WO2024240608A1 - Intubation system comprising a tube locking device, laryngoscope and tube - Google Patents

Abstract

The invention relates to an intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000), comprising a tube (102, 1002, 7002), a stylet (104), wherein the tube (102, 1002, 7002) can be at least partially pushed onto the stylet (104), a laryngoscope (106, 8006), comprising a spatula (108, 2008, 8008), wherein for insertion the stylet (104) can be pushed forward, together with the tube (102, 1002, 7002) which is pushed onto the stylet (104), relative to the spatula (108, 2008, 8008), and wherein the stylet (104), after insertion, can be pulled out of the tube (102, 1002, 7002), and a tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 7010, 8010, 9010), which is designed to prevent the tube (102, 1002, 7002) being pulled back relative to the spatula (108, 2008, 8008) when the stylet (104) is pulled back after being pushed out of the tube (102, 1002, 7002).

Description

Intubation system comprising a tube locking device, laryngoscope and tube

The present invention relates to an intubation system, a laryngoscope for an intubation system and a tube for an intubation system.

If a patient's respiratory function is impaired by a medical emergency such as an accident or illness, or if the patient's natural breathing is artificially restricted to perform an operation, it may be necessary to take measures to secure an airway. The gold standard for airway management is endotracheal intubation. During endotracheal intubation, a user usually inserts an endotracheal tube partially into the trachea through a patient's mouth. To do this, the user inserts the tube between the vocal cords of the larynx into the trachea and positions a distal end of the tube in a desired position within the trachea. The user then holds the tube in position so that it can be secured. A block cuff is attached to the tube just above the distal end and is inflated to secure it. In addition to securing the tube, this also seals the trachea and reduces the risk of aspiration. A ventilation device such as a ventilator or a resuscitation bag is then provided at the proximal end of the tube to enable ventilation of the patient.

Although endotracheal intubation is the gold standard for securing the airway, it causes many doctors great problems. Therefore, aids to simplify intubation are very popular. Intubations can also be complicated depending on the patient or the situation. For example, a patient may be bleeding or the larynx may not be easily visible. Aids are provided so that the airway can be secured as quickly as possible in an emergency situation.

A common tool for intubation is a laryngoscope. The laryngoscope can be used to make the larynx visible to facilitate intubation. The laryngoscope usually includes a handle and a spatula. The spatula allows the user to compress soft structures in the floor of the mouth, press down the lower jaw and push the tongue to the side. This gives the user a direct view into the larynx and allows them to see the vocal cords, for example. A light source and a Camera is provided. In this case, the larynx can be imaged and shown on a monitor, which further simplifies intubation.

Over time, different types of laryngoscopes have been developed. Basically, a distinction can be made between laryngoscopes that are intended for single use and those that can be used multiple times. The shape of the spatula can also vary. On the one hand, there are laryngoscopes with a straight spatula and, on the other hand, laryngoscopes with a curved spatula. With laryngoscopes with a straight spatula, the epiglottis is loaded with the spatula and pressed towards the handle to provide a view of the glottis. In adults, however, the upper incisors can easily be broken when the spatula is inserted into the mouth. This is not least why laryngoscopes of this type are more likely to be used on newborns and small children. In adults, however, laryngoscopes with a curved spatula have become more popular. These adapt better to the tongue and follow the shape of the throat. The spatula is guided in front of the epiglottis and the laryngoscope is pulled towards the handle of the laryngoscope. This raises the epiglottis and allows a view of the glottis. Basically, there are spatulas in different sizes, which are used depending on the patient's anatomy. This means that, for example, many different spatulas and/or laryngoscopes must be available in an ambulance.

Another common tool is a stylet, also called a stylet. This is inserted into the tube to give it shape and stability, making it easier to insert the tube into the airway. Once the stylet is in position in the tube, the stylet can be used to guide the tube through the vocal cords and into the trachea. There are different types of stylets, including rigid stylets and flexible stylets. The rigid stylet is a straight wire, often made from metal or plastic, while the flexible stylet is made from a flexible plastic material that bends easily to follow the anatomical course of the airway. There are also flexible stylets, which have a distal section that can be bent by a user using controls. The flexible stylet is often used on children and patients with difficult anatomical conditions. A camera can also be attached to the stylet to image the patient's airway. Such a stylet is also called a video stylet and is a common aid, especially for difficult intubations. In addition, the video stylet makes it easier to position the tube in the trachea at the desired position. because a side wall of the trachea can be viewed and the tube can be positioned relative to anatomical structures.

After the tube has been inserted using the stylet, the stylet must be pulled out of the tube again so that the patient can be ventilated. It is important that the tube remains in the desired position and, in particular, is not pulled out of the trachea again. In order to be able to safely pull the stylet out of the tube again, the tube must therefore be fixed relative to the stylet. For example, a second user can pull out the stylet while the other user holds the laryngoscope with one hand and the tube with the other hand.

Last but not least, in emergency situations and/or in confined spaces, such as in an emergency vehicle, it can be difficult to have a second user to pull out the stylet. In addition, coordination between different users is generally complicated and often results in a lower quality of action. Furthermore, the cost of intubation can increase as more trained personnel must be on standby.

In general, the tube can usually move relative to the blade. An individual user may therefore have difficulty keeping the tube in position.

Based on the prior art, the invention is based on the object of providing an intubation system with high operational reliability and efficiency.

This object is achieved according to the invention by an intubation system, a laryngoscope and a tube as described herein and defined in the claims.

The present invention provides an intubation system comprising a tube, a stylet, wherein the tube can be pushed at least partially onto the stylet, a laryngoscope comprising a spatula, wherein the stylet can be pushed forward relative to the spatula together with the tube pushed onto the stylet for insertion, and wherein the stylet can be pulled out of the tube after insertion, and a tube locking device which is designed to prevent retraction of the tube relative to the spatula when the stylet is pulled back from the tube after being pushed forward. In addition, a laryngoscope for an intubation system according to the invention is provided.

In addition, a tube for an intubation system according to the invention is provided.

The features according to the invention make it possible to provide an intubation system with high operational reliability and efficiency. Advantageously, the intubation system can also be operated and/or handled safely and reliably by a single user. In addition, the tube can be prevented from moving from a position within the trachea when the stylet is pulled out. In particular, the risk of the tube being pulled out completely from the trachea is reduced. In particular, the user can be supported during complicated intubations. In addition, the operation of the intubation system is more cost-effective and/or efficient. In principle, fewer trained personnel need to be kept on hand because the intubation can be carried out independently by a user. In addition, it is advantageous that no other person is required if, in an emergency situation, the user has to carry out a difficult intubation, particularly unexpectedly. In addition, the accuracy and/or quality of the intubation can be improved because the user is supported by the intubation system. As a result, the user can concentrate more on the patient himself and does not have to devote as much concentration to the correct handling of the system as with conventional intubation systems.

The tube can be any standard tube. In particular, the tube can be an endotracheal tube. The tube can also be a laryngeal tube. The tube can be of different sizes and be intended for intubation of patients of all ages. Furthermore, the tube can include a blocking cuff near a distal end of the tube. The tube can be made of a plastic, in particular polyvinyl chloride (PVC).

The stylet can be any common stylet. The stylet can be a flexible and/or a rigid stylet. The stylet can comprise a distal section that can be moved, in particular by a movement mechanism. Furthermore, the stylet can have an outer diameter that essentially corresponds to an inner diameter of the tube. The stylet can also be treated with an agent that provides a sliding property between the stylet and the tube. In particular, friction between the stylet and the tube can be reduced.

The laryngoscope can be any common laryngoscope. In particular, the laryngoscope can be a modular laryngoscope. Modular can mean that the laryngoscope can be assembled and/or parts of the laryngoscope can be provided in particular for the patient and/or application. In general, the laryngoscope can be an instrument that supports the user in inserting the tube. The laryngoscope can comprise a handle at least in addition to the spatula and the spatula can be designed to be detachably connected to the handle. In particular, the spatula can be connected in a patient and/or application-specific manner. In addition, at least parts of the laryngoscope can be intended for single use. For example, the laryngoscope can comprise an imaging module and a base body. The base body can be formed in one piece and/or intended for single use. In particular, the laryngoscope can be made at least partially from a plastic, for example in an injection molding or additive manufacturing process. The base body can comprise a recording space into which the imaging module can be introduced. The laryngoscope can in particular be a video laryngoscope. An anatomical structure can be imaged using the video laryngoscope, whereby image data is generated that can be transmitted to a monitor and displayed by it. The user can view the anatomical structure on the monitor.

The spatula can be a curved or a straight spatula. The spatula can also be a hyperangulated spatula. This can mean that the spatula can have a greater bend than a conventional curved spatula. In general, the intubation system according to the invention is not limited to certain spatula geometries. Features of the spatula and/or the intubation system described herein can be combined with any spatula. The spatula can be made of a plastic and/or a metal. The spatula can also be disinfected, in particular wipe-disinfectable, and/or autoclavable. For example, the spatula can be prepared for use by cleaning it with a cloth.

In this context, insertion means that the tube can be inserted into the patient's trachea. The tube can be guided along the spatula together with the stylet. In particular, the tube can guide the spatula in sections. The tube and/or the stylet can be held by the user at a proximal end during insertion. Furthermore, insertion can also mean the positioning of the tube within the trachea. Positioning can include arranging a distal end of the tube relative to an anatomical feature, in particular a feature of the trachea, of the patient. Furthermore, markings can be provided on the tube to assist the user in estimating a position of the distal end of the tube within the trachea. The user can assess the position of the markings relative to the patient's incisors. The aim of insertion is to bring the tube into a specific position in which ventilation can be carried out. This position should be at least essentially tenable.

In particular, the position should be stable while the stylet is being pulled out of the tube. The tube locking device is provided for this purpose. The tube locking device can prevent the tube from being pulled back relative to the spatula, for example, in such a way that the position is at least substantially stable and/or can be fixed. In this context, deviations from the position of, for example, up to 5 cm, in particular up to 2 cm and/or preferably up to 1 cm below at least substantially stable are meant. In particular, preventing does not mean a complete absence of relative movement. Preventing can be understood to mean that by pulling the stylet out of the tube, a greater relative movement can be brought about between the stylet and the tube than between the tube and the spatula. In this way, it can be achieved that the tube remains in the trachea when the stylet is pulled back from the tube. According to the invention, it can be provided that after the stylet has been pulled back, the tube in the trachea is brought into the position suitable for ventilation. In particular, after retraction, the user can put down the stylet and position the tube with his or her now free hand.

