CA1279799C - Gastro-jejunal feeding device - Google Patents
Gastro-jejunal feeding deviceInfo
- Publication number
- CA1279799C CA1279799C CA000536695A CA536695A CA1279799C CA 1279799 C CA1279799 C CA 1279799C CA 000536695 A CA000536695 A CA 000536695A CA 536695 A CA536695 A CA 536695A CA 1279799 C CA1279799 C CA 1279799C
- Authority
- CA
- Canada
- Prior art keywords
- tube
- patient
- ring
- feeding
- stomach
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/0069—Tubes feeding directly to the intestines, e.g. to the jejunum
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/003—Means for fixing the tube inside the body, e.g. balloons, retaining means
- A61J15/0034—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
- A61J15/0038—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/003—Means for fixing the tube inside the body, e.g. balloons, retaining means
- A61J15/0034—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
- A61J15/0038—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type
- A61J15/0042—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J15/00—Feeding-tubes for therapeutic purposes
- A61J15/0026—Parts, details or accessories for feeding-tubes
- A61J15/0053—Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin
- A61J15/0061—Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin fixing at an intermediate position on the tube, i.e. tube protruding the fixing means
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
ABSTRACT
GASTRO-JEJUNAL FEEDING DEVICE
A device is disclosed for supplying food and medication to a patient, the device being inserted through a stoma and into the patient's stomach for feeding into the stomach and/or the jejunum. The device may also be used to feed directly into the jejunum by by-passing the stomach, or for drainage and/or decompression.
The device is secured in place by an inflatable balloon (32) within the stomach, or by a plate if the stomach is by-passed, and by an adjustable ring (43) on the abdominal wall. The adjustable ring also prevents ingestion of the device into the stomach. During use, the ring can be retracted to permit cleaning of the stoma area. The ring can be perforated (42) and ribbed (41) to provide improved ventilation of the stoma area during use.
The device can be employed with conventional surgically formed procedures, and is replaceable.
Servicing of the device can be made at home, rather than at a hospital.
GASTRO-JEJUNAL FEEDING DEVICE
A device is disclosed for supplying food and medication to a patient, the device being inserted through a stoma and into the patient's stomach for feeding into the stomach and/or the jejunum. The device may also be used to feed directly into the jejunum by by-passing the stomach, or for drainage and/or decompression.
The device is secured in place by an inflatable balloon (32) within the stomach, or by a plate if the stomach is by-passed, and by an adjustable ring (43) on the abdominal wall. The adjustable ring also prevents ingestion of the device into the stomach. During use, the ring can be retracted to permit cleaning of the stoma area. The ring can be perforated (42) and ribbed (41) to provide improved ventilation of the stoma area during use.
The device can be employed with conventional surgically formed procedures, and is replaceable.
Servicing of the device can be made at home, rather than at a hospital.
Description
- ~7~37~ ;
.
CASTRO-JEJUNAL FEEDING DEVICE
Thi~ invention relateq to a new and improved feeding tube, and more specifically to a gastro-jejunal Peeding tube that i~ inqertable through a stoma Ln the patient's stomach wall and secured within the patient'~
stomach and against the abdominal wall. Alternatively, the device may be employed to by-pass the stomach and feed directly into the jejunum, or for drainage and/or decompression.
Some types of patient feeding devices employ a gastrostomy feeding tube. However, if the patient has a problem with gastric reflux or vomiting, or ii the stomach is not adequate for the patient's digestive proceqs requirements, another ~eeding mode must be chosen. This can be accompli3hed by by-passing the stomach and supplying ~ood directly into the jejunum with a feeding tube.
Many types of feeding devices have been developed, but they suffer from various drawbacks.
These include: the ejection or loss of liquids from the stomach and back through the device; leaking around the , " . :, :
. .
~ 7~37~s3 .
per1phery of the device; and, premature deterioration of the materials of construction. Also, lt 1~
difficult to maintain the device in place in a stable manner in the patient, and this latter problem can result in the device being ingested into the ~tomach, and eventually into the pylorum. Devices presently on the market are not 9 ized properly, and they use material~ that are prone to fairly rapid deterioration.
