US20080264993A1 - Article for Retaining Components of an Endoscopic Retrograde Cholangio-Pancreatography Delivery System - Google Patents

Article for Retaining Components of an Endoscopic Retrograde Cholangio-Pancreatography Delivery System Download PDF

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US20080264993A1
US20080264993A1 US11/739,541 US73954107A US2008264993A1 US 20080264993 A1 US20080264993 A1 US 20080264993A1 US 73954107 A US73954107 A US 73954107A US 2008264993 A1 US2008264993 A1 US 2008264993A1
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Prior art keywords
belt
ercp
guide wire
component
article
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US11/739,541
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Khrys Schulte
Jennifer Butts-Pluid
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E-BELTS LP
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E-BELTS LP
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Priority to US11/739,541 priority Critical patent/US20080264993A1/en
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Publication of US20080264993A1 publication Critical patent/US20080264993A1/en
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    • AHUMAN NECESSITIES
    • A41WEARING APPAREL
    • A41DOUTERWEAR; PROTECTIVE GARMENTS; ACCESSORIES
    • A41D13/00Professional, industrial or sporting protective garments, e.g. surgeons' gowns or garments protecting against blows or punches
    • A41D13/12Surgeons' or patients' gowns or dresses
    • A41D13/1209Surgeons' gowns or dresses
    • AHUMAN NECESSITIES
    • A41WEARING APPAREL
    • A41FGARMENT FASTENINGS; SUSPENDERS
    • A41F9/00Belts, girdles, or waistbands for trousers or skirts
    • A41F9/002Free belts
    • AHUMAN NECESSITIES
    • A45HAND OR TRAVELLING ARTICLES
    • A45FTRAVELLING OR CAMP EQUIPMENT: SACKS OR PACKS CARRIED ON THE BODY
    • A45F5/00Holders or carriers for hand articles; Holders or carriers for use while travelling or camping
    • A45F5/02Fastening articles to the garment
    • AHUMAN NECESSITIES
    • A45HAND OR TRAVELLING ARTICLES
    • A45FTRAVELLING OR CAMP EQUIPMENT: SACKS OR PACKS CARRIED ON THE BODY
    • A45F5/00Holders or carriers for hand articles; Holders or carriers for use while travelling or camping
    • A45F5/02Fastening articles to the garment
    • A45F5/021Fastening articles to the garment to the belt
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50Supports for surgical instruments, e.g. articulated arms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50Supports for surgical instruments, e.g. articulated arms
    • A61B90/53Supports for surgical instruments, e.g. articulated arms connected to the surgeon's body, e.g. by a belt
    • AHUMAN NECESSITIES
    • A45HAND OR TRAVELLING ARTICLES
    • A45FTRAVELLING OR CAMP EQUIPMENT: SACKS OR PACKS CARRIED ON THE BODY
    • A45F3/00Travelling or camp articles; Sacks or packs carried on the body
    • A45F3/14Carrying-straps; Pack-carrying harnesses
    • A45F2003/144Pack-carrying waist or torso belts
    • AHUMAN NECESSITIES
    • A45HAND OR TRAVELLING ARTICLES
    • A45FTRAVELLING OR CAMP EQUIPMENT: SACKS OR PACKS CARRIED ON THE BODY
    • A45F2200/00Details not otherwise provided for in A45F
    • A45F2200/05Holder or carrier for specific articles
    • A45F2200/0566Tubular, rod-shaped articles, e.g. batons

Definitions

  • This invention pertains to apparatus for supporting in-use components of an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. More particularly, the present invention relates to a belt having retainers for releasably attaching instrument components of an ERCP system, such as guide wires, tubes and catheters.
  • ERCP Endoscopic Retrograde Cholangio-Pancreatography
  • Endoscopic Retrograde Cholangio-Pancreatography utilizes an endoscope with a catheter and a guide wire.
  • a guide wire is place into position through a catheter that has been delivered via an open channel of the endoscope to a desired location within a patient. Afterwards, the guide wire can be used to further deliver instruments that are delivered about the guide wire to the desired location within the patient.
  • an endoscopic assistant is required to stow and retrieve the guide wire in a manner that is not going to contaminate the guide wire as it will later be inserted into the patient.
  • technicians attempt to coil the guide wires during removal and storage.
  • the guide wires are made from a springy material that tends to straighten out into a linear configuration, thereby tending to uncoil if they are not held in a coil configuration.
  • the endoscopic assistant has their hands full which further complicates any attempt to coil and stow the guide wire as it is partially or completely removed from the endoscope and patient.
  • FIGS. 1-8 illustrate one presently understood prior art technique for delivering and interchanging guide wires and components for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. More particularly, FIG. 1 illustrates an endoscopic assistant 20 preparing to deliver saline solution from a syringe 16 through a side channel, or port 28 within a hand actuated cutting instrument 18 having a catheter 32 . It is understood that catheter 32 is inserted into a port of an endoscope that has already been introduced through the mouth of the patient having lumenetic stints into the patient to a location proximate a treatment site. Catheter 32 is delivered through the lumen to the treatment site so that the saline solution is delivered to the treatment site.
  • ERCP Endoscopic Retrograde Cholangio-Pancreatography
  • a cutting actuator on instrument 14 is gripped with a hand 24 of assistant 20 to hold port 28 in a desirable position while syringe 16 is inserted therein.
  • a coil 12 of guide wire 10 is held by the same hand 22 that holds syringe 16 in preparation for a next step that must be performed by the endoscopic assistant.
  • the use of hand 22 to actuate syringe 16 while concurrently holding coil 12 can prove to be awkward at best.
  • FIG. 2 illustrates an endoscopist 34 supporting an endoscope 30 via a left hand 38 that is inserted into a patient's mouth.
  • a right hand 36 is holding catheter 32 which is inserted into a channel, or open port 31 of endoscope 30 .