Furthermore, the stylet can be a video stylet, in particular an endoscope, which comprises an at least substantially rigid shaft, wherein the tube can be pushed onto the shaft. Advantageously, the trachea can thereby be viewed during the insertion of the tube. In addition, a video stylet is particularly advantageous in complicated applications, in particular in the case of complicated patient anatomies and/or, for example, in the case of heavy bleeding of the patient. The video stylet can in particular be a bronchoscope. Substantially rigid can mean that the video stylet has such mechanical properties that it can be laterally deflected by a maximum of 20%, preferably by a maximum of 10% and preferably by a maximum of 5% in relation to its longitudinal extent during a particularly complicated insertion into the trachea. In other words, the shaft at least essentially retains its shape during insertion and is not bent and/or kinked.

In addition, the tube locking device can be modular and can be optionally attached to the spatula or removed from the spatula. For example, the tube locking device can be a stand-alone product. It can be provided that the user provides and/or attaches the tube locking device depending on the patient. In particular, any existing intubation system can be provided with the tube locking device. Advantageously, the tube locking device does not necessarily have to be attached to the spatula. The user can decide whether using the tube locking device is necessary and/or advantageous.

In addition, the spatula and/or the tube can at least partially form the tube locking device. Advantageously, the production costs can be reduced. A construction can be simple. In particular, it can be provided that the spatula is formed in one piece and comprises the tube locking device.

Furthermore, the spatula and the tube can jointly form the tube locking device. For example, features of the tube can advantageously interact with features of the spatula. Operating safety can be improved.

In addition, the tube can be selectively released by the tube locking device. Releasable can mean that the tube can be moved at least essentially arbitrarily, in particular freely, relative to the spatula. In particular, releasable can mean that the tube can be moved along its longitudinal axis in both directions along the spatula. Advantageously, it can be achieved that after the stylet has been retracted, the laryngoscope can be removed from the patient's mouth and/or larynx area, with the tube remaining in the trachea. This increases the operating safety of the intubation system. Furthermore, the tube locking device can have at least one operating element by means of which a locking state and/or a release state for the tube can be established. In the locking state, the tube is locked to the spatula in such a way that it is at least substantially immobile relative to the spatula. In particular, the tube can be movable together with the spatula in the locking state. For example, the user can align the tube by moving the spatula. Furthermore, the stylet can be pulled out of the tube in the locking state. In the release state, the tube can be movable relative to the spatula. In particular, the spatula can be removed from the patient's mouth and/or larynx area in the release state while the tube remains in the patient's trachea. Advantageously, the user can conveniently and/or easily change states for the tube by operating the operating element. The operability of the intubation system is improved and the user requires less effort and concentration to operate it. As a result, the quality of a user’s action may increase.

In addition, the tube can be subjected to a clamping force by operating the control element. In particular, the tube can be subjected to the clamping force in the locked state. Furthermore, the clamping force can be adapted to a tube and/or a tube-spatula combination. This can mean that it can react to the friction properties of the tube and/or the mechanical properties of the tube. By applying the clamping force, a simple construction can be achieved, whereby an intubation system that is safe to use and inexpensive can be provided. In particular, any conventional tube can be used with the intubation system. Different tubes can be reacted to by adjusting the clamping force, which improves the flexibility and versatility of the intubation system.

Furthermore, the operating element can have a clamping section that is opposite the spatula, so that the tube can be clamped between the clamping section and the spatula. The clamping section can be used to increase the area over which the clamping force acts. The clamping section can extend over a section of the tube. In particular, the clamping section can be designed in such a way that it simulates a shape of the spatula. Advantageously, the tube can be subjected to a homogeneous clamping force over the entire clamping section, at least essentially. This can mean that the pressure that is applied to the tube by the clamping section is at least essentially homogeneously distributed over the clamping section. The clamping section can for example, extend over up to 10 cm, in particular over up to 5 cm, preferably over up to 2 cm along the tube. Furthermore, the clamping section can be at least substantially adapted to an outer contour of the tube. This can mean that the clamping section is designed such that it at least partially has a curvature with a radius that at least substantially corresponds to a radius of the tube. Furthermore, the clamping section and/or the spatula, in particular the area of the spatula against which the tube can be clamped, can comprise a coating that increases a frictional force between the respective section and the tube. Furthermore, the coating can be deformable such that the corresponding section, in particular the coating, adapts to a shape of the tube when the tube is clamped. The risk of damaging the tube can be reduced by providing the clamping section. Furthermore, a higher clamping force can be applied without damaging the tube.

In addition, the operating element can be operated by means of an operating force, wherein the operating force can be converted into the clamping force. In particular, this means that the user applies the operating force. It can also mean that an electromechanical actuator, for example, is provided, by means of which the operating force can be applied. The user can, for example, operate the electromechanical actuator. According to the invention, the electromechanical actuator can also be activated automatically. Implementable can mean that a gear is provided. A lever arrangement can also be provided to implement the operating force. The user can dose the operating force according to the situation and/or as required. Furthermore, the user can receive information about the tube and/or the locking state by feeling resistance when applying the operating force. If the user notices, for example, that an operating force is not sufficient to create a locking state, he can react to this. Operating safety and efficiency are increased.

Furthermore, the operating element can comprise a lever which is arranged pivotably on the spatula. The lever can be arranged on the spatula in such a way that a clamping force can be applied to the tube by pulling the lever. In particular, the clamping force can be applied by clamping the tube between the operating element and the spatula. The lever can be arranged pivotably on the spatula about a pivot axis, wherein the pivot axis is at least substantially perpendicular to a The main extension direction of the spatula can correspond to the longitudinal direction of the tube during insertion. The user-friendliness is increased by the provision of the lever. Furthermore, this allows for an inexpensive and simple construction.

In addition, the laryngoscope can comprise the handle on which the spatula is arranged, and the operating element can comprise an actuating section which is arranged in a close region of the handle such that the user can actuate the actuating section while gripping the handle. In particular, this can mean that the user can actuate the actuating section with the hand with which he grips the handle. In particular, the user can actuate the actuating section with a finger, in particular the little finger or the index finger. Actuation can comprise pulling the operating element. User-friendliness can be increased in this way.

In addition, the lever can form the clamping section and the actuating section. In particular, the lever can be formed in one piece. The lever can be made from a plastic and/or a metal. In particular, the lever can be manufactured using an injection molding and/or additive manufacturing process. This can keep production costs low. In addition, the lever can be exchangeable if a different lever is required and/or the lever is defective. In addition, the lever can be removable for cleaning the intubation system. Assembly can therefore be simple, since the tube locking device can consist of just a few parts.

In addition, the tube locking device can be designed on one side. This can mean that the tube locking device is designed, mounted and/or arranged on just one, in particular a single, wall of the spatula. This means that operation and construction can be kept simple.

Furthermore, the tube locking device can be designed to act on the tube from at least two opposite sides of the tube. This can mean that the tube can extend at least partially between the tube locking device, in particular when the stylet is pulled out. Functional reliability can be increased in this way. In addition, usability can be made easier. Furthermore, the spatula can comprise a lateral tube guide wall and the tube locking device can be arranged on the tube guide wall. The spatula can, for example, comprise a main wall. The main wall can extend in the main extension direction of the spatula and at least essentially define it. A "main extension direction" of an object is to be understood in particular as a direction which runs parallel to a longest edge of a smallest imaginary cuboid which just completely encloses the object and which preferably runs through a geometric center and/or through a center of mass of the component. The functions of the laryngoscope can be provided at least essentially by means of the main wall. In the case of a straight laryngoscope, for example, the epiglottis can be charged by means of the main wall. The main wall can have a length of approximately 5 cm to 15 cm. Some lengths can deviate from this. The main wall can also extend in a direction which is at least essentially perpendicular to the longitudinal direction of the tube when it is inserted. In this direction, the main wall can extend over, for example, 1 cm to 5 cm, in particular over 2 cm to 3 cm. In particular, the extension in this direction can be a greater length than the diameter of the tube. Furthermore, the spatula, in particular the main wall, can be flat. This can mean that the main wall extends in a third direction over an at least substantially shorter length. A further wall can extend from the spatula. The further wall can be designed to partially accommodate an imaging device. In particular, the further wall can define a recording space for this purpose. Furthermore, a camera and/or a viewing window of the camera can be arranged at a distal end of this wall. The viewing window can comprise a lens arrangement. The wall can also be designed to push the patient's tongue away to the side. The tube guide wall can, for example, be part of this wall and/or be this wall. The tube guide wall can extend along the entire length of the spatula. In other embodiments, the tube guide wall can extend over, for example, up to 70%, in particular 80%, preferably up to 95% of the length of the spatula. Advantageously, the tube guide wall can be a wall of a conventional spatula. This can mean that the tube locking device can be attached to a wall of a conventional spatula. Advantageously, the tube locking device can be integrated into existing intubation systems by means of minor design measures. In addition, an arrangement on the lateral tube guide wall is advantageous, since there is a large extension in the lateral direction relative to the other directions. freedom of movement. A movement of the tube in a lateral direction can therefore be advantageous.

Furthermore, the tube locking device can comprise at least one rotatable locking element. In general, the locking element can be at least partially embedded in a wall of the spatula. Rotatable can in particular also comprise pivotable. The locking element can be rotationally symmetrical. In other embodiments, the locking element is not rotationally symmetrical. In particular, the locking element can be mounted eccentrically. According to other embodiments, the locking element can also be rotatable about, for example, two or three axes. The locking element can be provided for interaction with the tube. For this purpose, the locking element can comprise a coating, for example to increase friction. Rotatable locking elements have the advantage that they require a comparatively small installation space. Furthermore, constant rubbing of the tube on the locking element, as can occur with a non-rotatable locking element, can be at least largely avoided. Ease of use can be increased and the risk of damage to the tube reduced.

In addition, the locking element can have a locking direction of rotation and a release direction of rotation opposite to the locking direction of rotation. In the locking direction of rotation, turning the locking element can at least only be possible with a greater expenditure of force. In particular, turning in the locking direction of rotation may not be possible. Furthermore, in some embodiments, the locking element can be rotated in the locking direction of rotation until a lock occurs, for example by an angle of at most 90 degrees, at most 60 degrees, at most 45 degrees or at most 30 degrees. The position in which the lock occurs can be a locking position. In the locking direction of rotation, the locking element can at least substantially prevent the movement of the tube relative to the spatula. Incorrect operation can advantageously be at least largely avoided. This means that the operating safety of the intubation system can be increased.