Moreover, they can become entangled and dislodged from the patient due to improper sizing and inadequate locking of the device to the patient. In some prior art devices, the exterior of the gastrostomy tube is taped to the wearer7s body. This procedure can cause infection at the stoma entry, and along the taped area, as well as causing irritation due to the dif~iculty in maintaining these areas clean.
Other prior art devices employ a spring biased or threaded locking mechanism to secure a locking ring to the wearer's body, the locking ring being fastened on the gastrostomy tube. But these devices maintain a fixed pres3ure or position of the locking ring on the gastrostomy tube, and do not self adjust to peristaltic pressure of the stomach. This is of particular importance in the case of neonatal patientq or others such as Lncoherent or unconscious patients who are . . .
. . .
- 3 - ~ 799 .
unable to communicate the nature of their discomfort.
Cenerally, the use of tape or mechanical locking devicea require~ extra care which is usually provided by trained personnel such as nurses.
According to one aspect of the inventlon, a gastrostomy of ~ejunostomy Peeding tube is provided for in~ertion through the stoma of the patient's stomach wall and into the patient's stomach and~or jejunum.
The feeding tube is provided with an inflatable balloon at one end to position and secure the tube within the stomach. The outer end of the tube is provided with a moveable locking ring that can be adjusted by frictional engagement of the locking ring with the gastrostomy or jejunal feeding tube to accommodate to the size of the wearer. Since the locking ring does not require or employ tape to secure the device in place, problems associated with skin irritation and with maintaining both the taped areas and the stoma area clean are greatly reduced. The locking ring can simply be moved along the tube against the frictional force between the ring and the tube to permit cleaning of the stoma entry through which the catheter is inserted. The locking ring is then repositioned to its normal location, i.e. in close contact with the wearer's abdomen.
4 ~ 799 The balloon and locking ring thu~ both function to maintain the device in place, and prevent the device, by frictional engagement between the locking r~ng and tube, from being drawn into the ~tomach, or being inadvertently pulled out. If desired, a mushroom tip can be used in place of a baloon, and this can be important during the firqt few post-operative days when a balloon tip ls rnore vulunerable to being ruptured.
In the case of a gasto-jejunal feeding system, one embodiment of the invention involves extending the tube through the stomach and feeding directly into the jejunum. In another embodiment, the feeding system of thi~ invention permits liquid food to be supplied to the jejunum while the stomach is drained by means of a comounted gastrostomy tube. This represents a significant benefit for patient's who have a problem with ga~tric re~lux or vomiting. However, if the stomach ~unction is only somewhat impaired and vomiting or gastric re~lux are not a problem with a particular patient, liquid food can be qupplied to both the ~ejunum and the stomach through both tubes.
In another embodiment, the device may be adapted to feed dlrectly through a jejunal stoma and into the jejunum.
' .
' " . . ' ~ ~7~3799 The device of thi~ invention is preferably constructed of a medical grade silicone ela~tomer, rather than a latex or silicone latex comblnation.
Consequently, use of the silicone elastomer provides a ~uitably inert material compared to the latex. Hence, the elastomer requires replacement about every 6 - 8 weeks compared to a silicone latex which needs replacing about every three weeks.
There follow~ a description by way of example oE specific embodiments of the invention, reference being made to the accompanying drawings, in which:
Fig. 1 is an external perspective view of the gastrostomy device of this invention;
Fig. 2 is an external perspective view oP the said device partly Yragmented, showing the outlet end, and the balloon when deflated;
Fig. 3 is a perspective view, partly broken away, olf the said device installed in a patient;
Fig. 4 is an external perspective view of a preferred form of locking ring employed in the device;
Fig. 5A i~ an external perspective view showing the use oY a mushroom tip in place of the balloon, together with a per~orated and rlbbed locking ring;
- 6 ~ 9~9 . ?
Fig. 5B is an external, perspective view of the ~ald devic~ for feeding into the jejunum via a stomach placed stoma;
Fig. 6 is an external, perspective view of the said device for feeding into both the stomach and ~ejunum via a stomach placed stoma; and Fig. 7 is an external, perspective view of the said device adapted for by-passing the stomach and feeding directly into the jejunum.
The gastrostomy catheter device 10 of this invention is shown in Fig. 1, and provides an inlet end 12, through which is fed food and medication, and an outlet end 13 that extends into the patient's stomach.