  • Endoscopist 34 is waiting for the endoscopic assistant to uncoil the guide wire (as shown in FIG. 3 ).
  • FIG. 3 illustrates the endoscopic assistant 20 attempting to insert guide wire 10 into port 26 of catheter 32 while holding instrument 14 with hand 24 and, at the same time, holding coil 12 with hand 22 . It becomes difficult for endoscopic assistant 20 to uncoil coil 12 without unraveling the coil while they are attempting to feed guide wire 10 to the endoscopist.
  • FIG. 4 illustrates the endoscopist 34 waiting for catheter 32 and guide wire 10 to be fed forward while the assistant is having a difficult time uncoiling the guide wire 10 without having the guide wire uncoil (as depicted in FIG. 3 ).
  • FIG. 5 illustrates the endoscopic assistant 20 while they attempt to remove guide wire 10 from catheter 32 on instrument 14 via port 26 .
  • Left hand 24 is busy holding instrument 14
  • right hand 22 is used to attempt a single-handed coiling of coil 12 which proves to be difficult, if not impossible. If this coiling is not performed successfully, the guide wire will touch the floor and cause contamination of the floor with bodily fluids.
  • FIG. 6 illustrates the endoscopist 34 waiting for the endoscopic assistant of FIG. 5 while they attempt to coil guide wire 10 during removal of guide wire 10 from catheter 32 .
  • FIG. 7 illustrates a typical storage cart that is provided on an endoscopy suite floor for use by an endoscopic assistant when storing a guide wire 10 .
  • guide wire 10 has been attempted to be presented in the shape of a coil 12 .
  • coil 12 tends to unwind as guide wire 10 tends to maintain a linear shape due to the elastic memory in guide wire 10 .
  • syringes 16 can be stored atop cart 40 .
  • FIG. 8 illustrates an alternative means of storing coil 12 of guide wire 10 within a tray 42 atop cart 40 .
  • coil 12 tends to unravel and guide wire 10 can be left to overhang the top of cart 14 or touch the floor, which will contaminate the guide wire that may need to go back into the patient.
  • bodily fluids can drip from guide wire 10 over the edge of cart 40 onto the endoscopy suite floor which is undesirable.
  • An ERCP component support belt is provided for use by an endoscopic assistant to facilitate improved handling and storage of components that are coiled, uncoiled, stowed and retrieved during an ERCP procedure, usually as different components, or instruments, are used in alternating modes.
  • an article for retaining components of an endoscopic retrograde cholangio-pancreatography delivery system.
  • the article includes a body-encircling belt and an ERCP component retainer.
  • the ERCP component retainer is affixed to the belt.
  • the retainer has a pair of material strips connected together at one end with opposed inner surfaces.
  • An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • a guide wire storage device for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system.
  • the device includes a belt and a fastener.
  • the belt has a pair of opposed distal ends and is sized to encircle a wearer.
  • the fastener is affixed to the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • a component storage device for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system.
  • the component storage device includes a belt, a first ERCP component retainer, and a second ERCP component retainer.
  • the belt is configured to encircle a wearer.
  • the first ERCP component retainer is affixed to a right lateral anterior portion of the belt.
  • the retainer has a pair of material strips connected together at one end with opposed inner surfaces. An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • the second ERCP component retainer is affixed to a left lateral anterior portion of the belt.
  • the retainer has a pair of material strips connected together at one end with opposed inner surfaces.
  • An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • FIG. 1 is a partial perspective view of an endoscopic assistant attempting to hold a coiled ERCP guide wire while simultaneously injecting saline solution with a syringe into a catheter that is inserted through an endoscope within a patient, according to a prior art technique.
  • FIG. 2 is a partial perspective view of an endoscopist feeding a catheter into an open port on an endoscope that is placed within a patient, according to a prior art technique, and illustrating how the endoscopist has to wait for the assistant to uncoil the catheter before being able to further deliver the catheter into the endoscope.
  • FIG. 3 is a partial perspective view of the endoscopic assistant of FIG. 1 attempting to insert the guide wire into an open port of the catheter without unraveling the coil that is held in one hand to deliver the guide wire to the endoscopist for delivery into the endoscope and patient, according to a prior art technique.
  • FIG. 4 is a partial perspective view of the endoscopist waiting for the assistant to feed the guide wire and catheter of FIG. 3 so the endoscopist can feed the guide wire and catheter through an endoscope within a patient, according to a prior art technique.
  • FIG. 5 is a partial perspective view of the endoscopic assistant attempting to remove the guide wire from the catheter and while concurrently attempting to coil the guide wire with one hand during removal of the guide wire from a catheter within an endoscope in a patient, according to a prior art technique.
  • FIG. 6 is a partial perspective view of the endoscopist waiting for the assistant to coil the guide wire of FIG. 5 so the endoscopist can continue to remove the catheter and guide wire from within a patient via an endoscope, according to a prior art technique.
  • FIG. 7 is a perspective view of a surgical storage rack for storing syringes, guide wires and other components during an ERCP procedure, according to a prior art technique, illustrating how the guide wire uncoils and tends to tangle and drip liquids onto the endoscopy suite floor.
  • FIG. 8 is a perspective view of a pan and surgical storage rack for storing syringes, guide wires and other components during an ERCP procedure, according to a prior art technique, illustrating how the guide wire uncoils and tends to leave the pan and drip liquids onto the endoscopy suite floor.
  • FIG. 9 is a side elevational view of an endoscopic assistant's belt for storing components of an ERCP system, according to one aspect of the present invention.
  • FIG. 10 is an enlarged breakaway side elevational view of a portion of the belt of FIG. 9 having a fastener for stowing a coiled ERCP guide wire.
  • FIG. 11 is a further enlarged side elevational view of the fastener taken from the encircled region 11 of FIG. 10 .
