Saturday, February 26, 2011

Catheter


In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters . In most uses, a catheter is a thin, flexible tube ("soft" catheter), though in some uses, it is a larger, solid ("hard") catheter. A catheter left inside the body, either temporarily or permanently, may be referred to as an indwelling catheter. A permanently inserted catheter may be referred to as a permcath.

The ancient Syrians created catheters from reeds. "Katheter - καθετήρ" originally referred to an instrument that was inserted such as a plug. The word "katheter" in turn came from "kathiemai - καθίεμαι" meaning "to sit". The ancient Greeks inserted a hollow metal tube through the urethra into the bladder to empty it and the tube came to be known as a "katheter".

The modern application of the catheter was in use at least by 1868 when Dr. N.B.Sornborger patented the Syringe and Catheter (patent #73402) with features for fastening it to the body and controlling the depth of insertion.

A range of polymers are used for the construction of catheters, including silicone rubber, latex, and thermoplastic elastomers. Silicone is one of the most common choices because it is inert and unreactive to body fluids and a range of medical fluids with which it might come into contact. On the other hand, the polymer is weak mechanically, and a number of serious fractures have occurred in catheters. It is widely used, for example, in breast implants where failures by rupturing of the silicone shell are well attested. It is also used in Foley catheters where fractures have been reported, often requiring surgery to remove the tip left in the bladder.

David S. Sheridan was the inventor of the modern disposable catheter in the 1940s. In his lifetime he started and sold four catheter companies and was dubbed the "Catheter King" by Forbes Magazine in 1988. He is also credited with the invention of the modern "disposable" plastic endotracheal tube now used routinely in surgery. Prior to his invention, red rubber tubes were used, sterilized, and then re-used which often led to the spread of disease and also held a high risk of infection. As a result Mr Sheridan is credited with saving thousands of lives.

In the early 1900s, a Dubliner named Walsh and a famous Scottish urinologist called Norman Gibbon teamed together to create the standard catheter used in hospitals today. Named after the two creators, it was called the Gibbon-Walsh catheter.

The Gibbon and the Walsh catheters have been described and their advantages over other catheters shown. The Walsh catheter is particularly useful after prostatectomy for it drains the bladder without infection or clot retention. The Gibbon catheter has largely removed the necessity of emergency prostatectomy. It is also very useful in cases of urethral fistula. A simple procedure such as dilatation of the urethra and passage of a Gibbon catheter often causes the fistula to close. This catheter is also of use in the treatment of urethral stricture and, as a temporary measure, in the treatment of retention of urine caused by carcinoma of the prostate