In addition, the locking element can be rotatable about a rotation axis which, when the tube is advanced, is arranged in a region of the locking element at least substantially perpendicular to a longitudinal axis of the tube. This makes it possible to achieve a simple and space-saving construction. In addition, the rotatable locking element can comprise a clamp that is designed to prevent the tube from being pulled back relative to the spatula by clamping the tube. The clamp can comprise a clamping section that is intended in particular to interact with the tube. The clamp can comprise a coating and/or profiling to increase a clamping force, wherein the clamping force is a force that counteracts a movement of the tube out of the trachea. For example, the clamp can also comprise a serrated clamping section. In particular, the clamp can be activated in particular passively by pulling back the tube. This can mean that the clamp can be activated by the user pulling back the stylet between the clamp and the spatula. In this context, clamping can also be understood as blocking. This can mean that the locking element is designed to reduce a distance between the clamp and the spatula by pulling back the tube. The way the clamp works can, for example, at least essentially correspond to the way a rope clamp works. Advantageously, a tube locking device can be provided by relatively simple design measures. This can be characterized in particular by a small space requirement.

In addition, the rotatable locking element can comprise a guide roller for the tube. In addition, the tube locking device can comprise several guide rollers, for example two, three or four. The guide roller can have a width along its axis of rotation that corresponds at least to the diameter of the tube. In some embodiments, the guide roller can be wider than the diameter of the tube. Furthermore, the guide roller can comprise a recess perpendicular to the axis of rotation along the entire circumference. The recess can comprise a curvature with a radius that at least substantially corresponds to the radius of the tube. In particular, the guide roller can have a U-shaped and/or concave profile. Furthermore, the guide roller can comprise two lateral guide walls that are designed to guide the tube along the longitudinal axis of the tube. By providing at least one guide roller, a cost-effective intubation system can be provided. In addition, the guide roller can be arranged in a space-saving manner. In particular, a guide roller can be provided relatively easily embedded in the spatula.

Furthermore, the tube locking device can comprise a tensioning element which is arranged on the locking element and pre-tensions the locking element. The The clamping element can be designed to store potential energy and release it to prevent the tube from being pulled back along the spatula. The clamping element can also be deformed by pulling the tube back along the spatula. The deformation can increase the clamping force. In general, the clamping force can be increased by the clamping element. In particular, a higher clamping force can be achieved with the same installation space.

The tensioning element can also be a leg spring. Leg springs are particularly characterized by the small amount of space they require, they can be cost-effective and they are easy to design.

In addition, the tube locking device can comprise at least one projection that is designed to prevent the tube from being retracted by engaging behind at least part of the tube. In particular, the projection can be arranged on the spatula. Furthermore, the projection can be a distal end of the wall that includes the camera of the video laryngoscope. The tube can comprise a section that is designed to interact with the projection. The projection can also be understood as a mechanical stop. The tube can be pressed laterally against the mechanical stop by the user to prevent retraction. Preventing retraction by the projection and/or the mechanical stop is a simple and cost-effective method of preventing retraction. In addition, moving parts can be avoided. Furthermore, such an intubation system can be easy to clean, disinfect and/or autoclave.

In addition, the tube locking device can comprise a counter-holding element that is designed to prevent the tube from being pulled back by engaging behind at least part of the tube. The counter-holding element can be provided in addition to the projection. The counter-holding element can, for example, comprise a further projection. In addition, the counter-holding element can comprise a nose, in particular a plastic nose. Furthermore, the counter-holding element can comprise a pin, a bolt and/or the like. The counter-holding element can be mounted on the spatula. Furthermore, the counter-holding element can be formed by the spatula. The effect of the locking device can be improved by the counter-holding element. The probability of a malfunction can be reduced. In addition, this can be achieved by simple design measures in a small installation space. In addition, the counter-holding element can be arranged at a distance from the projection and the distance can correspond at least substantially to an outer diameter of the tube. The distance to the projection means in particular the smallest distance to the projection. The tube can extend between the projection and the counter-holding element, in particular along the longitudinal axis of the tube. The tube can touch the projection and the counter-holding element on opposite sides. The projection can, for example, comprise a step. The upper part of the step can be arranged proximally to the tube and the lower part of the step distally. The distance can, for example, be up to 3 cm, in particular up to 2 cm, preferably up to 1.5 cm. For example, frequently used spatulas can be paired with frequently used tubes. That is, a spatula that has a standard size can be provided with the counter-holding element at a distance from the projection that at least substantially corresponds to an outer tube diameter of a tube that is usually used with the spatula. Multiple tube sizes can be provided for a spatula. The counterholding element can be designed to make the distance adjustable. For example, the counterholding element can be eccentrically rotatable, whereby the distance can be changed by rotating the counterholding element. The tube can be guided more advantageously by such an arrangement. In particular, the tube can be guided along the longitudinal axis. This results in a lower risk of malfunction and greater operational reliability. The tube is easier to hold in a position in which part of the tube engages behind the projection.

In addition, the tube can comprise a circumferential widening and the circumferential widening can be gripped behind by at least part of the tube locking device. The circumferential widening can be formed by the tube and/or attached to the tube. In particular, the widening can be attached to the tube. For example, the widening can comprise a ring, an attachment, a projection, a bulge and/or the like. The widening can extend along the entire circumference. In other embodiments, the widening extends partially circumferentially. The widening can be displaceable in the longitudinal direction of the tube and/or a position in the longitudinal direction of the tube can be changed. In particular, the tube can be adapted to suit the patient, spatula and/or application. The flexibility and versatility of the tube and/or the intubation system can be improved. Furthermore, the intubation system can comprise at least one locking element, in particular a locking tongue, which can be moved by applying force in a first direction into a release position in which the locking element allows the stylet to be pushed forward together with the tube pushed onto the stylet relative to the spatula, and which can be moved by applying force in a second direction into a locking position in which the locking element prevents the tube from being retracted relative to the spatula. This can mean that the tube locking device is designed like a cable tie. The tube can be moved in one direction along the longitudinal axis and retraction can be prevented in the opposite direction in the locking position. The tube can be moved in the opposite direction into the locking position. This can mean that the tube can be moved in the first direction beyond the locking position. If the tube is moved in the opposite direction, the locking position can be reached again and further retraction can be prevented. In the locking position, the tube can be moved together with the spatula and/or at least be fixed to the spatula in a substantially immobile manner. In particular, the locking element can be movable in a direction radial to the longitudinal direction of the tube. The locking element can extend at least partially at an angle from the tube in an unloaded state. The locking element can be placed against the tube by a load in the radial direction. In particular, in an angled state, the locking element can be designed to prevent retraction. Furthermore, the locking element can be designed to prevent retraction up to a limit retraction force, the limit retraction force being a force that causes the tube to be retracted. Retraction can be possible above the limit retraction force. This can result in greater safety, since the user can, if necessary, apply a force that exceeds the limit retraction force. Furthermore, by providing the limit retraction force, the laryngoscope can be removed from the mouth and/or larynx area. In general, the provision of the locking element can provide an effective and efficient intubation system.

In addition, the tube locking device can comprise a plurality of locking projections, in particular locking teeth, which each define a locking position and which are arranged one behind the other along a longitudinal axis of the tube, and the locking element can be designed to prevent the tube from being pulled back by engaging behind at least one of the locking projections. Some features can be the same as some features in connection with the locking element. In particular, the Locking projections can be designed similarly to the locking tongues. In addition, the locking projections can be movable along the longitudinal axis of the tube. The locking projections can be movable in one direction in particular and less movable, in particular at least largely immobile, in a direction opposite to the direction. In addition, a stop and/or a wall can be provided, for example, which limits the mobility of the locking projections in one direction in particular. Such a tube locking device can be designed like a cable tie. By providing several locking positions, the versatility of the intubation system can be improved. It is possible to respond in a simple manner to patient anatomies and/or situations during use.

In addition, the tube locking device can comprise a retaining ring that is attached to the spatula, whereby the stylet can be pushed forward through the retaining ring relative to the spatula together with the tube pushed onto the stylet. The retaining ring can also be understood, for example, as a retaining tunnel and/or retaining channel. In particular, it can be understood as a device through which the tube can be passed and/or which can at least largely completely enclose the tube. The retaining ring can extend, for example, by up to 10 cm, in particular by up to 5 cm and/or preferably by up to 2 cm along the longitudinal direction of the tube. This can provide a high level of operational reliability and a safe intubation device.

In addition, the tube locking device can be designed to prevent the tube from being retracted by applying a frictional force to the tube. The frictional force can be brought about, for example, by contacting the spatula with the tube. The tube can be provided for contacting at least in sections. For example, the tube can comprise a frictional force-inducing attachment for this purpose, wherein the frictional force-inducing attachment can be pushed and/or slid onto the tube. Furthermore, the tube can be retracted by an adhesive interaction between the tube and the spatula. Such a tube locking device can be designed similarly to a tube locking device that is designed to prevent retraction by the frictional force. Both offer the advantage of a simple construction. Furthermore, in both cases it can be avoided that sharp edges in particular have to be provided. Sharp edges can cause injury to the patient. In addition, the tube locking device can comprise at least one rubberized, profiled and/or rough surface. This can be used to create the frictional force. Such a surface can be provided at least in sections on the tube and/or at least in sections on the spatula. Furthermore, a surface pairing can be provided on the tube and spatula, which is designed to increase the frictional force. The surface can be made of a metal, a plastic and/or a composite material. In particular, the surface can be made of rubber and/or a rubber-like material. A band, a jacket and/or the like comprising the surface can be attached to the tube. The band, the jacket and/or the like can extend, for example, up to 10 cm, in particular up to 5 cm, preferably up to 2 cm, along the longitudinal direction of the tube. In particular, the tube locking device can comprise a rubber band that can be arranged on the tube. Such a design measure can be integrated into conventional intubation systems. Furthermore, it is cost-effective and can be provided in a very small installation space.