  • FIG. 12 is a view corresponding with that of FIG. 11 depicting opening of the fastener during placement and/or removal of the coiled guide wire.
  • FIG. 13 is a partial perspective view of the endoscopic assistant wearing the belt of FIGS. 9-12 and ready for surgery by storing various components of an ERCP system on the belt.
  • FIG. 14 is an enlarged view over that depicted in FIG. 13 of the belt and stored components.
  • FIG. 15 is partial perspective view of an endoscopic assistant injecting saline solution with a syringe into a catheter that is inserted through an endoscope within a patient while the coiled guide wire and syringes are securely stored on the assistant's belt.
  • FIG. 16 is a partial perspective view of an endoscopist feeding a catheter that is receiving saline solution into an open port on an endoscope that is placed within a patient and illustrating delivery of the catheter into the endoscope by the endoscopist.
  • FIG. 17 is a partial perspective view of the endoscopic assistant of FIG. 15 feeding the coiled guide wire on the belt into an open port on the catheter for delivery into the endoscope and patient while a remaining portion of the guide wire is coiled on the belt.
  • FIG. 18 is a partial perspective view of the endoscopist feeding the catheter and guide wire in a timely manner as the assistant uncoils and feeds the guide wire into the catheter so the endoscopist can feed the catheter and guide wire through an endoscope and into a patient.
  • FIG. 19 is a partial perspective view of the endoscopist removing a catheter from over a guide wire that has been placed within a patient via an endoscope, with an assistant removing the guide wire from the catheter and coiling and storing the guide wire in a timely manner so the endoscopist is not overly delayed.
  • FIG. 20 is a partial perspective view of the endoscopic assistant retrieving the guide wire from the catheter during removal of the guide wire and catheter from within an endoscope in a patient by the endoscopist of FIG. 19 , and further illustrating storage of a portion of the guide wire in a coil on the belt.
  • FIG. 21 is a partial perspective view of the endoscopic assistant of FIG. 20 retrieving a remaining portion of the guide wire with two hands prior to coiling the remaining portion and storing it on the belt.
  • FIG. 22 is a partial perspective view of the endoscopic assistant with all the ERCP components retrieved and stored on the belt, including the coiled and stored guide wire.
  • FIG. 9 illustrates an article 50 of clothing for retaining components of an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system.
  • Article 50 includes a flexible belt 52 , a buckle 54 , a plurality of retainers 60 , 62 , and 64 , and a syringe holster 66 .
  • buckle 54 comprises a pair of mating male and female connectors 56 and 58 , respectively.
  • belt 52 comprises a body-encircling belt of flexible material, such as synthetic or Nylon webbing. Alternatively, leather, plastic, rubber strips or webs, or any other suitable material can be used.
  • Retainers 60 , 62 and 64 each provide an ERCP component retainer affixed to belt 52 .
  • Syringe holster 66 provides another retainer for releasably holding ERCP components.
  • guide wire 10 is stored in the form of a coil 12 by retainer 60 .
  • a cutting instrument 14 is also stored by coiling a catheter portion 32 which is releasively held by retainer 62 .
  • another catheter, or guide tube 32 is stored as a coil by retainer 64 .
  • Four different syringes 16 are stored within elastic slots in syringe holster 66 on belt 52 .
  • FIG. 10 illustrates in enlarged detail coil 12 of guide wire 10 being supported by retainer 60 on apparatus 50 .
  • FIG. 11 illustrates in further enlarged detail the use and construction of retainer 60 .
  • retainer 60 comprises a pair of material strips 70 and 72 that have on opposed inner surfaces a strip of hook fasteners 74 and a strip of loop fasteners 76 , respectively. When pressed together, the hook fastener 74 releasably attached with the loop fastener 76 to retain together material strips 70 and 72 , while securing coil 12 of guide wire 10 therebetween.
  • Material strips 70 and 72 are connected together along a top end 84 by a hinge 82 that is formed when a stitched region 78 is joined together by sewing strips 70 and 72 directly onto belt 52 using an array of stitches 80 . Accordingly, a hinge 82 is formed between strips 70 and 72 , whereas a lower free end 86 of strips 70 and 72 can be separated apart about hinge 82 .
  • ERCP component retainers 60 , 62 and 64 are each affixed to belt 52 at distinct locations.
  • Each retainer 60 , 62 and 64 includes a pair of material strips 70 and 72 connected together at one end with opposed inner surfaces.
  • FIG. 12 further illustrates the manner in which strips 70 and 72 can be releasably separated by pulling apart hook fastener 74 from loop fastener 76 about hinge 82 . Accordingly, a top end 84 of strip 70 and 72 is secured together on belt 52 , whereas a bottom end 86 of strip 70 and 72 are releasably separated by pulling apart hook 74 from loop 76 . Such an operation can be done single-handedly by a user wearing belt 52 so as to store and retrieve loop 12 of guide wire 10 therebetween. Hence, retainer 60 on apparatus 50 provides an effective means for an endoscopic assistant to store and retrieve coil 12 of guide wire 10 from belt 52 .
  • material strips 70 and 72 are elongate with a large dimension extending transverse to a large dimension of belt 52 .
  • a top end of strips 70 and 72 are connected together via stitches which are further connected to belt 52 .
  • strip 72 is connected to belt 52 from a top end to a bottom end with stitches.
  • strip 72 can be affixed to belt 52 with adhesive, rivets, or any other form of suitable fasteners.
  • a free end of strip 70 is releasably attached to belt 52 via coaction of hook fasteners 74 with loop fasteners 76 .
  • hook fasteners 74 and loop fasteners 76 are formed from Velcro® fastener strips, available from Velcro USA Inc., 406 Brown Ave Manchester, N.H. 03103.
  • an endoscopic assistant is wearing apparatus 10 in a secured manner with the buckle 54 (see FIG. 10 ) provided in a back, lumbar region (not shown) of assistant 20 .
