fig1 illustrating the prior art , shows trocar 10 in phantom as it might be inserted into the peritoneal cavity 24 prior to cholescystectomy . trocar 10 , usually of 5 or 10 mm diameter , is a cylinder comprising valve 12 for initiating and maintaining insufflation and permitting desufflation of co 2 constituting the pneumoperitoneum . ordinary suction - irrigation tool 14 , comprising openings at both ends , is shown inserted in trocar 10 . suction - irrigation tool 14 is further depicted inserted into transverse incision 16 in cystic duct 20 . endoscopic catheter 18 is depicted as inserted in cystic duct 20 prior to commencement of cholangiography . the insertion or introduction of catheter 18 into cystic duct 20 , and ultimately into common bile duct 22 is , at best , a difficult and awkward maneuver . first , transverse incision 16 is made in cystic duct 20 , usually with microscissors . following the incision , suction - irrigation tool 14 , having been passed through trocar 10 , is inserted through incision 16 . this insertion may be attended with difficulty due to an undersized or misplaced incision . catheter 18 is then manipulated ( sometimes by two or more surgical personnel ) through suction - irrigation tool 14 into cystic duct 20 . catheter 18 must be sufficiently small and of the proper stiffness to negotiate the angular entrance required . subsequent bending and manipulation is also required for entrance of catheter 18 into common bile duct 22 . fig2 and 3 depict the preferred cholangiography catheter introducer 26 of the invention . tool 26 is generally 5 mm in diameter , corresponding to the smallest sized trocar with which it is to be used . in the event trocar 10 is of great internal diameter relative to the diameter of introducer tool 26 , gaskets and other gas sealing means , as are well known in the art , may be used to prevent gas leakage and assure integrity of the pneumoperitoneum . the introducer tool 26 of the invention comprises a cylinder which further comprises a hollow lumen . tool 26 comprises a length in the range of between approximately 25 and 35 cm . distal end 31 of introducer tool 26 comprises ovate aperture 28 in communication with the lumen of the tool . the plane of aperture 28 may coincide with the plane tangent to the cylinder of tool 26 , but may also lie 45 ° on either side of the plane . ovate aperture 28 is created by bending tool 26 90 ° and serving the bend at the tangent plane . spoon - like ovate aperture 28 and corresponding curve 29 thus form and serve as directional guides for proper catheter placement in the cystic duct 20 . as is apparent in fig2 and 3 , the plane of ovate aperture 28 is preferably parallel to the longitudinal axis 30 of introducer tool 26 . as is further apparent in fig2 , 5 , 6 , and 8 , distal tip 31 may project substantially beyond a plane a -- a &# 39 ; tangent to the outside surface of the cylinder of tool 26 . further , a line normal to the plane of ovate aperture and passing through its center would also be normal to longitudinal axis 30 . however , ovate aperture distal tip 31 of introducer tool 26 may further comprise a sharpened or lanceolate tip 32 , as depicted in fig4 and 5 . such a tip facilitates entrance into transverse incision 16 , especially when such incision is of insufficient width . fig6 and 7 illustrate an alternative embodiment of the invention in which the introducer tool 26 comprises a removably attachable tip on rod 34 , which rod 34 then fits within trocar 10 . as can be appreciated by those skilled in the art , all of the embodiments shown in the drawings and those encompassed by the present invention could be either tips on a rod or integral with the rod . the embodiment of fig6 and 7 is preferably made of a flexible plastic material which can be cut to form two side notches 36 allowing the end to be curved over with the notches glued or otherwise joined together . a pointed tip 38 is useful for entry into traverse incision 16 . fig8 and 9 illustrate yet another alternative embodiment of tool introducer 26 in which two distal end pieces 40 and 42 are glued or otherwise joined together at juncture 44 to allow for a curved distal end . as can be appreciated by those skilled in the art , many types of junctures and shapes are possible with this multiple piece embodiment . introducer tool 26 may comprise several materials . stainless steel and aluminum provide strength . on the other hand , since cholangiography normally requires removal of all unnecessary metal instruments from the field , the various plastics , generally including the thermoplastic and thermosetting plastics , are particularly suitable . polypropylene is a preferred material which is approved by the food and drug administration ( fda ). the use of plastic introducer tools , which are disposable , further lessens the risk of infection , both to the patient and others . other suitable materials will suggest themselves to those ordinarily skilled in the art . further , other uses and modifications of introducer tool 26 will suggest themselves to those ordinarily skilled in the art . for example , introducer tool 26 may be used in other surgical applications requiring catheter insertion , such as arterial or urethral catheterization . a variety of catheters may be used therewith , including balloon catheters . although the invention has been described with reference to these preferred embodiments , other embodiments can achieve the same results . variations and modifications of the present invention will be obvious to those skilled in the art and it is intended to cover in the appended claims all such modifications and equivalents . the entire disclosures of all applications , patents , and publications cited above , and of the corresponding application are hereby incorporated by reference .
the disclosure is directed to a cholangiography catheter insertion tool , or introducer . in the preferred embodiment , the tool comprises a hollow cylinder with an ovate directional aperture lying in the plane of a tangent to the cylinder and parallel to the longitudinal axis of the cylinder . also disclosed is a method of using the tool .