In addition, the tube locking device can comprise at least one clamp into which the tube can be hooked. The clamp can be designed to clamp the tube on one side, two sides and/or multiple sides. In particular, the clamp can be designed to apply a clamping force to the tube. The tube can be subjected to the clamping force in such a way that the tube can be held between the spatula and the clamp. In particular, the tube can be clamped against the spatula. Furthermore, the tube can be clamped between two clamp elements. The clamp, in particular the clamp elements, can at least partially clamp the tube. The clamp and the spatula and/or the clamp elements can be arranged at a distance from one another by a clamp distance when the tube is not hooked in. This can define an opening. The clamp distance and/or the opening can be at least substantially smaller than the outer diameter of the tube. The clamp can be movable and/or elastically deformable at least in sections. As a result, the clamp spacing and/or the opening for hooking the tube can be increased. In particular, the clamp can be designed like a pipe clamp and/or a pipe clamp. The clamp can comprise a coating on a surface, in particular the inside, wherein the surface faces the tube in a hooked state. In particular, hookable can be understood to mean that the tube can be hooked as required and/or optionally. For example, the User can hook the tube. In particular, the user can hook the tube after the tube has been inserted into the trachea, for example. The clamp can achieve a high level of reliability of the tube locking device.

In addition, the tube can be hooked into the clamp from the side and unhooked from the clamp from the side. Lateral can mean in particular at least substantially perpendicular to the longitudinal direction of the tube and/or the main extension direction of the spatula. The opening can open laterally to the longitudinal direction of the tube. In the lateral direction, there is greater freedom of movement in the patient's oral cavity. This can reduce the risk of injury to the patient when hooking and/or unhooking.

In addition, the tube locking device can comprise a clamping spring that is designed to prevent the tube from being pulled back by clamping. Furthermore, the tube locking device can comprise a clamping element that is pressed against the tube by the clamping spring in order to clamp the tube. Furthermore, the clamping spring itself can press against the tube at least in sections in order to clamp the tube. The clamping spring can comprise a spiral spring, a ring spring, a disc spring and/or the like. This can advantageously provide a cost-effective intubation system.

In addition, the spatula can comprise a lateral tube guide wall and the clamping spring can be designed to press the tube against the tube guide wall by applying a lateral force for clamping. In the lateral direction, there is greater freedom of movement in the patient's oral cavity. This can reduce the risk of injury to the patient when hooking and/or unhooking. Furthermore, the space required for the tube locking device can be reduced.

In particular, the clamping spring can be a leaf spring. This makes it easy to clamp the tube over a relatively large contact surface between the clamping spring and the tube. The leaf spring can be fastened to at least two fastening elements on the spatula. The fastening elements can include, for example, a nose, in particular a plastic nose, a pin and/or a bolt. In addition, the fastening elements can be formed by the spatula. In addition, the stylet can be withdrawn from the tube by a single user using two hands. In particular, this can reduce the cost of using an intubation system, particularly financial and/or time-related, as no other user needs to be available. Furthermore, the efficiency of the intubation system can be increased. In addition, the quality of using an intubation system can be improved as coordination between at least two users can increase complexity. In addition, it is possible to react spontaneously and/or flexibly to complicated situations. In particular, this can be done even if no other, particularly trained, user is present.

The present invention is described below by way of example with reference to the attached figures. The drawing, the description and the claims contain numerous features in combination. The person skilled in the art will expediently also consider the features individually and use them in combination as appropriate within the scope of the claims.

If there is more than one example of a particular object, only one of them may be provided with a reference symbol in the figures and in the description. The description of this example can be transferred to the other examples of the object accordingly. If objects are named in particular using numerical words, such as first, second, third object, etc., these serve to name and/or assign objects. Accordingly, for example, a first object and a third object, but not a second object, can be included. However, a number and/or sequence of objects could also be derived using numerical words.

They show:

Fig. 1A a laryngoscope in a schematic side view;

Fig. 1 B the laryngoscope in a schematic view from the front;

Fig. 1 C the laryngoscope in a schematic view from behind;

Fig. 1 D the laryngoscope in a schematic view from below;

Fig. 2 is a schematic view of a tube and a video stylet; Fig. 3 is a schematic view of the tube and a stylet;

Fig. 4 is a schematic view of a portion of a tube;

Fig. 5A is a schematic bottom view of a laryngoscope and tube;

Fig. 5B is a schematic view from below of the laryngoscope and the

tube;

Fig. 6 is a schematic view from below of another embodiment of an intubation system;

Fig. 7 is a sectional view of the intubation system from a proximal side;

Fig. 8 is a schematic bottom view of an intubation system;

Fig. 9 is a schematic bottom view of an intubation system;

Fig. 10A is a schematic bottom view of another embodiment of an intubation system;

Fig. 10B is a sectional view of the intubation system from a proximal side;

Fig. 11 is a schematic bottom view of an intubation system;

Fig. 12 is a schematic bottom view of an intubation system;

Fig. 13 is a schematic view from below of another embodiment of an intubation system;

Fig. 14 is a sectional view of the intubation system from a proximal side;

Fig. 15 an alternative embodiment of the tube locking device; Fig. 16 a further development of the intubation system in a sectional view from a distal side;

Fig. 17A shows a tube of another embodiment of an intubation system;

Fig. 17B the tube in another view;

Fig. 18A is a cross-sectional view of the intubation system;

Fig. 18B is a schematic bottom view of the intubation system;

Fig. 19A is a perspective schematic view of an intubation system;

Fig. 19B is a schematic front view of the intubation system;

Fig. 19C is a schematic side view of the intubation system;

Fig. 20A is a perspective schematic view of an intubation system;

Fig. 20B is a schematic front view of the intubation system;

Fig. 20C is a schematic side view of the intubation system;

Fig. 21 A is a schematic view from below of another embodiment of an intubation system; and

Fig. 21 B is a sectional view of a distal side of the intubation system.

Figures 1A to 1D show various schematic views of a laryngoscope 106 that is part of an intubation system 100. In Fig. 1A, the laryngoscope 106 can be seen in a side view, in Fig. 1B in a view from the front, in Fig. 1C in a view from the back and in Fig. 1D in a view from below. The features described below are not to be understood as limiting. There are various types of laryngoscope that can be combined with the features according to the invention. In this context, the laryngoscope 106 of Fig. 1 is to be understood as an example. The laryngoscope 106 comprises a handle 118 and a spatula 108. The spatula 108 is made of metal and has a curved shape that allows a user to see and manipulate the larynx of a patient. The spatula 108 extends from the handle 118 at least substantially in a main extension direction. In the main extension direction, the spatula 108 bends in the direction of the handle 118 such that the laryngoscope 106 is formed in a sickle shape. The spatula 108 comprises a main wall 125 and a lateral tube guide wall 126. The main wall 125 is intended to indirectly manipulate the epiglottis of the patient. The spatula 108, in particular the main wall 125, is guided in front of the epiglottis of the patient and the laryngoscope 106 is pulled by the user in the direction of the handle 118 of the laryngoscope 106.

The curved spatula 108, in particular the main wall 125, is flat and wide and bends in a slight curve. The length and width of the spatula 108 is application and manufacturer specific. In general, the spatula 108 is long enough to reach the patient's larynx, while being narrow enough to allow a clear view of the surroundings, in particular the patient's vocal cords. The schematically illustrated spatula 108 is, for example, 98 mm long and 14 mm wide at the distal end. The lateral tube guide wall 126 extends along the main wall 125 and tapers along the main extension direction and tapers at least substantially towards the distal end of the main wall 125. Furthermore, it can be seen that the lateral tube guide wall 126 comprises a step 135 in a distal end region of the spatula 108. The step 135 may also be referred to as a projection 142. Distal to the step, the lateral tube guide wall 126 is narrow, in particular narrower than the rest of the lateral tube guide wall 126.

The surface of the spatula 108 is smooth to allow easy cleaning and/or sterilization. The spatula 108 can be detachably connected to the handle 118 via a fastening mechanism not shown in detail.

The laryngoscope 106 comprises an imaging device 136, the laryngoscope 106 is consequently a video laryngoscope. The imaging device 136 is at least partially accommodated by the handle 118. Furthermore, the imaging device 136 extends at least partially along the lateral tube guide wall 126. The imaging device 136 comprises a camera 137 which is arranged in a distal end region of the spatula 108, in particular the lateral Tube guide wall 126. An anatomical structure, in particular the larynx, of the patient can be imaged by means of the imaging device 136 and/or the camera 137. The camera 137 is arranged in particular in the region of the step 135 and/or the projection 142. The step 135 and/or the projection 142 defines a surface which points in the direction of the larynx when the spatula 108 is inserted into the patient's oral cavity.

The intubation system 100 also includes a tube 102 and a stylet 104, which are shown schematically in Figs. 2 and 3 by way of example. In both examples shown, the tube 102 is an endotracheal tube. However, the present invention is not limited to endotracheal tubes. The tube 102 is shown schematically in Fig. 2. The tube 102 is designed to be inserted into the patient's windpipe (trachea) and to provide an unhindered flow of air into the lungs, even in the event of limited breathing ability or unconsciousness. The tube 102 is tubular and is made of polyvinyl chloride (PVC). In principle, the tube is available in different sizes to meet the individual needs of the patient. At a distal end 113 of the tube 102, the tube 102 comprises an opening through which air can be introduced into the lungs, and at a proximal end 115, the tube 102 is configured to be connected to a ventilation device. The tube further comprises a blocking cuff 103 in a vicinity of the distal end 113 and a balloon 105 configured to fill the blocking cuff 103 with air when the tube 102 is inserted into the patient's trachea. Before the tube 102 is inserted, the blocking cuff 103 is at least substantially flat, so that an outer diameter 146 of the tube 102 is at least substantially unchanged.

The tube 102 is at least partially pushed onto a stylet 104, in particular a video stylet 109. Alternatively, Fig. 3 shows that the tube can be pushed onto a stylet 104 that is not a video stylet. Fig. 3 shows the same tube 102 being used with a stylet 104 that differs in terms of a few features. In both cases, the stylet 104 comprises a rigid shaft 111. The stylet 104 and the video stylet 109, in particular the shaft 111, have an outer diameter that essentially corresponds to an inner diameter of the tube 102. The shaft 111 gives the tube 102 a flexural rigidity that simplifies the insertion of the tube 102 into the trachea. The shaft 111 extends along the entire tube 102. The video stylet 109 of Fig. 2 has the advantage over the stylet 104 of Fig. 3 that the interior of the trachea in particular can be imaged in an inserted state. Other types of stylets are also possible and the two stylets 104, 109 shown are to be understood as examples only.

To insert the tube 102, it is pushed into the trachea through the patient's mouth while it is pushed onto the stylet 104, 109. The laryngoscope 106 is used to visualize the opening of the trachea so that the tube 102 can be accurately positioned. The stylet 104, 109, together with the tube 102 pushed onto the stylet 104, 109, is advanced relative to the spatula 108. After insertion into the trachea, the stylet 104, 109 is withdrawn from the tube to enable ventilation. The balloon 105 is used to inflate the block cuff 103 to hold the tube 102 in its position in the trachea, for example.