  • retainer 60 , 62 , 64 and holster 66 are situated on an anterior portion of assistant 20 .
  • Guide wire 10 is stowed as a coil 12 by retainer 60 where wire 10 can be easily secured and released using a single hand of assistant 20 .
  • Article 50 also supports tool 14 which includes a catheter 32 by way of retainer 62 .
  • another catheter 33 is supported by retainer 64 .
  • Retainer 62 and 64 can easily be manipulated using a single hand of assistant 20 .
  • syringe holster 60 is formed by sewing together an elastic strip of web material 67 at discrete spaced apart locations so as to provide stretchable retention loops 69 each configured to receive a respective syringe 16 therein.
  • retainer 60 , holster 66 , retainer 62 , and retainer 64 are substantially equal distance spaced apart along a frontal portion of apparatus 20 for relatively easy stowage and retrieval of coil 12 of guide wire 10 , catheter 32 , catheter 33 and syringes 16 by endoscopic assistant 20 .
  • retainers 60 , 62 and 64 With this configuration for retainers 60 , 62 and 64 , one retainer is affixed to a right lateral anterior portion of the belt and another pair of retainers is affixed to a left lateral anterior portion of the belt. This enables a user to affix a coiled guide wire on either side, which might depend on whether the user is dominantly right handed or left handed.
  • FIG. 15 illustrates the endoscopic assistant 20 wearing apparatus 50 after assistant 20 has retrieved a syringe using right hand 22 while holding instrument 14 with left hand 24 to facilitate placement of syringe 16 into side channel, or port 28 .
  • Coil 12 is shown stowed in retainer 60 for later retrieval by assistant 20 in a subsequent operation.
  • Syringe 16 has been retrieved from holster 60 in a single-handed operation using right hand 22 .
  • Instrument 14 and accompanying catheter 32 were previously retrieved from container 62 by assistant 20 .
  • FIG. 16 illustrates an endoscopist introducing catheter 32 , presumably along with a guide wire contained therein at a pace that corresponds with the endoscopic assistant's ability to unwind and feed the guide wire and catheter to the endoscopist for placement within open port 31 of endoscope 60 .
  • Endoscopist 34 utilizes a left hand 38 to support endoscope 60 at a distal end within a patient while using right hand 36 to feed catheter 32 (and the guide wire) into port 31 and endoscope 30 .
  • FIG. 17 illustrates endoscopic assistant 20 feeding guide wire 10 into side channel, or port 26 on instrument 14 which goes into catheter 32 and further to an endoscopist who places it into an endoscope (see FIG. 16 ).
  • Assistant's left hand 24 is used to hold instrument 14 while right hand 22 is used to feed guide wire 10 from coil 12 while coil 12 is further secured within retainer 60 .
  • FIG. 18 illustrates endoscopist 34 feeding catheter 32 and guide wire 10 into open port 31 of endoscope 30 as the endoscopic assistant feeds the guide wire 10 into catheter 32 .
  • FIG. 19 illustrates endoscopist 34 retrieving catheter 32 and guide wire 10 from open port 31 of endoscope 30 using right hand 36 to pull catheter 32 and guide wire 10 from open port 31 while supporting endoscope 30 using left hand 38 .
  • FIG. 20 illustrates endoscopic assistant 20 retrieving guide wire 10 to further coil guide wire 10 into coil 12 of retainer 60 while supporting instrument 14 using left hand 24 .
  • Such action occurs concurrently with the actions of endoscopist 34 in FIG. 19 .
  • the ability of assistant 20 to retrieve guide wire 10 through side channel 26 from catheter 32 speeds up the operations of endoscopist 34 in FIG. 19 .
  • retainer 60 further enables endoscopic assistant to single-handedly retrieve and coil guide wire 10 .
  • FIG. 21 further illustrates endoscopic assistant 20 grasping guide wire 24 with both hands after instrument 14 has been stowed in retainer 62 by coiling catheter 32 of instrument 14 and affixing it into retainer 62 . Additionally, catheter 33 has also been stored in retainer 64 . Endoscopic assistant 20 uses left hand 24 in combination with right hand 22 to form individual additional coils with guide wire 10 that are subsequently secured alongside coil 12 within retainer 60 . Accordingly, apparatus 50 further assists endoscopic assistant 20 in retaining and stowing coil 12 of guide wire 10 .
  • FIG. 22 illustrates endoscopic assistant 20 with loop 12 of guide wire 10 properly stowed in retainer 60 . Additionally, syringes 16 are stowed in holster 66 , whereas catheter 32 of instrument 14 is stowed in retainer 62 and catheter 33 is stowed in retainer 64 .
  • fasteners 60 , 62 and 64 can be constructed with alternative configurations.
  • each material strip can be provided by flexible magnetic strips that can be releasably mated and demated via magnetic attraction to stow and release a coiled ERCP component during a surgical operation.
  • any form of strips that can be mechanically, magnetically or electrically mated and demated along their respective surface lengths would provide a suitable fastener construction for releasably retaining coiled ERCP components.

Abstract

An article is provided for retaining components of an endoscopic retrograde cholangio-pancreatography delivery system. The article includes a body-encircling belt and an ERCP component retainer. The ERCP component retainer is affixed to the belt. The retainer has a pair of material strips connected together at one end with opposed inner surfaces. An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.

Description

    TECHNICAL FIELD
  • This invention pertains to apparatus for supporting in-use components of an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. More particularly, the present invention relates to a belt having retainers for releasably attaching instrument components of an ERCP system, such as guide wires, tubes and catheters.
  • BACKGROUND OF THE INVENTION
  • Endoscopic Retrograde Cholangio-Pancreatography (ERCP) utilizes an endoscope with a catheter and a guide wire. A guide wire is place into position through a catheter that has been delivered via an open channel of the endoscope to a desired location within a patient. Afterwards, the guide wire can be used to further deliver instruments that are delivered about the guide wire to the desired location within the patient.
