Chest tube insertion sheath

Abstract

A chest tube insertion device includes a semi-rigid curvilinear sheath body having a distal end and a proximal end, a lumen defined axially through the sheath body from the distal end to the proximal end, the lumen including a distal end opening at the distal end and a proximal end opening at the proximal end, and a tapered pneumostatic tube clamp at the distal end of the sheath body, the tube clamp including one or more clamp tabs angled radially inward toward the distal end opening. The chest tube insertion device is supported during insertion into the chest cavity by a stylet. The chest tube insertion device is also removable from a chest tube when a free end of the chest tube is positioned in the chest cavity of a patient.

What is claimed is: 
     
         1 . A chest tube insertion sheath apparatus, comprising:
 a sheath body having a distal end and a proximal end;   a lumen defined axially through the sheath body from the distal end to the proximal end, the lumen including a distal end opening at the distal end and a proximal end opening at the proximal end; and   a tapered tube clamp at the distal end of the sheath body, the tube clamp including one or more clamp tabs angled radially inward toward the distal end opening.   
     
     
         2 . The apparatus of  claim 1 , further comprising:
 a first groove on the sheath body extending from the distal end to the proximal end of the sheath body; and   a second groove on the sheath body extending from the distal end to the proximal end of the sheath body.   
     
     
         3 . The apparatus of  claim 2 , further comprising a first handle and a second handle positioned on the proximal end of the sheath body, the first handle positioned between the first groove and the second groove on a first side of the sheath body and the second handle positioned opposite the first handle between the first groove and the second groove on a second side of the sheath body. 
     
     
         4 . The apparatus of  claim 3 , further comprising:
 a first notch positioned on the proximal end of the sheath body and positioned at the first groove; and   a second notch positioned on the proximal end of the sheath body and positioned at the second groove.   
     
     
         5 . The apparatus of  claim 1 , wherein the sheath body is rigid. 
     
     
         6 . The apparatus of  claim 5 , wherein the sheath body is disposed about a curvilinear axis. 
     
     
         7 . The apparatus of  claim 6 , wherein at least a portion of the one or more clamp tabs are semi-flexible. 
     
     
         8 . A chest tube insertion apparatus, comprising:
 a sheath including a sheath body having a distal end and a proximal end, a lumen defined axially through the sheath body from the distal end to the proximal end of the sheath, and a tapered tube clamp at the distal end of the sheath body;   a stylet operable to be inserted and removed from the lumen of the sheath.   
     
     
         9 . The apparatus of  claim 8 , wherein the sheath body is disposed about a first curvilinear axis. 
     
     
         10 . The apparatus of  claim 9 , wherein the stylet is disposed about a second curvilinear axis, wherein the second curvilinear axis substantially matches at least a portion of the first curvilinear axis. 
     
     
         11 . The apparatus of  claim 10 , wherein the lumen includes a distal end opening at the distal end and a proximal end opening at the proximal end. 
     
     
         12 . The apparatus of  claim 11 , wherein the sheath further comprises:
 a collar positioned at the proximal end of the sheath body;   a first handle disposed on the collar; and   a second handle disposed on the collar opposite the first handle.   
     
     
         13 . The apparatus of  claim 12 , wherein the sheath further comprises:
 a first groove disposed on the sheath body and the collar extending between the proximal end and the distal end of the sheath, wherein at least a portion of the first groove is positioned between the first handle and the second handle; and   a second groove disposed on the sheath body and the collar extending between the proximal end and the distal end of the sheath, wherein at least a portion of the second groove is positioned between the first handle and the second handle opposite the first groove.   
     
     
         14 . The apparatus of  claim 13 , wherein the first groove is a first fracture line and wherein the second groove is a second fracture line. 
     
     
         15 . The apparatus of  claim 8 , wherein the tube clamp includes one or more clamp tabs angled radially inward toward the distal end opening. 
     
     
         16 . The apparatus of  claim 15 , wherein the tube clamp includes one or more clamp tab gaps between the one or more clamp tabs. 
     
     
         17 . The apparatus of  claim 16 , wherein the one or more clamp tabs includes a clamp tab hinge between the one or more clamp tabs and the sheath body. 
     
     
         18 . The apparatus of  claim 10 , wherein the stylet includes a stylet lumen disposed in the stylet and about the second curvilinear axis. 
     
     
         19 . A method of inserting a chest tube into a chest cavity of a patient, comprising:
 making an incision in a chest of the patient;   inserting a chest tube insertion apparatus into the chest cavity of the patient, the chest tube insertion apparatus comprising a sheath having a stylet installed in the sheath, the sheath including a sheath body having a distal end and a proximal end, a lumen defined axially through the sheath body from the distal end to the proximal end of the sheath, and a tapered tube clamp at the distal end of the sheath body;   positioning the chest tube insertion apparatus in the chest cavity;   removing the stylet from the sheath;   inserting the chest tube through the lumen of the sheath into the chest cavity; and   removing the sheath from the chest of the patient.   
     
     
         20 . The method of  claim 19 , wherein positioning the chest tube insertion apparatus includes rotating the chest tube apparatus inside the chest cavity via a first handle and a second handle positioned on the proximal end of the sheath body. 
     
     
         21 . The method of  claim 19 , further comprising separating the sheath from the chest tube. 
     
     
         22 . The method of  claim 19 , further comprising:
 inserting a guidewire into the chest cavity of a patient via a trochar,   wherein when the chest tube insertion apparatus is inserted into the chest cavity, the chest tube insertion apparatus includes a stylet lumen, and   wherein when the chest tube insertion apparatus is inserted into the chest cavity, a free end of the guidewire is inserted into the stylet lumen and the chest tube insertion apparatus is translated along the guidewire.