Furthermore, the laryngoscope 106, in particular the spatula 108 and/or the lateral tube guide wall 126, and the tube 102 comprise a tube locking device 110. The tube locking device 110 is designed to prevent the tube 102 from being retracted relative to the spatula 108 when the stylet 104, 109 is retracted from the tube 102 after being pushed forward, in particular into the trachea. The retraction of the stylet 104 from the tube 102 can be carried out by a single user with two hands, in particular. The user can grasp the laryngoscope 106 with one hand and retract the stylet 104, 109 from the tube with the other hand. The user does not have to hold the tube 102 during this process. The tube locking device 110 prevents the tube 102 from moving relative to the spatula 108 and in particular prevents the tube 102 from remaining in the trachea. In the case shown in Figs. 1A to 1D, Fig. 2 and Fig. 3, the spatula 108 and the tube 102 together form the tube locking device 110. In this context, the spatula 108 and/or the tube 102 at least partially form the tube locking device 110. The tube locking device 110 shown in these figures can, however, also be formed by just the tube or just the spatula. In principle, features of the tube locking device 110 can be the same.

The spatula-side tube locking device 110 can comprise a rubberized, profiled and/or rough surface 160. As shown in Figs. 1A to 1D, the tube locking device 110 comprises a rubberized surface 160. The tube locking device 110 extends over approximately 50% of the length of the spatula 108 in a middle section of the spatula 108. It can also be seen that the tube locking device 110 is designed to be one-sided. This means that the tube locking device 110 interacts with the tube 102 only from one side of the spatula 108 and/or only the tube 102 is stressed on one side by the tube locking device 110. In particular, it can be seen that the tube locking device 110 is arranged on the lateral tube guide wall 126 and extends over 50% of the length of the tube guide wall 126, in particular in the main extension direction of the spatula 108. The tube 102 is guided along the main extension direction of the spatula 108. Therefore, the tube locking device 110 extends along the guide direction of the tube 102 when the tube 102 is inserted into the patient's trachea. In the case shown, the tube locking device 110, in particular the surface 160, is permanently provided on the spatula 108. In other cases, the tube locking device 110, in particular the surface 160, can be modular and can be optionally attached to the spatula 108 and removed from the spatula 108. For example, the tube locking device 110 can be adhesively attached and/or clipped on. The surface 160 can prevent the tube 102 from retracting relative to the spatula 108 by friction when the stylet 104, 109 is retracted.

Alternatively or additionally, the tube locking device 110 can be arranged and/or can be arranged on the tube. In the case shown, the tube locking device 110 is additionally arranged on the tube 102. However, the tube locking device 110 can also be arranged only on the tube. In Fig. 2 and Fig. 3, the tube locking device 110 is shown as a band 127 that is pushed onto the tube 102. The band 127 comprises a rubberized surface 160 on its outside. In particular, the entire band 127 is made of rubber. The band 127 can be pushed onto the tube 102 by the user if the user wants to improve a function of the tube locking device 110. For example, it may be necessary to provide the band 127 if the patient is bleeding and/or intubation is difficult. However, it can also be provided that the tube 102 is made available to the user together with the pushed-on band 172, in particular in sterile packaging. In the case shown, the band 127 is 30 mm long and is arranged in an area proximal to the blocking cuff 103. The area also extends from a middle area of the tube 102 to a distal area of the tube 102. The tube locking device 110 is designed to prevent the tube 102 from being pulled back by applying of the tube 102 with a frictional force. To prevent the retraction of the tube 102 relative to the spatula 108, the user presses, for example, the tube 102, in particular the band 127, against the rubberized surface 160 of the spatula 108 while retracting the stylet 104, 109 from the tube 102. The tube 102 can be selectively released by the tube locking device, in particular by the user varying the applied pressure of the tube 102 against the spatula 108 and thereby the frictional force.

Figs. 4, 5A and 5B show a further embodiment of a tube locking device 1010. This can be provided on the laryngoscope 106 and/or a tube 1002 as an alternative or in addition to the tube locking device 110. In Fig. 4, the tube 1002 is shown schematically in sections with a tube-side part of the tube locking device 1010. In Figs. 5A and 5B, the tube 1002 and the laryngoscope 106 are shown in a schematic view from below onto the laryngoscope 106.

The tube 1002 is at least substantially similar to the tube 102, which is why reference can be made to the above statements with regard to its features. In contrast, the tube 1002 comprises a circumferential widening 148, which can be gripped behind by at least a part of the tube locking device 1010, in particular on the spatula side. The circumferential widening 148 extends completely along the longitudinal direction of the tube 1002, is designed as a cone and comprises a projection through which an active surface 149 is provided at least substantially perpendicular to the longitudinal axis. The active surface is designed to interact with the projection 142 of the laryngoscope 106. The widening 148 can be pushed onto the tube 1002 and/or can be formed by the tube 1002.

The laryngoscope 106 of Figs. 5A and 5B is the laryngoscope of Figs. 1A to 1D, wherein the laryngoscope does not comprise a rubberized surface. The lateral guide wall 126 comprises the projection 142 in the form of the step 135. Alternatively or additionally, the projection 142 can be formed, for example, on the tube guide wall 126, as shown in Fig. 11 and Fig. 12. In Fig. 11 and Fig. 12, the projection is formed as a wedge that extends laterally from the tube guide wall 126 into an area in which the tube 102 is guided during insertion and/or withdrawal. The projection 142 is designed to prevent the tube 1002 from being withdrawn by engaging behind at least a part of the tube 1002, in particular the widened portion 148. In In the case shown, the projection 142 is designed to interact with the active surface 149 of the widened portion 148 to prevent retraction. The tube 1002 is pushed onto the stylet 104. After insertion into the trachea, the user moves the stylet 104 and the tube 1002 laterally so that when the stylet 104 is retracted from the tube 1002, the active surface 149 of the widened portion 148 presses against the projection 142. During retraction, the user continuously applies a lateral force to the tube 1002 so that the tube 1002 remains in the engaged state. The projection 142 of the tube locking device 1010 can be provided alternatively or in addition to the step 135 (see, for example, Fig. 11 and/or Fig. 12).

As an alternative to the conical widening 148, an annular widening 148 can be provided on the tube 1002. For example, in Figs. 6 and 7, the tube 1002 is shown with a circumferential widening 148 that is designed as a ring. At least essentially, different embodiments of widenings 148 have similar features and hardly differ in function. The projection 142 of the laryngoscope 106 can also engage behind the annular circumferential widening 148.

6 and 7 show a schematic representation of an intubation system 2000 in a view from below of a tube locking device 2010 and in a schematic sectional view from a proximal side. A lateral tube guide wall 2026 forms a projection 2042 which is designed to engage behind a part of the tube 1002, in particular the widening 148. In addition, the tube locking device 2010 comprises a counter-holding element 144 which is designed to prevent the retraction of the tube 1002 by engaging behind a part of the tube 1002, in particular the widening 148. The counter-holding element 144 is designed as a pin 2044 which extends at least substantially perpendicularly from a main wall 2025 of a spatula 2008 at least substantially parallel to the tube guide wall 2026. In particular, the pin 2044 is arranged in a plane perpendicular to the longitudinal direction of the tube 1002 together with the projection 2042 such that the pin 2044 engages behind the widening 148 when the projection 2042 engages behind the widening 148. The counter-holding element 144, in particular the pin 2044, is spaced from the projection 2042 by a distance which at least substantially corresponds to an outer diameter 2046 of the tube 1002. The tube 1002 can be guided proximally from the projection 2042 along the tube guide wall 2026 such that one side of the tube 1002 engages the tube guide wall 2026 Distal from the projection 2042, the tube guide wall 2026 is spaced from the tube 1002 by the projection 2042, which is designed in a step-like manner. In the area of the projection 2042, the pin 2044 is spaced from the projection 2042 such that the tube 1002 touches the pin 2044 and the tube guide wall 2026. The pin 2044 and the projection 2042 thus define an opening. The user can guide the tube 1002 into the opening with the widened portion 148 to prevent the tube 1002 from being retracted and can retract the stylet 104, 109 from the tube 1002.

Fig. 8 shows a schematic view from below of another embodiment of an intubation system 3000 comprising a tube locking device 3010. The intubation system 3000 is designed similarly to the intubation system 100. Therefore, the distinguishing features will be discussed primarily.

The tube locking device 3010 comprises a rotatable locking element 3128, which comprises a guide roller 131. The locking element 3128 is rotatable about a rotation axis 3130, which is arranged in an advanced state of the tube 102 at least substantially perpendicular to a longitudinal axis 132 of the tube 102 in a region of the locking element 3128. In addition, the locking element 3128 has a locking direction of rotation and a release direction of rotation opposite to the locking direction of rotation. The locking element 3128 is arranged on one side of the tube guide wall 126. It comprises a bearing device by means of which the guide roller 131 is mounted. The guide roller 131 is arranged at a distance from the side wall 126. Alternatively, the guide roller 131 can be arranged recessed into the side wall 126 or another part of the spatula 108. The locking element 3128 is arranged in a distal end region of the spatula 108. The user can press the tube 102 against the locking element 3128 when he withdraws the stylet 104 from the tube 102. During the withdrawal, the guide roller 131 is subjected to a force in the locking direction of rotation by a frictional force between the tube and the guide roller 131. In the locking direction of rotation, the guide roller 131 does not rotate or only rotates with greater force than in the release direction of rotation. This prevents the tube 102 from being withdrawn when the stylet 104 is withdrawn. In the release direction of rotation, the guide roller rotates along the spatula 108, in particular when the tube 102 is inserted.

In Fig. 16, a further development of the intubation system 3000 is shown in a sectional view from a distal side of the spatula 108. The Tube locking device 3010 comprises a further guide roller 131, which is arranged on a side opposite to the tube 102. This means that one guide roller 131 is arranged on one side 122 and one guide roller is arranged on a side 124 of the tube 102 opposite the side 122. The tube locking device 3010 is designed to act on the tube 102 from the two opposite sides 122, 124 of the tube 102. The second guide roller 131 can increase the frictional force between the tube 102 and the tube locking device 3010 and also guide the tube 102 better during insertion into the trachea. The guide rollers 131 are spaced apart from one another by a distance that at least essentially corresponds to the outer diameter of the tube 102. In the case shown, the guide rollers 131 are arranged laterally. Alternatively or additionally, guide rollers 131 can be arranged at the top and bottom, i.e. on the main wall 125 and opposite the main wall 125. The tube locking device 3010 can also be designed like a tunnel and the tube 102 can be guided through the tunnel formed. Alternatively, the tube locking device 3010 can define an opening into which the tube 102 can be introduced such that the guide rollers 131 can guide or hold back the tube.