  • During surgical procedures to place and remove a guide wire, an endoscopic assistant is required to stow and retrieve the guide wire in a manner that is not going to contaminate the guide wire as it will later be inserted into the patient. In some cases, technicians attempt to coil the guide wires during removal and storage. However, the guide wires are made from a springy material that tends to straighten out into a linear configuration, thereby tending to uncoil if they are not held in a coil configuration. Furthermore, during a typical surgical procedure, the endoscopic assistant has their hands full which further complicates any attempt to coil and stow the guide wire as it is partially or completely removed from the endoscope and patient.
  • FIGS. 1-8 illustrate one presently understood prior art technique for delivering and interchanging guide wires and components for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. More particularly, FIG. 1 illustrates an endoscopic assistant 20 preparing to deliver saline solution from a syringe 16 through a side channel, or port 28 within a hand actuated cutting instrument 18 having a catheter 32. It is understood that catheter 32 is inserted into a port of an endoscope that has already been introduced through the mouth of the patient having lumenetic stints into the patient to a location proximate a treatment site. Catheter 32 is delivered through the lumen to the treatment site so that the saline solution is delivered to the treatment site. A cutting actuator on instrument 14 is gripped with a hand 24 of assistant 20 to hold port 28 in a desirable position while syringe 16 is inserted therein. At the same time, a coil 12 of guide wire 10 is held by the same hand 22 that holds syringe 16 in preparation for a next step that must be performed by the endoscopic assistant. The use of hand 22 to actuate syringe 16 while concurrently holding coil 12 can prove to be awkward at best.
  • FIG. 2 illustrates an endoscopist 34 supporting an endoscope 30 via a left hand 38 that is inserted into a patient's mouth. A right hand 36 is holding catheter 32 which is inserted into a channel, or open port 31 of endoscope 30. Endoscopist 34 is waiting for the endoscopic assistant to uncoil the guide wire (as shown in FIG. 3). FIG. 3 illustrates the endoscopic assistant 20 attempting to insert guide wire 10 into port 26 of catheter 32 while holding instrument 14 with hand 24 and, at the same time, holding coil 12 with hand 22. It becomes difficult for endoscopic assistant 20 to uncoil coil 12 without unraveling the coil while they are attempting to feed guide wire 10 to the endoscopist. FIG. 4 illustrates the endoscopist 34 waiting for catheter 32 and guide wire 10 to be fed forward while the assistant is having a difficult time uncoiling the guide wire 10 without having the guide wire uncoil (as depicted in FIG. 3).
  • FIG. 5 illustrates the endoscopic assistant 20 while they attempt to remove guide wire 10 from catheter 32 on instrument 14 via port 26. Left hand 24 is busy holding instrument 14, while right hand 22 is used to attempt a single-handed coiling of coil 12 which proves to be difficult, if not impossible. If this coiling is not performed successfully, the guide wire will touch the floor and cause contamination of the floor with bodily fluids. FIG. 6 illustrates the endoscopist 34 waiting for the endoscopic assistant of FIG. 5 while they attempt to coil guide wire 10 during removal of guide wire 10 from catheter 32.
  • FIG. 7 illustrates a typical storage cart that is provided on an endoscopy suite floor for use by an endoscopic assistant when storing a guide wire 10. More particularly, guide wire 10 has been attempted to be presented in the shape of a coil 12. However, coil 12 tends to unwind as guide wire 10 tends to maintain a linear shape due to the elastic memory in guide wire 10. Additionally, syringes 16 can be stored atop cart 40.
  • FIG. 8 illustrates an alternative means of storing coil 12 of guide wire 10 within a tray 42 atop cart 40. However, coil 12 tends to unravel and guide wire 10 can be left to overhang the top of cart 14 or touch the floor, which will contaminate the guide wire that may need to go back into the patient. In the case of both FIG. 7 and FIG. 8, bodily fluids can drip from guide wire 10 over the edge of cart 40 onto the endoscopy suite floor which is undesirable.
  • Accordingly, improvements are needed to help endoscopic assistants deliver, retrieve and stow guide wires for Endoscopic Retrograde Cholangio-Pancreatography (ERCP) systems.
  • SUMMARY OF THE INVENTION
  • An ERCP component support belt is provided for use by an endoscopic assistant to facilitate improved handling and storage of components that are coiled, uncoiled, stowed and retrieved during an ERCP procedure, usually as different components, or instruments, are used in alternating modes.
  • According to one aspect, an article is provided for retaining components of an endoscopic retrograde cholangio-pancreatography delivery system. The article includes a body-encircling belt and an ERCP component retainer. The ERCP component retainer is affixed to the belt. The retainer has a pair of material strips connected together at one end with opposed inner surfaces. An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • According to another aspect, a guide wire storage device is provided for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. The device includes a belt and a fastener. The belt has a pair of opposed distal ends and is sized to encircle a wearer. The fastener is affixed to the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • According to yet another aspect, a component storage device is provided for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. The component storage device includes a belt, a first ERCP component retainer, and a second ERCP component retainer. The belt is configured to encircle a wearer. The first ERCP component retainer is affixed to a right lateral anterior portion of the belt. The retainer has a pair of material strips connected together at one end with opposed inner surfaces. An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component. The second ERCP component retainer is affixed to a left lateral anterior portion of the belt. The retainer has a pair of material strips connected together at one end with opposed inner surfaces. An inner surface on one strip is covered with hook fasteners and an inner surface on another strip is covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • Preferred embodiments of the invention are described below with reference to the following accompanying drawings.
  • FIG. 1 is a partial perspective view of an endoscopic assistant attempting to hold a coiled ERCP guide wire while simultaneously injecting saline solution with a syringe into a catheter that is inserted through an endoscope within a patient, according to a prior art technique.
