric conduit 80 passes upwardly out of the patient's mouth and has a operative upper end 82 that can be operatively coupled to an external suction conduit 70 outside the patient's body. The orogastric conduit 80 can be used to remove gastric secretions that are drawn up through the orogastric conduit 80 by application of suction via the external suction conduit 70. The orogastric conduit 80 is formed of a flexible tube like the ventilation conduit 12 and generally follows the path of the ventilation conduit 12 as it travels upwardly from the mask 20 to its operative upper end 16.

[0137] The orogastric conduit 80 has a connector or pipe connection 91 at its upper end 82, as shown in the figures. The pipe connection 91 is essentially the same as the pipe connection 90 at the upper end of the oropharyngeal suction conduit 40. Specifically, the pipe connection 91 has a suction control formed by a branch line 94 having an open end that can be blocked by a clinician applying suction to the orogastric conduit 80.

[0138] In the above description, the orogastric conduit 80 with a suitable pipe connection structure 91 can be used as a suction conduit for the direct removal of gastric material contained directly within the conduit 91 itself which is used to guide and direct the gastric material to the operable upper end 82. In this application, the gastric conduit 80 is not used as a port to guide the insertion of a separate catheter that constitutes the conduit for withdrawing stomach contents.

[0139] However, it should be understood that the orogastric conduit 80 can also be used as a port (or receiving lumen or guide) to provide a passageway for receiving a small catheter therein for removing stomach related material from the patient. The catheter can be fed down through the orogastric port and then down through the operable lower end of the port. Typically, the catheter is inserted down into the esophagus and, if necessary, into the stomach. Such a catheter will necessarily be a small catheter, for example, 8Fr to 12Fr, in order to be able to fit into the gaps within the orogastric conduit 80.

[0140] The collector 62 attached to the oropharyngeal surface of the mask 20 in Figures 9-13 has some differences from the collector 62 of the first embodiment described above. The collector 62 has a circumferential region that extends to the periphery 31 of the mask 20. The collector 62 also has a raised inner region that is disposed inward of the circumferential region. The raised inner region has a highline extending along its length and slopes downwardly from either side of the highline to the circumferential region on each side of the highline.

[0141] The collector 62 has a plurality of suction openings 64 arranged in a row along the circumferential region. In the illustrated embodiment, the collector 62 has at least 10 suction openings 64, e.g., at least 18 suction openings, arranged along the circumferential region.

[0142] Additionally, the peripheral region is also configured to form a recessed groove or channel 67 for collecting and directing secretions towards the suction opening 64 formed in the peripheral zone, as most clearly shown in the cross-sectional view of Figure 12. In the illustrated embodiment of Figures 9-13, the channel 67 extends along a substantial portion of the length of the peripheral region.

[0143] The collector 62 also includes a number of additional suction openings 64 within the raised inner region thereof. Applicant believes that the additional suction openings 64 in the raised inner region will help draw substantially all bodily secretions into the suction conduit 40, thereby avoiding the risk of the secretions being drawn into the airway or trachea. In the illustrated embodiment of Figures 9-13, these additional suction openings 64 include suction openings 64 on either side of the highline. Moreover, these suction openings 64 extend from the upper operable end of the mask 20 adjacent the ventilation conduit 12 to the lower operable end of the mask 20 remote from the conduit 12. Again, it should be understood that this is merely an exemplary configuration of suction openings 64, and that various other configurations could be used. Those skilled in the art will readily appreciate that the configuration of the suction openings will depend on the size of the LMA, which in turn will depend on the fit of the patient. It also depends on the style of LMA, the size of the LMA, the materials used, and the proper structural integrity of the collector.

[0144] Additionally, applicants point out that the collector 62 is configured with gently curved surfaces with rounded edges. The collector 62 has some square edges as well as some sharp edges that allow the mask 20 with collector 62 to conform to the patient's anatomy. This helps to avoid any trauma to the patient when the LMA device is inserted and withdrawn from the patient in use.

[0145] As shown in the figures, the suction conduit 40 and the collector 62, which extends to the oropharyngeal surface 24 of the mask 20, are integrally formed with the remainder of the device 10, and the collector 62 is embedded in the mask 20 of the LMA device 10, for example, during manufacture. As further shown in Figures 9 and 10, the suction conduit 40 is housed within a housing or sheath 98 that also houses the air tube or ventilation conduit 12 and the orogastric conduit 80. This conveniently bundles the three conduits 12, 40 and 80 together while keeping the interior conduit spaces strictly separated from one another. The housing 98 has a generally circular or elliptical cross-sectional configuration.