A plurality of outlet ports, two of which are shown, are located ak the outlet end 13. The catheter 10 is secured inside the stomach by an in~latable balloon 16, and on the patient's abdomen by an adjustable silicone locking ring 17. As shown in Fig. 4, the locking ring 17 is provided with a plurality of vent holeq 17A and a circular ridge 17B to permit air to contact the entry to the stoma and reduce infection and skin irritation.
As indicated, use of the ring prevents the catheter from being drawn into the patient's stomach.
In addition, since the adjustable ring does not require the use of tape, a potential source of skin irritation .
. , :
.
7 ~7~7g9 and infection iq eliminated. The portlon 18 o~ the catheter tube 11 between the ring 17 and balloon 16 iq secured within the stoma, and thi~ arrangement of the balloon and ring prevents the catheter from being drawn lnto the patient'~ qtomach.
In Flg. 1, the balloon ls inflated by liquid or gas which is pa~sed through a valve 19 and llne 20 into port.21 that i~ surrounded by the balloon. The line 20 is bonded along the inside of the catheter tube 11 and extends to the outlet of the catheter where it is end sealed; the end seal forces the inflating gas into the port 21. Fig. 2 shows the balloon 16 in a deflated position.
The inlet end 12 is provided with an integrally ~ormed end plug 22 attached to the catheter by a band 23. A plurality o~ rings, 24, 25 are formed on the plug to engage corresponding groovss (not shown) on the inside o~ the bore at the inlet. The combined effect o~ the plug and bore fit, and the fit between the grooves and ringY prevent the plug from being dislodged during use, and hence, will prevent the contents of the stomach from draining out through the catheter.
Basically, the catheter device is inserted into the patient through a surgically prepared stoma created in the abdominal wall using pre-existing ! ~ 8 _ ~Z79 surgical procedures. These procedures include Stamms Castrostomy, Witzel Gaatrostomy, and others. ALso, non surgical procedures may be employed such as percutaneous ga~trostomy. The Janeway surgical procedure also may be used.
The catheter tube 10, with surrounding, concentric pur~e strlng sutures, i9 inserted through the stoma and gastric wall into the stomach. The purse strings will permanently invaginate a portion of the stomach and stoma to shape around the catheter tube and then will dissolve, leaving the gastrostomy tube in place and ready for use. Fig. 3 shows the device when installed. ~he inflated balloon forms a gasket that seals the entrance to the stoma, and along with the locking ring 17, secures the device in place. The device may be constructed in various sizes to accommodate a particular patient. Sizes such as 12~
14, 16, 18 and 20 French, and corresponding diameters varying from about 0.157" - 0.263", (4 - 6.7mm), and a wall thickness of about 0.035" (0.9mm), may be used.
After being used for a suitable time, say 6 to 8 or 9 weeks, the catheter tube is, of course, replaced. This ls accomplished simply by deflating the balloon, retracting the adjustable ring, and removing the tube from the patient.
~ ! ' - 9 ~ 379~
Fig. 5A illustrates the use of a mushroom tip employed in place of a balloon, and a locking ring designed to provide air circulation between the ring and stoma areas to reduce irrltation and the possibility of infection. The ga3trostomy catheter device 30 in¢ludes a tube portion 31, mushroom tip 32, ad~ustable locking ring 33, and food inlet portion 34.
The locking ring 33 includes a collar 35 and a plurality of raised, concentric legs 36, air ~ents 37, and air gaps 38 between the legs 36 to permit circulation of air between the ring and stoma area.
The mushroom tip 32 is inserted (and removed) with a stylet through the tube and expands to its final shape in the stomach when it is pushed through the tube. The food inlet 34 has the same construction as that shown in Fig,. 1.
It will be appreciated that while a balloon or mushroom tip are described above ~or securing the device internally, components such as a plate may be used a~ a substitute ~or the balloon or mushroom tip components.
The operation of the locking ring 33 is the same as that of the ring 17 in Fig. 1. Basically, the locking ring 33 i~ adjustable along the tube 31 and forms a light friction lock against the user's abdomen.
1 o - ~ ~7~7~ ~
When the stoma area requires cleaning, the ring 33 i~
slmply retracted agalnst the frictlonal force between the ring and tube 31, and then forced back against the abdomen after the stoma area has been cleaned.