  • FIG. 2 is a partial perspective view of an endoscopist feeding a catheter into an open port on an endoscope that is placed within a patient, according to a prior art technique, and illustrating how the endoscopist has to wait for the assistant to uncoil the catheter before being able to further deliver the catheter into the endoscope.
  • FIG. 3 is a partial perspective view of the endoscopic assistant of FIG. 1 attempting to insert the guide wire into an open port of the catheter without unraveling the coil that is held in one hand to deliver the guide wire to the endoscopist for delivery into the endoscope and patient, according to a prior art technique.
  • FIG. 4 is a partial perspective view of the endoscopist waiting for the assistant to feed the guide wire and catheter of FIG. 3 so the endoscopist can feed the guide wire and catheter through an endoscope within a patient, according to a prior art technique.
  • FIG. 5 is a partial perspective view of the endoscopic assistant attempting to remove the guide wire from the catheter and while concurrently attempting to coil the guide wire with one hand during removal of the guide wire from a catheter within an endoscope in a patient, according to a prior art technique.
  • FIG. 6 is a partial perspective view of the endoscopist waiting for the assistant to coil the guide wire of FIG. 5 so the endoscopist can continue to remove the catheter and guide wire from within a patient via an endoscope, according to a prior art technique.
  • FIG. 7 is a perspective view of a surgical storage rack for storing syringes, guide wires and other components during an ERCP procedure, according to a prior art technique, illustrating how the guide wire uncoils and tends to tangle and drip liquids onto the endoscopy suite floor.
  • FIG. 8 is a perspective view of a pan and surgical storage rack for storing syringes, guide wires and other components during an ERCP procedure, according to a prior art technique, illustrating how the guide wire uncoils and tends to leave the pan and drip liquids onto the endoscopy suite floor.
  • FIG. 9 is a side elevational view of an endoscopic assistant's belt for storing components of an ERCP system, according to one aspect of the present invention.
  • FIG. 10 is an enlarged breakaway side elevational view of a portion of the belt of FIG. 9 having a fastener for stowing a coiled ERCP guide wire.
  • FIG. 11 is a further enlarged side elevational view of the fastener taken from the encircled region 11 of FIG. 10.
  • FIG. 12 is a view corresponding with that of FIG. 11 depicting opening of the fastener during placement and/or removal of the coiled guide wire.
  • FIG. 13 is a partial perspective view of the endoscopic assistant wearing the belt of FIGS. 9-12 and ready for surgery by storing various components of an ERCP system on the belt.
  • FIG. 14 is an enlarged view over that depicted in FIG. 13 of the belt and stored components.
  • FIG. 15 is partial perspective view of an endoscopic assistant injecting saline solution with a syringe into a catheter that is inserted through an endoscope within a patient while the coiled guide wire and syringes are securely stored on the assistant's belt.
  • FIG. 16 is a partial perspective view of an endoscopist feeding a catheter that is receiving saline solution into an open port on an endoscope that is placed within a patient and illustrating delivery of the catheter into the endoscope by the endoscopist.
  • FIG. 17 is a partial perspective view of the endoscopic assistant of FIG. 15 feeding the coiled guide wire on the belt into an open port on the catheter for delivery into the endoscope and patient while a remaining portion of the guide wire is coiled on the belt.
  • FIG. 18 is a partial perspective view of the endoscopist feeding the catheter and guide wire in a timely manner as the assistant uncoils and feeds the guide wire into the catheter so the endoscopist can feed the catheter and guide wire through an endoscope and into a patient.
  • FIG. 19 is a partial perspective view of the endoscopist removing a catheter from over a guide wire that has been placed within a patient via an endoscope, with an assistant removing the guide wire from the catheter and coiling and storing the guide wire in a timely manner so the endoscopist is not overly delayed.
  • FIG. 20 is a partial perspective view of the endoscopic assistant retrieving the guide wire from the catheter during removal of the guide wire and catheter from within an endoscope in a patient by the endoscopist of FIG. 19, and further illustrating storage of a portion of the guide wire in a coil on the belt.
  • FIG. 21 is a partial perspective view of the endoscopic assistant of FIG. 20 retrieving a remaining portion of the guide wire with two hands prior to coiling the remaining portion and storing it on the belt.
  • FIG. 22 is a partial perspective view of the endoscopic assistant with all the ERCP components retrieved and stored on the belt, including the coiled and stored guide wire.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • This disclosure of the invention is submitted in furtherance of the constitutional purposes of the U.S. Patent Laws “to promote the progress of science and useful arts” (Article 1, Section 8).
  • Reference will now be made to a preferred embodiment of Applicant's invention comprising an article, or belt, for retaining ERCP components during an ERCP procedure. While the invention is described by way of a preferred embodiment, it is understood that the description is not intended to limit the invention to such embodiment, but is intended to cover alternatives, equivalents, and modifications which may be broader than the embodiment, but which are included within the scope of the appended claims.
  • In an effort to prevent obscuring the invention at hand, only details germane to implementing the invention will be described in great detail, with presently understood peripheral details being incorporated by reference, as needed, as being presently understood in the art.
  • FIG. 9 illustrates an article 50 of clothing for retaining components of an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system. Article 50 includes a flexible belt 52, a buckle 54, a plurality of retainers 60, 62, and 64, and a syringe holster 66. According to one construction, buckle 54 comprises a pair of mating male and female connectors 56 and 58, respectively. Also according to one construction, belt 52 comprises a body-encircling belt of flexible material, such as synthetic or Nylon webbing. Alternatively, leather, plastic, rubber strips or webs, or any other suitable material can be used. Retainers 60, 62 and 64 each provide an ERCP component retainer affixed to belt 52. Syringe holster 66 provides another retainer for releasably holding ERCP components.