Furthermore, as a further development of the tube locking device of Fig. 11, a guide roller 131 can be provided in addition to the projection 142, as shown in Fig. 12. In general, a tube locking device can comprise various locking elements and/or the like. As shown in Fig. 12, the guide roller, which is similar to the guide roller of Fig. 8, can be arranged, in particular embedded, in the main wall 125. In Fig. 12, the guide roller 131 is at least substantially as wide as the tube 102 and extends with the width perpendicular to the longitudinal axis 132 of the tube 102. In addition, the guide roller 131 is arranged distally from the projection 142.

Fig. 9 shows a schematic view from below of another embodiment of an intubation system 4000 comprising a tube locking device 4010. The intubation system 4000 is designed similarly to the intubation system 100. Therefore, the distinguishing features will be discussed primarily.

The tube locking device 4010 comprises a rotatable locking element 4128 which comprises a clamp 4134. The clamp 4134 comprises a profiled surface with Prongs are shown schematically, which are designed to interact with the tube 102. The locking element 4128 is rotatable about a rotation axis 4130, which is arranged in an advanced state of the tube 102 at least substantially perpendicular to a longitudinal axis 132 of the tube 102 in a region of the locking element 4128. In addition, the locking element 4128 has a locking direction of rotation and a release direction of rotation opposite to the locking direction of rotation. The clamp 4134 is arranged at a distance from the guide wall 126. The tube 102 can be guided between the clamp 4134 and the guide wall 126. When the user inserts the tube 102 (in the direction of the arrow), the clamp is loaded in the release direction of rotation and the tube 102 can be inserted at least substantially without resistance. In the opposite direction, in particular when the stylet 104 is withdrawn from the tube 102, the clamp 4134 is loaded by the tube 102 in the locking rotation direction. The clamp 4134 is designed to rotate in the locking rotation direction, in particular with the profiled surface in the direction of the tube 102. The clamp 4134 is designed to clamp the tube between the clamp 4134 and the guide wall 126, in particular when the stylet 104 is withdrawn from the tube 102. The clamp 4134 clamps the tube 102 in particular because rotation of the clamp 4134 by the tube 102 is prevented in the locking rotation direction. The distance between at least part of the clamp 4134 and the guide wall 126 could be reduced without the tube 102 arranged. The clamping force of the clamp 4134 can increase steadily by retracting the stylet 104. The function of the clamp 4134 is similar to that of a rope clamp, in particular a rope clamp on a sailboat. For example, two clamps 4134 can be provided that move towards each other in the locking direction of rotation. Alternatively or in addition to the serrated surface that is designed to interact with the tube 102, a rubberized surface can be provided, for example.

In Figs. 10A and 10B, a schematic view from below (Fig. 10A) of a further embodiment of an intubation system 5000 and a sectional view of the intubation system 5000 from a proximal side (Fig. 10B) are shown, comprising a tube locking device 5010. The intubation system 5000 is designed similarly to the intubation system 4000. Therefore, the distinguishing features will be discussed primarily. The tube locking device 5010 additionally comprises a tensioning element 138 which is arranged on the locking element 5128, in particular the clamp 5134, and pre-tensions the locking element 5128, in particular the clamp 5134. The tensioning element 138 is a leg spring 140. One leg of the leg spring 140 is tensioned against a nose 5131 which is formed by the laryngoscope 106. The nose 5131 extends parallel to the rotation axis 5130 of the locking element 5128. The leg spring 140 is wound with its middle section around the rotation axis 5130 of the locking element 5128 and the second leg of the leg spring 140 is arranged against the locking element 5128 such that the leg spring 140 presses the locking element 5128 in the locking rotation direction. When the tube 102 is arranged between the locking element 5128 and the tube guide wall 126, the leg spring 140 presses the locking element 5128 against the tube and thereby prestresses it. Consequently, a clamping force can be increased which prevents the retraction of the tube 102 relative to the spatula 108.

Locking elements, in particular rotatable locking elements as described herein, can be provided in addition to, for example, a projection. In other embodiments not shown, a locking element can be designed to press the tube 102 against a projection in such a way that the projection engages behind at least part of the tube 102.

13 and 14 show a schematic view from below (Fig. 13) of a further embodiment of an intubation system 6000 and a sectional view of the intubation system 6000 from a distal side (Fig. 14), comprising a tube locking device 6010. The intubation system 6000 is designed similarly to the intubation system 100. Therefore, the distinguishing features will be discussed primarily.

The tube locking device 6010 comprises at least one clamp 162 into which the tube 102 can be hooked. In particular, the tube 102 can be hooked laterally into the clamp 162 and unhooked laterally from the clamp 162. The user can hook the tube 102 into the clamp 162, in particular by moving the tube laterally. The clamp 162 comprises a clamp element 165 which is arranged on the lateral tube guide wall 126. The clamp element 165 is bent and extends along the bend at least substantially parallel to the main wall 125. The clamp 162 is designed to apply a clamping force to the tube 102. The tube 102 can be subjected to the clamping force in such a way that the tube 102 is between the main wall 125 and the Clamp 162 can be clamped. The clamp element 165 and the main wall 125 together define an opening 163 that opens laterally and through which the tube 102 can be inserted laterally in order to hook the tube 102. The clamp 162, together with the main wall 125 and the tube guide wall 126, thus defines a clamp space 161 into which the tube 102 can be inserted in order to clamp the tube 102. The clamp element 165 can be bendable. In particular, the clamp element 165 can be bendable in such a way that the clamp space 161 can be changed in size. For example, the cross-section of the clamp space 161 shown in Fig. 14 can be smaller than the cross-section of the tube 102. When the tube 102 is hooked into the clamp laterally through the opening 163, the cross-section increases and the tube 102 is subjected to a force by the clamp element 165. In particular, the clamp element 165 presses the tube against the main wall 125. The bend of the clamp element 165 can at least substantially correspond to the radius of the tube. In this regard, the clamp 162 can be designed like a pipe clamp and/or like a pipe clamp that is open at the side.

In Fig. 15, an alternative embodiment of the tube locking device 6010 is shown in a sectional view from a distal side. The clamp 162 comprises a second clamp element 165. The tube 102 can be hooked in such a way that the clamp elements 165 clamp the tube 102 from two opposite sides of the tube 102. The other features, as described in connection with Figs. 13 and 14, can be at least substantially the same.

In both alternative embodiments, the tube can be hooked laterally into the clamp 162 and unhooked laterally from the clamp 162. The user can hook the tube laterally into the clamp when retracting the stylet 104 from the tube 102. This allows the user to retract the stylet 104 using two hands alone. After retraction, the user can optionally release the tube 102 by unhooking the tube 102 laterally. In this state, the user can remove the laryngoscope 106 from the patient's oral cavity, leaving the tube 102 in the trachea.

The clamp 162 can be arranged and/or can be arranged at any advantageous position along the main extension direction of the spatula 108. In the embodiments shown, the clamp is arranged in a distal end region of the spatula 108. Figs. 17A to 18B show a further embodiment of an intubation system 7000. The spatula 108 and a tube 7002 together form a tube locking device 7010. Figs. 17A and 17B show schematically the tube 7002 for the intubation system 7000 in a side view (Fig. 17A) and a top view (Fig. 17B). Figs. 18A and 18B show the spatula 108, on which a spatula-side part of the tube locking device 7010 is arranged.

The tube 7002, in particular the tube locking device 7010, comprises a plurality of locking projections 154, in particular locking teeth 156, which each define a locking position and which are arranged one behind the other along a longitudinal axis 7022 of the tube 7002. In the side view of Fig. 17A, it can be seen that the locking projections 154 are at least substantially embedded in the tube 7002. Furthermore, the locking projections 154, in particular the locking teeth 156, are designed such that they define a constant slope in a direction along the longitudinal axis 7022 and widen due to the slope at least substantially perpendicular to the longitudinal axis 7022. In particular, the slope encloses an angle of approximately 20° to 30° with the longitudinal axis 7022. It is understood that this is to be understood as an example and other angles and/or geometries can also be provided. In the opposite direction, the locking projections 154, in particular locking teeth 156, each form a contact surface 155 that is arranged at least substantially perpendicular to the longitudinal axis 7022. As a result, the locking projections 154, in particular locking teeth 156, taper in particular in a step-like manner with respect to the longitudinal axis 7022. The locking projections 154, in particular locking teeth 156, thus form a sawtooth-like profile along the longitudinal axis 7022. The tube 7002 is shown in a state pushed onto the stylet 104. The arrow indicates the direction in which the stylet 104 is pulled after insertion in order to retract the stylet 104 after being pushed forward out of the tube 7002.

In Figs. 18A and 18B it can be seen that a retaining ring 158 is attached to the spatula 108. The retaining ring 158 is part of the tube locking device 7010. The stylet 104 can be pushed forward through the retaining ring 158 relative to the spatula 108 together with the tube 7002 pushed onto the stylet 104. In particular, the stylet 104 can be pushed forward together with the tube for insertion. The retaining ring 158 has an inner diameter which is at least substantially larger than the outer diameter of the tube 7002. In addition, the intubation system 7000 comprises at least one locking element 150, in particular a Locking tongue 152. In the present case, the intubation system 7000 comprises a plurality of locking elements 150, in particular locking tongues 152. Five locking tongues 152 are arranged along the inner circumference of the retaining ring 158, for example, which protrude into the opening of the retaining ring 158. The radially innermost points of the locking tongues 152 define a circle with a diameter that is smaller than the outer diameter of the tube 7002. When the tube 7002 is pushed forward during insertion through the retaining ring 158, the locking tongues 152 bend in the direction in which the tube 7002 is pushed.