Usuallyt the locking ring 33 and tube 31 are both made Or medical grade ~ilicone material.
Fig~. 5B and 6 Lllustrate the use of a gastrostomy placed stoma for feeding into the jejunum (Fig. 5B), or into the stomach and/or the jejunum (Fig.
6). Fig. 7 illustrates the use of a jejunal placed stoma which by-passes the stomach and feeds directly into the jejunum.
In Fig. 5B, the jejunal feeding device 30 includes a feeding tube 31 having an open end 31a that extends through the stomach and into the jejunum. The device provides an expandable balloon portion 32, locking ring 33 and an end member 34 having an inflating valve 35 and feed inlet 36. A gas line 37 is bonde~ along the interior of the tube and joins the interior of the balloon with the valve. An outlet port 38 enables the balloon to be filled from the valve via the ga~ line.
The locking ring 33 includes a collar 40 and plurality of raised, concentric ribs 41, air vents 42, and air gaps 43 between the legs to permit clrculation ' ' ' ':
' ~79799 of air between the ring and stoma area. The central portlon of the locking ring defines a bore 44 through which paqqes the feeding tube 31. The frictlonal contact between the bore wall and collar 40 with the tube ls sufficiently great to permit the locking ring to remain in contact with the patient's abdominal wall during uqe. However, the frictional contact between the tube and locking ring i9 sufficiently low so as to permit outward movement of the locking ring from the patient if the peristaltic pressure o~ the stomach becomes too great. Also, the frictional contact between the locking ring 33 and tube is su~ficiently low to permit the locking ring to be moved away from the abdominal wall and enable the stoma area to be cleaned.
As in Fig. 1, the feed inlet 36 includes an attached cover plug 45 which can be inserted into the inlet and remain in place by means of a ring 46 ~hat engages a corresponding groove (not shown) on the inside oY the bore at the inlet.
The ~ejunal feeding tube 30 is inserted into the patient in the same manner as for the gastrostomy tube shown in Fig. l. Since the jejunal tube is about 2 feet (600mm) longer than the gastrostomy tube, it can be fed directly into the ~ejunum through a simple gastrostomy stoma.
_ 12 ~ 7~9 The embodiments shown in Figs. 58 and 6 represent a considerable advantage to a patient who has a problem with gastric rePlux or vomiting,.but does not require gastric decompre~sion or drainage. In Fig. 6, the jejunal feeding tube device 50 includes a Jejunal feeding tube 51, having an outlet end portion 51a which extends through the stomach into the jejunum1 and which is perforated at 52 to permit liquid food to be passed therethrough. The tube 51 connect~ at its inlet end 51b to a food inlet port 53 having a connecting plug cover 54 bearing one or more circular ridges 55. The plug cover can be inserted into the inlet port and will be secured therein by corresponding grooves (not shown) that engage the ridges 55.
Surrounding the feeding tube 51 i~ a shorter length gastrostomy tube 56 having a plurality of drainage inletq or ~ood outlet ports, one such port 57 being shown~ The drainage outlet (or food inlet) end 56a is enlarged to form a port 59 having an attached cover plug 60. One or more circular ridges 61 formed on the plug engages corresponding grooves (not shown) on the inside of the entry port to ensure a tight fit when the entry port 59 i9 closed.
An inflatable balloon 65 is provided near the end of the gastrostomy tube and is inflatable through a 1~79~79~3 valve 66 bonded lnto the drainage (or inlet) end 56aO
The valve is used to 3upply air to the balloon through a connecting line 67 and outlet port 68 under the balloon.
A connector 69 ia employed to ~oin the jejunum tube 51, inlet end 51b, gastrostomy tube 56, and drainage (or feeding) end 56a into a rigid package.
An ad~ustable, silicone locking ring 70 is provlded with a plurality of vent holes 71 to permit air to contact the entry to the stoma and reduce infection and skin irridation. This is aided by a series of concentric ribs 72 being spaced at 73 for circulation of air therebetween. The central portion of the locking ring defines a bore 74 through which pass the jejunal and gastrostomy tubes 51 and 5~.