  • As shown in FIG. 9, guide wire 10 is stored in the form of a coil 12 by retainer 60. A cutting instrument 14 is also stored by coiling a catheter portion 32 which is releasively held by retainer 62. Similarly, another catheter, or guide tube 32 is stored as a coil by retainer 64. Four different syringes 16 are stored within elastic slots in syringe holster 66 on belt 52.
  • FIG. 10 illustrates in enlarged detail coil 12 of guide wire 10 being supported by retainer 60 on apparatus 50. More particularly, FIG. 11 illustrates in further enlarged detail the use and construction of retainer 60. More particularly, retainer 60 comprises a pair of material strips 70 and 72 that have on opposed inner surfaces a strip of hook fasteners 74 and a strip of loop fasteners 76, respectively. When pressed together, the hook fastener 74 releasably attached with the loop fastener 76 to retain together material strips 70 and 72, while securing coil 12 of guide wire 10 therebetween. Material strips 70 and 72 are connected together along a top end 84 by a hinge 82 that is formed when a stitched region 78 is joined together by sewing strips 70 and 72 directly onto belt 52 using an array of stitches 80. Accordingly, a hinge 82 is formed between strips 70 and 72, whereas a lower free end 86 of strips 70 and 72 can be separated apart about hinge 82.
  • Accordingly, ERCP component retainers 60, 62 and 64 are each affixed to belt 52 at distinct locations. Each retainer 60, 62 and 64 includes a pair of material strips 70 and 72 connected together at one end with opposed inner surfaces.
  • FIG. 12 further illustrates the manner in which strips 70 and 72 can be releasably separated by pulling apart hook fastener 74 from loop fastener 76 about hinge 82. Accordingly, a top end 84 of strip 70 and 72 is secured together on belt 52, whereas a bottom end 86 of strip 70 and 72 are releasably separated by pulling apart hook 74 from loop 76. Such an operation can be done single-handedly by a user wearing belt 52 so as to store and retrieve loop 12 of guide wire 10 therebetween. Hence, retainer 60 on apparatus 50 provides an effective means for an endoscopic assistant to store and retrieve coil 12 of guide wire 10 from belt 52.
  • According to one construction, material strips 70 and 72 are elongate with a large dimension extending transverse to a large dimension of belt 52. Also according to the one construction, a top end of strips 70 and 72 are connected together via stitches which are further connected to belt 52. Furthermore, strip 72 is connected to belt 52 from a top end to a bottom end with stitches. Alternatively, strip 72 can be affixed to belt 52 with adhesive, rivets, or any other form of suitable fasteners. A free end of strip 70 is releasably attached to belt 52 via coaction of hook fasteners 74 with loop fasteners 76. According to one construction, hook fasteners 74 and loop fasteners 76 are formed from Velcro® fastener strips, available from Velcro USA Inc., 406 Brown Ave Manchester, N.H. 03103.
  • As shown in FIG. 13, an endoscopic assistant is wearing apparatus 10 in a secured manner with the buckle 54 (see FIG. 10) provided in a back, lumbar region (not shown) of assistant 20. Accordingly, retainer 60, 62, 64 and holster 66 are situated on an anterior portion of assistant 20. Guide wire 10 is stowed as a coil 12 by retainer 60 where wire 10 can be easily secured and released using a single hand of assistant 20. Article 50 also supports tool 14 which includes a catheter 32 by way of retainer 62. Likewise, another catheter 33 is supported by retainer 64. Retainer 62 and 64 can easily be manipulated using a single hand of assistant 20.
  • As shown in FIG. 14, details of apparatus 50 can be more clearly seen. More particularly, syringe holster 60 is formed by sewing together an elastic strip of web material 67 at discrete spaced apart locations so as to provide stretchable retention loops 69 each configured to receive a respective syringe 16 therein. Also depicted in FIG. 14, retainer 60, holster 66, retainer 62, and retainer 64 are substantially equal distance spaced apart along a frontal portion of apparatus 20 for relatively easy stowage and retrieval of coil 12 of guide wire 10, catheter 32, catheter 33 and syringes 16 by endoscopic assistant 20. With this configuration for retainers 60, 62 and 64, one retainer is affixed to a right lateral anterior portion of the belt and another pair of retainers is affixed to a left lateral anterior portion of the belt. This enables a user to affix a coiled guide wire on either side, which might depend on whether the user is dominantly right handed or left handed.
  • FIG. 15 illustrates the endoscopic assistant 20 wearing apparatus 50 after assistant 20 has retrieved a syringe using right hand 22 while holding instrument 14 with left hand 24 to facilitate placement of syringe 16 into side channel, or port 28. Coil 12 is shown stowed in retainer 60 for later retrieval by assistant 20 in a subsequent operation. Syringe 16 has been retrieved from holster 60 in a single-handed operation using right hand 22. Instrument 14 and accompanying catheter 32 were previously retrieved from container 62 by assistant 20.
  • FIG. 16 illustrates an endoscopist introducing catheter 32, presumably along with a guide wire contained therein at a pace that corresponds with the endoscopic assistant's ability to unwind and feed the guide wire and catheter to the endoscopist for placement within open port 31 of endoscope 60. Endoscopist 34 utilizes a left hand 38 to support endoscope 60 at a distal end within a patient while using right hand 36 to feed catheter 32 (and the guide wire) into port 31 and endoscope 30.
  • FIG. 17 illustrates endoscopic assistant 20 feeding guide wire 10 into side channel, or port 26 on instrument 14 which goes into catheter 32 and further to an endoscopist who places it into an endoscope (see FIG. 16). Assistant's left hand 24 is used to hold instrument 14 while right hand 22 is used to feed guide wire 10 from coil 12 while coil 12 is further secured within retainer 60.
  • FIG. 18 illustrates endoscopist 34 feeding catheter 32 and guide wire 10 into open port 31 of endoscope 30 as the endoscopic assistant feeds the guide wire 10 into catheter 32.