The locking tongues 152 can be designed to be flexurally symmetrical. This can mean that the locking tongues 152 have at least substantially the same flexural rigidity in the feed direction of the tube 7002 and in the opposite direction. In other embodiments, the locking tongues 152 can be designed to be flexurally asymmetrical. This can mean that the locking tongues 152 have a different flexural rigidity in the feed direction of the tube 7002 than in the opposite direction. In particular, the locking tongues 152 can have a lower flexural rigidity in the feed direction of the tube 7002. Furthermore, a mechanical stop can be provided in the opposite direction, for example, which limits and/or prevents bending of the locking tongues 152. The mechanical stop can be provided, for example, on the retaining ring 158 (not shown).

The at least one locking element 150, in particular the one locking tongue 152, can be moved into a release position by applying force in a first direction, in particular the advance direction of the tube 7002 during insertion. In the release position, the locking element 150 allows the stylet 104 to be advanced together with the tube 7002 pushed onto the stylet 104 relative to the spatula 108. By applying force in a second direction, in particular when retracting the stylet 104 from the tube 7002, the locking element 150, in particular the locking tongue 152, can be moved into a blocking position. In the locking position, the locking element 150 prevents the tube 7002 from being retracted relative to the spatula 108. In particular, the locking element 150 prevents the tube 7002 from being retracted by engaging behind at least one of the locking projections 154. During insertion, the tube 7002 is guided together with the stylet 104 through the retaining ring 158. At least one of the locking tongues 152 interacts with the locking teeth 156 of the tube 7002, which are arranged in particular in a sawtooth shape. The interacting locking tongue 152 is designed to bend along the slope of the locking teeth 156 during insertion. This means that that the circle defined by the locking tongues 152 is enlarged in diameter and the tube can be passed through the retaining ring 158. This means that the locking tongue 152 is in the release position. The locking tongue 152 is designed to press against the locking tooth 156, in particular radially, when the tube 7002 is inserted. In the area in which the locking teeth 156 taper in steps, the locking tongue 152 bends back at least substantially into the original alignment or bending position. By bending the locking tongue 152 by the slope of the following locking tooth 156, the locking tongue is moved back into the release position. If the tube 7002 is moved in the opposite direction, the locking tongue 152 strikes against one of the contact surfaces 155 of the locking teeth 156 in the locking position. In the locking position, the locking tongue 152 is therefore at least essentially non-bendable. The tube 7002 can only be moved in the opposite direction with a greater amount of force. The amount of force must be so great that the locking tongue 152 bends in such a way that it no longer rests against the contact surface 155. The way it works can be at least essentially similar to that of a cable tie.

19A to 19C show a further embodiment of an intubation system 8000. Fig. 19A shows the intubation system 8000 in a schematic perspective view, Fig. 19B in a front view and Fig. 19C in a side view. Referring to all three figures, it can be seen that the intubation system 8000 comprises a laryngoscope 8006 which comprises a handle 8018 and a spatula 8008, wherein the spatula 8008 is arranged on the handle 8018. In addition, the intubation system 8000 comprises a tube locking device 8010 which is designed to prevent retraction of the tube 102 relative to the spatula 8008 when the stylet 104 is retracted from the tube 102 after being advanced. The tube 102 is shown without the stylet 104. It is understood that any tube and/or stylet may be part of the intubation system 8000.

The tube locking device 8010 has an operating element 112, by means of which a locking state and/or a release state for the tube 102 can be established. The locking state is achieved by clamping, in particular by applying a clamping force to the tube 102. For this purpose, the operating element 112 has a clamping section 114, which is opposite the spatula 8008, in particular an underside of a main wall 8025 of the spatula 8008. The underside is the side of a spatula along which a tube is guided during insertion in conventional spatulas. The tube 102 is between the clamping section 114 and the spatula 8008. In particular, the clamping force acts in such a way that the tube 102 is pressed against the spatula 8008, in particular against the underside of the main wall 8025. By means of a frictional force, the retraction of the tube 102 by applying pressure to the tube 102 can be prevented. The clamping force can be converted into the frictional force with reference to a friction coefficient between the tube 102 and the clamping section 114 and/or the spatula 8008.

It can also be seen that the tube 102 can be subjected to the clamping force by operating the operating element 112. The operating element 112 can be operated using an operating force, wherein the operating force can be converted into the clamping force. The user applies the operating force by pulling on the operating element 112. This allows the user to control the clamping force directly. If a stronger clamping effect is required, the user can pull harder on the operating element 112. The operating element 112 for this purpose comprises a lever 116 which is pivotably arranged on the spatula 8008. The lever 116 forms the clamping section 114 and an actuating section 120. The lever 116 is in particular rotatably arranged on a pivot axis 8117, whereby it can pivot. The pivot axis 8117 extends perpendicular to the longitudinal direction of the tube 102 when the tube 102 is inserted. This means that the pivot axis 8117 extends at least substantially perpendicular to a main direction of extension of the spatula 8008. Furthermore, the pivot axis 8117 is arranged proximal to the tube 102, in particular closer to the handle 8018. In addition, the pivot axis 8117 is arranged in a proximal third of the longitudinal extension of the spatula 8008. The lever 116, in particular the clamping section 114, extends distally from the pivot axis 8117 along the spatula 8008. In addition, the lever 116 extends laterally from the spatula 8008 in a close range around the pivot axis 8117. The lever 116 has an at least substantially right-angled angle section distally therefrom, which is at least partially the clamping section 114. The tube 102 can be inserted into the right-angled angle section such that the tube 102 extends between the lever 116 and the spatula 8008.

The actuating portion 120 extends in the proximal direction from the pivot axis 8117, in particular in the direction of the handle 8018 and/or at least partially along the handle 8018. As a result, the actuating portion 120 is arranged in a close range of the handle 8018 such that the user can actuate the actuating portion 120, while gripping the handle 8018. In this embodiment, actuation means pulling in particular. If the user pulls the actuating section 112 in the direction of the handle 8018, he clamps the tube 102 and/or establishes the locking state. If he does not pull or pulls with a relatively small force, the tube is movable and/or the release state can be established as a result. The actuating section 112 extends only along a distal section of the handle 8018. When the user grips the handle, normally only the little finger and/or the ring finger are in the area of the actuating section 112. To actuate, the user pulls the lever 116 with the little finger and/or the ring finger in the direction of the handle 8018.

Figs. 20A to 20C show another variant of the intubation system 8000, which is why differences are primarily discussed. Some features are the same, which can be seen from the assigned reference numerals. Fig. 20A shows the intubation system 8000 in a schematic perspective view, Fig. 20B in a front view and Fig. 20C in a side view.

In this variant, a different operating element 81 12, in particular lever 81 16, is provided with regard to some features. The functionality is at least essentially the same as that of the operating element 1 12. The lever 81 16 again comprises a clamping section 81 14 and an actuating section 8120. The clamping section 81 14 is designed very similarly to the clamping section 114. The primary difference of the lever 81 16 can be seen in the way the actuating section 8120 is designed. In contrast, the lever 81 16 extends at least along the entire handle 8018 and/or at least partially proximally beyond it. In the area and/or in the vicinity of the handle 8018, the lever 8116 has a bend which is designed such that the user's fingers are arranged between the lever 8112 and the handle 8018 when the user grips the handle 8018. The actuating section 8120 is in particular designed to be actuated with the user's index finger when the user grips the handle 8018. Furthermore, the lever 8116 is spaced from the handle 8018 such that sufficient space is provided for the user's fingers when the locking state is established. The user can also grip the lever 8116 together with the handle 8018 with his hand and close his hand such that the actuating section 8120 is pivoted towards the handle 8018. This allows the user to apply a greater operating force, which is converted into the clamping force by the lever 81 16. In Figs. 21 A and 21 B, a schematic view from below (Fig. 21 A) of a further embodiment of an intubation system 9000 and a sectional view from a distal side (Fig. 21 B) of the intubation system 9000 are shown, comprising a tube locking device 9010. The intubation system 9000 is designed similarly to the intubation system 100. Therefore, the distinguishing features will be discussed primarily.

The tube locking device 9010 comprises a clamping spring 164 which is designed to prevent the retraction of the tube 102 by clamping. In the embodiment shown, the clamping spring 164 is a leaf spring 166. The clamping spring 164 is designed to press the tube 102 against the tube guide wall 126 by applying a lateral force for clamping. Two mounting elements 9011, in the case shown mounting pins, are attached to the spatula 108 in such a way that they at least substantially protrude from the underside of the spatula. The tube 102 can be guided along the underside, in particular during insertion. The leaf spring 166 is attached to the mounting elements 9011 and extends at least substantially between the mounting elements 9011. The leaf spring 164 forms a guide surface 9013 in the area between the mounting elements 9011. The guide surface 9013 extends at least substantially parallel to the tube guide wall 126 and is spaced apart from the tube guide wall 126 by a distance. The distance arises at least substantially from the outer diameter 146 of the tube when, as in the case shown, the tube is guided between the tube guide wall 126 and the guide surface 9013 of the leaf spring 164. The guide surface 9013 extends over, as in this example, 3 cm along the longitudinal axis of the tube 102 and/or contacts the tube along the 3 cm. The leaf spring 164 is elastically bendable perpendicular to the longitudinal axis of the tube 102 and/or the guide surface 9013. In a state in which the tube 102 is not arranged between the leaf spring 164 and the tube guide wall 126, the guide surface 9013 is spaced from the tube guide wall 126 by a distance that is smaller than the outer diameter 146 of the tube 102. By passing the tube 102 between the tube guide wall 126 and the leaf spring 164, the leaf spring 164 is deformed, in particular elastically. The tube is pressed against the tube guide wall 126 by the resulting restoring force and the tube 102 is clamped. The user can push the tube along the longitudinal direction between the leaf spring 164 and the tube guide wall 126 in order to clamp the tube 102. Alternatively or additionally, the user can push the tube from below, i.e. at least in the Substantially perpendicular to the longitudinal direction of the tube 102, between the leaf spring 164 and the tube guide wall 126. In the case of a relatively small restoring force of the clamping spring 164, the user can guide the tube between the clamping spring 164 and the tube guide wall 126 while inserting the tube 102. In the case of a large restoring force, the user can

After insertion, the tube 102 is clamped between the clamping spring 164 and the tube guide wall 126. The restoring force can depend, for example, on the mechanical properties of the clamping spring 164, the outer diameter 146 of the tube 102 and/or the distance between the clamping spring 164 and the tube guide wall 126.