[0146] In use, the LMA device 10 of Figures 9 to 12 is employed in a similar manner to the embodiment described above with reference to Figures 3 to 8, and therefore the description above in relation to Figures 3 to 8 is also applicable here.

[0147] The LMA is inserted into a patient in the same manner as the LMA device of Figure 3. Once in place, the LMA is ready to use because it has a conformable cuff that naturally seals with the patient's body tissue, and does not have an inflatable cuff.

[0148] 9-12, the suction conduit 40 is releasably coupled to the further external suction conduit 70 by complementary male and female pipe coupling structures on the suction conduit 40 and the further external suction conduit 70, respectively. This allows the attending physician to apply suction to the suction conduit 40 and the suction opening 64 of the collector 62 when required. As mentioned above, suction control is performed by the clinician placing a finger on the open end of the branch line or pipe 94 of the male pipe coupling structure 90 to draw air through the suction conduit 40 rather than from the outside.

[0149] Thereafter, if the clinician wishes to apply suction to the orogastric conduit 80, the further suction conduit 70 is manually detached or disconnected from the suction conduit 40 and instead connected to the orogastric conduit 80. This act of detaching and then reattaching the orogastric conduit 80 can be quickly and easily accomplished manually by the clinician. This in turn allows the clinician to apply suction to the orogastric conduit 80 and to draw gastric reflux or secretions through the orogastric conduit 80 and out of the patient's mouth. Thus, a single external suction conduit 70 operably coupled to a suction or vacuum source can be used to provide suction to both the suction conduit 40 and the orogastric conduit 80, which provides operational advantages.

[0150] In another aspect of the LMA device not illustrated in this specification, the LMA device has an orogastric suction conduit parallel to the ventilation conduit. The LMA device also has a collector spanning the oropharyngeal surface of the mask for drawing secretions into the suction tube. The structure and function of these components are similar to the corresponding components described above with respect to the illustrated embodiment.

[0151] The LMA device also has an inflatable cuff around the periphery of the mask, such as that shown in the embodiment of Figures 3 to 8. The cuff is inflated in the same manner as the previous embodiments, by an airline and valve.

[0152] The LMA device further includes an orogastric conduit 80 for extending to the esophagus and, if necessary, to the stomach for removal of stomach contents. The orogastric conduit 80 is very similar to the conduit 80 in the embodiment described above with reference to Figures 9-13.

[0153] Additionally, this embodiment also includes a bite block that surrounds the ventilation conduit, and optionally the oropharyngeal suction conduit and orogastric conduit, to form a block for the patient to bite down on when the LMA device 10 is inserted in place in the patient's throat. The bite block thus helps to position and keep the LMA device in place.

[0154] The LMA device described above, but not shown, functions in use in a manner very similar to the previous embodiments described above, and it is used by a clinician in a manner very similar to that described above with reference to Figures 3-8 and 9-13.

[0155] One advantage of the LMA device, as described above in the detailed description with reference to Figures 3-8 and 9-13 of the drawings, is that it allows secretions in the body cavity adjacent the oropharyngeal surface of the mask to be drawn through the oropharyngeal suction conduit. This avoids aspiration of those secretions into the patient's lungs, especially when the LMA device is removed from the patient after treatment. This helps to avoid respiratory complications such as potentially life-threatening bronchospasm and laryngospasm. Thus, the LMA device helps to reduce the risk and occurrence of respiratory complications for patients treated with an LMA device.

[0156] Another advantage of the LMA device described above in the detailed description with reference to Figures 3-8 and 9-13 of the drawings is that the LMA device has been modified to provide an oropharyngeal suction conduit and collector on the oropharyngeal surface of the mask, thereby implementing the invention in a manner that does not pose any additional risk or discomfort or harshness to the patient, which is seamlessly integrated into the structure of the LMA device.

[0157] Another advantage of the LMA device, as described above in the detailed description with reference to Figures 3-8 and 9-13 of the drawings, is that the mask, and in particular the collector on the oropharyngeal surface of the mask, does not have any sharp edges. Rather, the edges are gently curved to match the natural curves and contours of the other features of the mask of the LMA device. Furthermore, the oropharyngeal suction conduit, which runs up from the mask through the oropharyngeal passageway and throat of the patient, is relatively unobtrusive and conveniently bundled with the ventilation conduit which supplies intake air to the patient's trachea.