  • FIG. 19 illustrates endoscopist 34 retrieving catheter 32 and guide wire 10 from open port 31 of endoscope 30 using right hand 36 to pull catheter 32 and guide wire 10 from open port 31 while supporting endoscope 30 using left hand 38.
  • FIG. 20 illustrates endoscopic assistant 20 retrieving guide wire 10 to further coil guide wire 10 into coil 12 of retainer 60 while supporting instrument 14 using left hand 24. Such action occurs concurrently with the actions of endoscopist 34 in FIG. 19. Accordingly, the ability of assistant 20 to retrieve guide wire 10 through side channel 26 from catheter 32 speeds up the operations of endoscopist 34 in FIG. 19. Hence, retainer 60 further enables endoscopic assistant to single-handedly retrieve and coil guide wire 10.
  • FIG. 21 further illustrates endoscopic assistant 20 grasping guide wire 24 with both hands after instrument 14 has been stowed in retainer 62 by coiling catheter 32 of instrument 14 and affixing it into retainer 62. Additionally, catheter 33 has also been stored in retainer 64. Endoscopic assistant 20 uses left hand 24 in combination with right hand 22 to form individual additional coils with guide wire 10 that are subsequently secured alongside coil 12 within retainer 60. Accordingly, apparatus 50 further assists endoscopic assistant 20 in retaining and stowing coil 12 of guide wire 10.
  • FIG. 22 illustrates endoscopic assistant 20 with loop 12 of guide wire 10 properly stowed in retainer 60. Additionally, syringes 16 are stowed in holster 66, whereas catheter 32 of instrument 14 is stowed in retainer 62 and catheter 33 is stowed in retainer 64.
  • It is understood that fasteners 60, 62 and 64 can be constructed with alternative configurations. For example, each material strip can be provided by flexible magnetic strips that can be releasably mated and demated via magnetic attraction to stow and release a coiled ERCP component during a surgical operation. Optionally, any form of strips that can be mechanically, magnetically or electrically mated and demated along their respective surface lengths would provide a suitable fastener construction for releasably retaining coiled ERCP components.
  • In compliance with the statute, the invention has been described in language more or less specific as to structural and methodical features. It is to be understood, however, that the invention is not limited to the specific features shown and described, since the means herein disclosed comprise preferred forms of putting the invention into effect. The invention is, therefore, claimed in any of its forms or modifications within the proper scope of the appended claims appropriately interpreted in accordance with the doctrine of equivalents.

Claims (20)

1. An article for retaining components of an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) delivery system, comprising:
a body-encircling belt of flexible material; and
an ERCP component retainer affixed to the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
2. The article of claim 1, wherein the pair of material strips are elongate with a large dimension transverse to a large dimension of the belt.
3. The article of claim 2, wherein the connected together one end of the strips is a top end, and one of the one strip and the another strip is affixed to the belt, and a bottom end of another of the one strip and the another strip is a free end that is releasably attached to the belt via coaction of the hook fasteners and the loop fasteners.
4. The article of claim 1, wherein the hook fasteners and the loop fasteners are made from Velcro fastening material.
5. The article of claim 1, further comprising at least two ERCP component retainers affixed to the belt each having a pair of material strips connected together at one end with opposed inner faces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
6. The article of claim 5, wherein one ERCP component retainer is provided for retaining an ERCP guide wire.
7. The article of claim 6, wherein another ERCP component retainer is provided for retaining an ERCP instrument having a guide tube.
8. The article of claim 7, further comprising a syringe holster having a plurality of vertically-oriented elastic channels each configured to snuggly receive a tubular barrel of a respective syringe for storage and retrieval therefrom.
9. The article of claim 1, wherein the belt is a formed from a web of synthetic woven material terminating in a pair of free distal ends, and further comprising mating/demating buckle connectors provided respectively at the distal ends.
10. A guide wire storage device for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system, comprising:
a belt having a pair of opposed distal ends and sized to encircle a wearer; and
a fastener affixed to the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
11. The guide wire storage device of claim 10, wherein the faster comprises a pair of elongated material strips having a major axis perpendicular to a major axis of the belt.
12. The guide wire storage device of claim 11, wherein the pair of material strips are connected together along a top end and one of the strips is secured to the belt while another of the strips has a bottom end that is free to be separated and secured with the one strip on the belt.
13. The guide wire storage device of claim 10, wherein the belt comprises a web of woven material terminating at opposed distal ends.
14. The guide wire storage device of claim 13, wherein one distal end receives a first buckle connector and another distal end receives a second buckle connector configured to mate and demate with the first buckle connector.
15. The guide wire storage device of claim 14, wherein one of the first buckle connector and the second buckle connector is supported by the respective distal end at desired selected locations along the belt to adjust length of the belt between the first buckle connector and the second buckle connector.
16. The guide wire storage device of claim 10, wherein a plurality of retainers are provided on the belt.
17. The guide wire storage device of claim 10, wherein the retainer is provided on a lateral portion of the belt when the belt is secured about a user.
18. The guide wire storage device of claim 17, further comprising an elastic holster provided on an anterior portion of the belt configured to removably receive at least one syringe.
19. A component storage device for an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) system, comprising:
a belt having configured to encircle a wearer;
a first ERCP component retainer affixed to a right lateral anterior portion of the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component; and
a second ERCP component retainer affixed to a left lateral anterior portion of the belt having a pair of material strips connected together at one end with opposed inner surfaces, an inner surface on one strip covered with hook fasteners and an inner surface on another strip covered with loop fasteners that releasably attach to the hook fasteners to retain a coiled ERCP component.
20. The guide wire storage device of claim 19, further comprising a third retainer including a holster for retaining syringes affixed to a central anterior portion of the belt.
US11/739,541 2007-04-24 2007-04-24 Article for Retaining Components of an Endoscopic Retrograde Cholangio-Pancreatography Delivery System Abandoned US20080264993A1 (en)

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