Frictional contact between the bore 74 and collar 75 with the gastrostomy tube 56 is sufficiently great to permit the locking ring to remain in contact with the patient's abdominal wall during use. However, the frictional contact between the tube and locking ring is sufficiently low so as to permit outward movement of the locking ring from the patient Lf the peristaltic pressure of the stomach becomes too great. Also the frictional contact between the locking ring 70 ls sufficiently low to enable the locking ring to be 1 4 - ~ 9799 retracted ~rom the abdominal wall and permit the stoma area to be cleaned. As in Fig. 5B, the already existing ~toma can ~erve either as an entry for a ~e~unal tube of ~or a ga~troqtomy tube without any additlonal surgery being required.
In Fig. 7, use o~ an inflatable balloon is elimirlated~ and a plate is employed instead. The ~e~unum feeding device 80 is shown providing a je~unal tube 81, retaining plate 82, locking ring 83 and food inlet 84. The device is secured permanently by means of the plate 82 constructed of say a silicone material, which presses against the entrance to the stoma on the inside of the jejunal wall, and by the locking ring 83 which is pressed against the wearer's abdomen at the stoma entry. As in the other embodiments, the extent of frictional engagement between the locking ring 83 and the tube 81 i~ sufficient to prevent the device from being drawn into the user by peristalsis, while still enabling the ring to move outwardly due to expansion, or to be retracted so that the stoma may be cleaned.
The present device is inexpensive and can be readily manufactured by conventional extrusion and injection molding techniques. Also, it can be easily inserted for use without generally requiring the , .. ' ., ', ~9 7~
~ervices of a physiclan or even outpatient services.
Furthermore, when in a hospital, nursing time with lt~
attendant co~ts have been found to be reduced signlficantly.
The device may be cleaned during u~e anclcan be manipulated to permlt cleaning of the stom2 area.
Finally, the device i9 safe in that it cannot be drawn into the u~er, which can be particularly dangerous to unsu~pecting in~ant~ and incoherent or unconscious patients, or the like. During use, it will not inadvertently drain the contents of the stomach of jejunum because of the end plug.
.
CASTRO-JEJUNAL FEEDING DEVICE
Thi~ invention relateq to a new and improved feeding tube, and more specifically to a gastro-jejunal Peeding tube that i~ inqertable through a stoma Ln the patient's stomach wall and secured within the patient'~
stomach and against the abdominal wall. Alternatively, the device may be employed to by-pass the stomach and feed directly into the jejunum, or for drainage and/or decompression.
Some types of patient feeding devices employ a gastrostomy feeding tube. However, if the patient has a problem with gastric reflux or vomiting, or ii the stomach is not adequate for the patient's digestive proceqs requirements, another ~eeding mode must be chosen. This can be accompli3hed by by-passing the stomach and supplying ~ood directly into the jejunum with a feeding tube.
Many types of feeding devices have been developed, but they suffer from various drawbacks.
These include: the ejection or loss of liquids from the stomach and back through the device; leaking around the , " . :, :
. .
~ 7~37~s3 .
per1phery of the device; and, premature deterioration of the materials of construction. Also, lt 1~
difficult to maintain the device in place in a stable manner in the patient, and this latter problem can result in the device being ingested into the ~tomach, and eventually into the pylorum. Devices presently on the market are not 9 ized properly, and they use material~ that are prone to fairly rapid deterioration.
Moreover, they can become entangled and dislodged from the patient due to improper sizing and inadequate locking of the device to the patient. In some prior art devices, the exterior of the gastrostomy tube is taped to the wearer7s body. This procedure can cause infection at the stoma entry, and along the taped area, as well as causing irritation due to the dif~iculty in maintaining these areas clean.
Other prior art devices employ a spring biased or threaded locking mechanism to secure a locking ring to the wearer's body, the locking ring being fastened on the gastrostomy tube. But these devices maintain a fixed pres3ure or position of the locking ring on the gastrostomy tube, and do not self adjust to peristaltic pressure of the stomach. This is of particular importance in the case of neonatal patientq or others such as Lncoherent or unconscious patients who are . . .
. . .
- 3 - ~ 799 .
unable to communicate the nature of their discomfort.
Cenerally, the use of tape or mechanical locking devicea require~ extra care which is usually provided by trained personnel such as nurses.