All intubation systems 100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000 described herein are designed such that the withdrawal of a stylet from a tube can be performed by a single user using two hands.

list of reference symbols

100 intubation system

102 tube

103 block cuff

104 Stiletto

105 balloons

106 Laryngoscope

107 imaging device

108 spatulas

109 video stiletto

110 tube locking device

111 shaft

112 control element

113 distal end

114 clamping section

115 proximal end

116 levers

118 handle

120 operating section

122 pages

124 pages

125 main wall

126 tube guide wall

127 volumes

131 leadership role

132 longitudinal axis

135th level

136 imaging device

137 camera

138 clamping element

140 leg spring

142 lead

144 counterholding element

146 outer diameter

148 widening

149 effective area

150 locking element 152 locking tongue

154 locking projection

155 contact surface

156 ratchet tooth

158 retaining ring

160 surface

161 bracket room

162 bracket

163 opening

164 clamping spring

165 clamp element

166 leaf spring

1000 intubation system

1002 tube

1010 tube locking device

2000 intubation system

2008 Spatel

2010 tube locking device

2025 main wall

2026 tube guide wall

2042 Vorsprung

2044 pen

2046 outer diameter

3000 intubation system

3010 tube locking device

3128 locking element

3130 rotation axis

4000 intubation system

4010 tube locking device

4128 locking element

4130 rotary axis

4134 terminal

5000 intubation system

5010 tube locking device

5128 locking element

5130 rotation axis

5131 Nose

5134 terminal 6000 intubation system

6010 tube locking device

7000 intubation system

7002 tube

7010 tube locking device

7022 longitudinal axis

8000 intubation system

8006 Laryngoscope

8008 spatula

8010 tube locking device

8018 handle

8025 main wall

8112 control element

8114 clamping section

8116 lever

8117 swivel axis

8120 operating section

9000 intubation system

9010 tube locking device

9011 mounting element

9013 guide surface

Claims

claims 1. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000), comprising: a tube (102, 1002, 7002); a stylet (104), wherein the tube (102, 1002, 7002) can be at least partially pushed onto the stylet (104); a laryngoscope (106, 8006) comprising a spatula (108, 2008, 8008), wherein for insertion the stylet (104) together with the tube (102, 1002, 7002) pushed onto the stylet (104) can be advanced relative to the spatula (108, 2008, 8008), and wherein the stylet (104) can be pulled out of the tube (102, 1002, 7002) after insertion; and a tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 7010, 8010, 9010) configured to prevent retraction of the tube (102, 1002, 7002) relative to the spatula (108, 2008, 8008) when the stylet (104) is retracted from the tube (102, 1002, 7002) after being moved. 2. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to claim 1, wherein the stylet (104) is a video stylet (109), in particular an endoscope, which comprises an at least substantially rigid shaft (111), wherein the tube (102, 1002, 7002) can be pushed onto the shaft (111). 3. Intubation system (100, 1000, 2000, 3000, 4000) according to claim 1 or 2, wherein the tube locking device (1 10, 1010, 2010, 3010, 4010, 5010, 6010, 7010, 8010, 9010) is modular and can be optionally attached to the spatula (108, 2008, 8008) and removed from the spatula (108, 2008, 8008). 4. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to one of the preceding claims, wherein the spatula (108, 2008, 8008) and/or the tube (102, 1002, 7002) at least partially forms the tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 7010, 8010, 9010). 5. Intubation system (100, 1000, 2000, 3000, 4000, 7000) according to one of the preceding claims, wherein the spatula (108, 2008) and the tube (102) together form the tube locking device (110, 1010, 2010, 3010, 4010, 7010). 6. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to one of the preceding claims, wherein the tube (102, 1002) can be selectively released by the tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 7010, 8010, 9010). 7. Intubation system (8000) according to one of the preceding claims, wherein the tube locking device (8010) has at least one operating element (112, 8112) by means of which a locking state and/or a release state for the tube (102) can be established. 8. Intubation system (8000) according to claim 7, wherein the tube (102) can be subjected to a clamping force by operating the operating element (112, 8112). 9. Intubation system (8000) according to claim 8, wherein the operating element (112, 8112) has a clamping portion (114, 8114) which is opposite the spatula (8008) so that the tube (102) can be clamped between the clamping portion (114, 8114) and the spatula (8008). 10. Intubation system (8000) according to one of claims 7 to 9, wherein the operating element (112, 8112) can be operated by means of an operating force, wherein the operating force can be converted into the clamping force. 11. Intubation system (8000) according to one of claims 7 to 10, wherein the operating element (112, 8112) comprises a lever (116, 8116) which is pivotally arranged on the spatula (8008). 12. Intubation system (8000) according to one of claims 7 to 11, wherein the laryngoscope (8006) comprises a handle (8018) on which the spatula (8008) is arranged, and wherein the operating element (112, 8112) comprises an actuating section (120, 8120) which is arranged in a vicinity of the handle (8018) such that a user can actuate the actuating section (120, 8120) while gripping the handle (8018). 13. Intubation system (8000) according to all of claims 9 to 12, wherein the lever (116, 8116) the clamping portion (114, 8114) and the actuating section (120, 8120). 14. Intubation system (100, 1000, 3000, 6000) according to one of the preceding claims, wherein the tube locking device (110, 3010) is designed on one side. 15. Intubation system (100, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to one of the preceding claims, wherein the tube locking device (110, 2010, 4010, 5010, 6010, 7010, 8010, 9010) is designed to act on the tube (102, 1002, 7002) from at least two opposite sides (122, 124) of the tube (102, 1002, 7002). 16. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000) according to one of the preceding claims, wherein the spatula (108, 2008) comprises a lateral tube guide wall (126, 2026); and wherein the tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010) is arranged on the tube guide wall (126, 2026). 17. Intubation system (3000, 4000, 5000) according to one of the preceding claims, wherein the tube locking device (3010, 4010, 5010) comprises at least one rotatable locking element (3128, 4128, 5128). 18. Intubation system (3000, 4000, 5000) according to claim 17, wherein the locking element (3128, 4128, 5128) has a locking direction of rotation and a release direction of rotation opposite to the locking direction of rotation. 19. Intubation system (3000, 4000, 5000) according to claim 17 or 18, wherein the locking element (3128, 4128, 5128) is rotatable about a rotation axis (3130, 4130, 5130) which, in an advanced state of the tube (102), is arranged at least substantially perpendicular to a longitudinal axis (132) of the tube (102) in a region of the locking element (3128, 4128, 5128). 20. Intubation system (4000, 5000) according to one of claims 17 to 19, wherein the rotatable locking element (4128, 5128) comprises a clamp (4134, 5134) which is adapted to prevent retraction of the tube (102) relative to the blade (108) by clamping the tube (102). 21. Intubation system (3000) according to one of claims 17 to 20, wherein the rotatable locking element (3128) comprises a guide roller (131) for the tube (102). 22. Intubation system (5000) according to one of claims 17 to 21, wherein the tube locking device (5010) comprises a tensioning element (138) which is arranged on the locking element (5128) and pretensions the locking element (5128). 23. Intubation system (5000) according to claim 22, wherein the tensioning element (138) is a leg spring (140). 24. Intubation system (1000, 2000) according to one of the preceding claims, wherein the tube locking device (1010, 2010) has at least one projection (142, 2042) which is adapted to prevent retraction of the tube (1002) by engaging behind at least a portion of the tube (1002). 25. Intubation system (2000) according to one of the preceding claims, wherein the tube locking device (2010) comprises a counter-holding element (144) which is adapted to prevent the retraction of the tube (1002) by engaging behind at least a part of the tube (1002). 26. Intubation system (2000) at least according to claim 24 and 25, wherein the counter-holding element (144) is arranged at a distance from the projection (2042), and wherein the distance at least substantially corresponds to an outer diameter (2046) of the tube (1002). 27. Intubation system (1000, 2000) according to at least claim 24, wherein the tube (1002) comprises a circumferential widening (148), and wherein the circumferential widening (148) is defined by at least a portion of the The tube locking device (1010) can be engaged behind it. 28. Intubation system (7000) according to one of the preceding claims, comprising at least one locking element (150), in particular a locking tongue (152) which can be moved by applying force in a first direction into a release position in which the locking element (150) allows the advancement of the stylet (104) together with the tube (7002) pushed onto the stylet (104) relative to the spatula (108), and which can be moved by applying force into a second direction into a locking position in which the locking element (150) prevents the retraction of the tube (7002) relative to the spatula (108). 29. Intubation system (7000) according to claim 28, wherein the tube locking device (7010) comprises a plurality of locking projections (154), in particular locking teeth (156), each defining a locking position and which are arranged one behind the other along a longitudinal axis (7022) of the tube (7002), and wherein the locking element (150) is designed to prevent the retraction of the tube (7002) by engaging behind at least one of the locking projections (154). 30. Intubation system (7000) according to one of the preceding claims, wherein the tube locking device (7010) comprises a retaining ring (158) which is attached to the spatula (108), wherein the stylet (104) together with the tube (7002) pushed onto the stylet (104) can be advanced through the retaining ring (158) relative to the spatula (108). 31. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 8000, 9000) according to one of the preceding claims, wherein the tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 8010, 9010) is designed to prevent the retraction of the tube (102, 1002) by applying a frictional force to the tube (102, 1002). 32. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 8000, 9000) according to one of the preceding claims, wherein the tube locking device (110, 1010, 2010, 3010, 4010, 5010, 6010, 8010, 9010) comprises at least one rubberized, profiled and/or rough surface (160). 33. Intubation system (6000) according to one of the preceding claims, wherein the tube locking device (6010) comprises at least one clamp (162) into which the tube (102) can be hooked. 34. Intubation system (6000) according to claim 33, wherein the tube (102) can be hooked laterally into the clamp (162) and unhooked laterally from the clamp (162). 35. Intubation system (9000) according to one of the preceding claims, wherein the tube locking device (9010) comprises a clamping spring (164) which is adapted to prevent retraction of the tube (102) by clamping. 36. Intubation system (9000) according to claim 35, wherein the spatula (108) comprises a lateral tube guide wall (126), and wherein the clamping spring (164) is configured to press the tube (102) against the tube guide wall (126) by applying a lateral force for clamping. 37. Intubation system (9000) according to claim 35 or 36, wherein the clamping spring (164) is a leaf spring (166). 38. Intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to one of the preceding claims, wherein the withdrawal of the stylet (104) from the tube (102, 1002, 7002) can be carried out by a single user with two hands. 39. Laryngoscope (106, 8006) for an intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) according to one of the preceding claims. 40. Tube (102, 1002, 7002) for an intubation system (100, 1000, 2000, 3000, 4000, 5000, 6000, 7000, 8000, 9000) at least according to claim 4.