[0158] Another advantage of the LMA device, as described above in the detailed description with reference to Figures 8-13 of the drawings, is that it provides an orogastric conduit that aspirates gastric contents directly from the patient and does not require a separate catheter. The device in this application provides more than a basic orogastric port that requires a catheter to be inserted through the port before it can be used. This gives the operational advantage of speed of use, which is advantageous in emergency situations. The device also makes it easier for clinicians to access and remove gastric contents when using the LMA device.

[0159] Another advantage of the LMA, as described above in the detailed description with reference to Figures 8-13 of the drawings, is that the oropharyngeal suction conduit is attached to a pipe coupling structure that allows it to be quickly and easily coupled to a standard, commercially available, external suction conduit in the operating room. Additionally, the orogastric conduit is also attached to the same pipe coupling structure that allows it to be coupled to the same external suction conduit. The two conduits can be interchangeably coupled to a single external suction conduit to provide the clinician with suction in both conduits when needed.

[0160] Another advantage of the LMA, as described above in the detailed description with reference to Figures 3-13 of the drawings, is that the collector on the mask for collecting secretions can be integrally formed with the mask when the mask is manufactured.

[0161] Of course, it will be recognized that the foregoing is merely illustrative of the present invention, and that all modifications and variations thereto, as would be apparent to one skilled in the art, are deemed to fall within the broad scope and sphere of the invention as if described herein.

Claims

1. a vent conduit having an operable upper end and an operable lower end; a mask at the operable lower end of the ventilation conduit, the mask having an inner surface defining a receptacle in fluid communication with the ventilation conduit, and an outer oropharyngeal surface opposite the inner surface and facing away from the receptacle; The mask is an airway wall having an inner surface that, in use, is positioned adjacent the glottis of a patient; an oropharyngeal wall providing said outer oropharyngeal surface and extending opposite and spaced from said airway wall to define an oropharyngeal space therebetween, said oropharyngeal wall defining a plurality of suction openings forming a collector for drawing secretions through said suction openings into said oropharyngeal space; at least one internal support for supporting the oropharyngeal wall at a constant distance from the airway wall; a conformable cuff or seal that extends around the airway wall and the oropharyngeal wall; a mask, wherein the airway wall, the oropharyngeal wall, the at least one internal support, and the compliant cuff or seal are integrally formed; a separate oropharyngeal suction conduit having a maneuverable upper end and a maneuverable lower end forming the collector defining the plurality of suction openings spanning the oropharyngeal surface of the mask, wherein in use secretions are drawn through the suction openings and into the oropharyngeal suction conduit for removal from a patient via the oropharyngeal suction conduit.

2. 2. The laryngeal mask device of claim 1, wherein the collector extends across substantially all of the oropharyngeal surface of the mask and the plurality of suction openings are spaced apart from one another across the oropharyngeal surface.

3. 3. The laryngeal mask device of claim 1 or 2, wherein the collector has a circumferential region extending along at least a portion of the collector and a raised inner region inward of the circumferential region.

4. A laryngeal mask device as described in claim 3, wherein the plurality of suction openings are arranged in a row along the peripheral region and spaced apart from one another, and the collector includes a further plurality of suction openings in the raised inner region.

5. 5. The laryngeal mask device of claim 4, wherein the collector further includes a recess extending along a portion of the length of the peripheral region for directing secretions towards the suction opening of the peripheral region.

6. 6. The laryngeal mask airway device of claim 1, wherein the operable upper end of the oropharyngeal suction conduit includes a pipe coupling structure for releasable coupling to an external suction conduit, and the pipe coupling structure includes a suction control for enabling a clinician to selectively apply suction to the oropharyngeal suction conduit.

7. 7. The laryngeal mask device of claim 6, wherein the pipe coupling arrangement comprises a male pipe coupling arrangement for releasable connection to a female pipe coupling arrangement on the external suction conduit to facilitate removal of the pipe coupling arrangement from and reattachment of the pipe coupling arrangement to the external suction conduit during use.

8. 8. The laryngeal mask device of claim 1, further comprising an orogastric conduit having a maneuverable upper end and a maneuverable lower end for removing stomach related material from the patient, the orogastric conduit not opening into or communicating with the oropharyngeal suction conduit along its length.

9. 9. The laryngeal mask airway device of claim 8, wherein the orogastric conduit includes an orogastric pipe coupling structure for releasable connection to an external suction conduit, and the orogastric pipe coupling structure includes a suction control for enabling a clinician to selectively apply suction to the orogastric conduit.