According to one aspect of the inventlon, a gastrostomy of ~ejunostomy Peeding tube is provided for in~ertion through the stoma of the patient's stomach wall and into the patient's stomach and~or jejunum.
The feeding tube is provided with an inflatable balloon at one end to position and secure the tube within the stomach. The outer end of the tube is provided with a moveable locking ring that can be adjusted by frictional engagement of the locking ring with the gastrostomy or jejunal feeding tube to accommodate to the size of the wearer. Since the locking ring does not require or employ tape to secure the device in place, problems associated with skin irritation and with maintaining both the taped areas and the stoma area clean are greatly reduced. The locking ring can simply be moved along the tube against the frictional force between the ring and the tube to permit cleaning of the stoma entry through which the catheter is inserted. The locking ring is then repositioned to its normal location, i.e. in close contact with the wearer's abdomen.
4 ~ 799 The balloon and locking ring thu~ both function to maintain the device in place, and prevent the device, by frictional engagement between the locking r~ng and tube, from being drawn into the ~tomach, or being inadvertently pulled out. If desired, a mushroom tip can be used in place of a baloon, and this can be important during the firqt few post-operative days when a balloon tip ls rnore vulunerable to being ruptured.
In the case of a gasto-jejunal feeding system, one embodiment of the invention involves extending the tube through the stomach and feeding directly into the jejunum. In another embodiment, the feeding system of thi~ invention permits liquid food to be supplied to the jejunum while the stomach is drained by means of a comounted gastrostomy tube. This represents a significant benefit for patient's who have a problem with ga~tric re~lux or vomiting. However, if the stomach ~unction is only somewhat impaired and vomiting or gastric re~lux are not a problem with a particular patient, liquid food can be qupplied to both the ~ejunum and the stomach through both tubes.
In another embodiment, the device may be adapted to feed dlrectly through a jejunal stoma and into the jejunum.
' .
' " . . ' ~ ~7~3799 The device of thi~ invention is preferably constructed of a medical grade silicone ela~tomer, rather than a latex or silicone latex comblnation.
Consequently, use of the silicone elastomer provides a ~uitably inert material compared to the latex. Hence, the elastomer requires replacement about every 6 - 8 weeks compared to a silicone latex which needs replacing about every three weeks.
There follow~ a description by way of example oE specific embodiments of the invention, reference being made to the accompanying drawings, in which:
Fig. 1 is an external perspective view of the gastrostomy device of this invention;
Fig. 2 is an external perspective view oP the said device partly Yragmented, showing the outlet end, and the balloon when deflated;
Fig. 3 is a perspective view, partly broken away, olf the said device installed in a patient;
Fig. 4 is an external perspective view of a preferred form of locking ring employed in the device;
Fig. 5A i~ an external perspective view showing the use oY a mushroom tip in place of the balloon, together with a per~orated and rlbbed locking ring;
- 6 ~ 9~9 . ?
Fig. 5B is an external, perspective view of the ~ald devic~ for feeding into the jejunum via a stomach placed stoma;
Fig. 6 is an external, perspective view of the said device for feeding into both the stomach and ~ejunum via a stomach placed stoma; and Fig. 7 is an external, perspective view of the said device adapted for by-passing the stomach and feeding directly into the jejunum.
The gastrostomy catheter device 10 of this invention is shown in Fig. 1, and provides an inlet end 12, through which is fed food and medication, and an outlet end 13 that extends into the patient's stomach.
A plurality of outlet ports, two of which are shown, are located ak the outlet end 13. The catheter 10 is secured inside the stomach by an in~latable balloon 16, and on the patient's abdomen by an adjustable silicone locking ring 17. As shown in Fig. 4, the locking ring 17 is provided with a plurality of vent holeq 17A and a circular ridge 17B to permit air to contact the entry to the stoma and reduce infection and skin irritation.
As indicated, use of the ring prevents the catheter from being drawn into the patient's stomach.
In addition, since the adjustable ring does not require the use of tape, a potential source of skin irritation .
. , :
.
7 ~7~7g9 and infection iq eliminated. The portlon 18 o~ the catheter tube 11 between the ring 17 and balloon 16 iq secured within the stoma, and thi~ arrangement of the balloon and ring prevents the catheter from being drawn lnto the patient'~ qtomach.