10. 10. The laryngeal mask device of claim 9, wherein the orogastric pipe connection arrangement comprises a male pipe connection arrangement for releasable connection to a female pipe connection arrangement on the external suction conduit to facilitate removal of the orogastric pipe connection arrangement from and reattachment of the orogastric pipe connection arrangement to the external suction conduit during use.

11. 11. The laryngeal mask device of claim 10, wherein the orogastric conduit is also configured to define a port for receiving a catheter therethrough for withdrawing gastric matter from the patient.

12. A laryngeal mask device as described in any one of claims 1 to 11, wherein the cuff includes an inflatable cuff that is inflated to seal the mask against the patient's body, the cuff further including an inflation line extending away from the cuff for inflating the cuff.

13. A laryngeal mask device as claimed in any one of claims 1 to 11, wherein the cuff is formed of a suitable material that conforms to and seals with the patient's body without being inflated.

14. 14. A laryngeal mask device according to any preceding claim, wherein the ventilation conduit and the oropharyngeal suction conduit are each formed of a tube.

15. 15. A laryngeal mask device according to any preceding claim, wherein the ventilation conduit and the oropharyngeal suction conduit are contained along their lengths within a common housing.

16. 7. The laryngeal mask device of claim 6, wherein the suction control is in the form of a branch tube on a male pipe fitting having an open end normally open to ambient air for drawing outside air into the oropharyngeal suction conduit, and the open end of the branch tube is closed for applying suction to the oropharyngeal suction conduit to draw fluids and secretions into the collector.

17. The method of claim 16, wherein the operable upper end includes a pipe coupling structure for releasable coupling to a complementary pipe coupling structure on an external suction conduit; an independent orogastric conduit parallel to said oropharyngeal suction conduit, the orogastric conduit having a maneuverable upper end and a maneuverable lower end, and an orogastric pipe coupling structure at the maneuverable upper end for releasable coupling to a complementary pipe coupling structure on an external suction conduit; 2. The laryngeal mask airway device (LMA) of claim 1, wherein the pipe coupling structure of the oropharyngeal suction conduit and the pipe coupling structure of the orogastric conduit are configured to mate with identical complementary pipe coupling structures, thereby allowing the oropharyngeal suction conduit and the orogastric conduit to be interchangeably coupled to a single external additional suction conduit.

18. 20. The laryngeal mask device of claim 17, wherein the oropharyngeal suction conduit pipe connection and the orogastric conduit pipe connection are male pipe connection structures configured to be received within a standard female pipe connection structure on the external suction conduit.

19. an airway wall for, in use, being positioned adjacent the glottis of a patient; an oropharyngeal wall extending opposite and spaced from the airway wall to define an oropharyngeal space therebetween, the oropharyngeal wall defining a plurality of suction openings forming a collector for drawing secretions through the suction openings into the oropharyngeal space; and at least one internal support for supporting the oropharyngeal wall at a constant distance from the airway wall.

20. A mask for a laryngeal mask apparatus (LMA) as described in claim 19, wherein the airway wall, the oropharyngeal wall and the at least one internal support are integrally formed.

21. A mask for a laryngeal mask apparatus (LMA) as described in claim 19 or claim 20, wherein the multiple suction openings are distributed over a surface of the oropharyngeal wall to collect secretions from all sides of the oropharyngeal wall.

22. A mask for a laryngeal mask apparatus (LMA) as described in any one of claims 19 to 21, wherein each of the airway wall and the oropharyngeal wall has a perimeter, and the internal support is spaced inwardly from the perimeter of each of those walls.

23. A mask for a laryngeal mask device (LMA) as described in any one of claims 19 to 22, wherein at least one of the internal supports is substantially centrally positioned within the oropharyngeal space.

24. A mask for a laryngeal mask device (LMA) as described in any one of claims 19 to 23, further comprising a side wall extending between and around the periphery of the airway wall and the oropharyngeal wall.

25. A mask for a laryngeal mask apparatus (LMA) as described in claim 24, wherein the side walls are integrally formed with the airway wall and the oropharyngeal wall.

26. A mask for a laryngeal mask apparatus (LMA) as described in any one of claims 19 to 25, further comprising a conforming cuff or seal extending around the airway wall and the oropharyngeal wall.

27. A mask for a laryngeal mask device (LMA) as described in any one of claims 19 to 26, wherein the adapted cuff or seal is integrally formed with the airway wall and the oropharyngeal wall.

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