In Flg. 1, the balloon ls inflated by liquid or gas which is pa~sed through a valve 19 and llne 20 into port.21 that i~ surrounded by the balloon. The line 20 is bonded along the inside of the catheter tube 11 and extends to the outlet of the catheter where it is end sealed; the end seal forces the inflating gas into the port 21. Fig. 2 shows the balloon 16 in a deflated position.
The inlet end 12 is provided with an integrally ~ormed end plug 22 attached to the catheter by a band 23. A plurality o~ rings, 24, 25 are formed on the plug to engage corresponding groovss (not shown) on the inside o~ the bore at the inlet. The combined effect o~ the plug and bore fit, and the fit between the grooves and ringY prevent the plug from being dislodged during use, and hence, will prevent the contents of the stomach from draining out through the catheter.
Basically, the catheter device is inserted into the patient through a surgically prepared stoma created in the abdominal wall using pre-existing ! ~ 8 _ ~Z79 surgical procedures. These procedures include Stamms Castrostomy, Witzel Gaatrostomy, and others. ALso, non surgical procedures may be employed such as percutaneous ga~trostomy. The Janeway surgical procedure also may be used.
The catheter tube 10, with surrounding, concentric pur~e strlng sutures, i9 inserted through the stoma and gastric wall into the stomach. The purse strings will permanently invaginate a portion of the stomach and stoma to shape around the catheter tube and then will dissolve, leaving the gastrostomy tube in place and ready for use. Fig. 3 shows the device when installed. ~he inflated balloon forms a gasket that seals the entrance to the stoma, and along with the locking ring 17, secures the device in place. The device may be constructed in various sizes to accommodate a particular patient. Sizes such as 12~
14, 16, 18 and 20 French, and corresponding diameters varying from about 0.157" - 0.263", (4 - 6.7mm), and a wall thickness of about 0.035" (0.9mm), may be used.
After being used for a suitable time, say 6 to 8 or 9 weeks, the catheter tube is, of course, replaced. This ls accomplished simply by deflating the balloon, retracting the adjustable ring, and removing the tube from the patient.
~ ! ' - 9 ~ 379~
Fig. 5A illustrates the use of a mushroom tip employed in place of a balloon, and a locking ring designed to provide air circulation between the ring and stoma areas to reduce irrltation and the possibility of infection. The ga3trostomy catheter device 30 in¢ludes a tube portion 31, mushroom tip 32, ad~ustable locking ring 33, and food inlet portion 34.
The locking ring 33 includes a collar 35 and a plurality of raised, concentric legs 36, air ~ents 37, and air gaps 38 between the legs 36 to permit circulation of air between the ring and stoma area.
The mushroom tip 32 is inserted (and removed) with a stylet through the tube and expands to its final shape in the stomach when it is pushed through the tube. The food inlet 34 has the same construction as that shown in Fig,. 1.
It will be appreciated that while a balloon or mushroom tip are described above ~or securing the device internally, components such as a plate may be used a~ a substitute ~or the balloon or mushroom tip components.
The operation of the locking ring 33 is the same as that of the ring 17 in Fig. 1. Basically, the locking ring 33 i~ adjustable along the tube 31 and forms a light friction lock against the user's abdomen.
1 o - ~ ~7~7~ ~
When the stoma area requires cleaning, the ring 33 i~
slmply retracted agalnst the frictlonal force between the ring and tube 31, and then forced back against the abdomen after the stoma area has been cleaned.
Usuallyt the locking ring 33 and tube 31 are both made Or medical grade ~ilicone material.
Fig~. 5B and 6 Lllustrate the use of a gastrostomy placed stoma for feeding into the jejunum (Fig. 5B), or into the stomach and/or the jejunum (Fig.
6). Fig. 7 illustrates the use of a jejunal placed stoma which by-passes the stomach and feeds directly into the jejunum.
In Fig. 5B, the jejunal feeding device 30 includes a feeding tube 31 having an open end 31a that extends through the stomach and into the jejunum. The device provides an expandable balloon portion 32, locking ring 33 and an end member 34 having an inflating valve 35 and feed inlet 36. A gas line 37 is bonde~ along the interior of the tube and joins the interior of the balloon with the valve. An outlet port 38 enables the balloon to be filled from the valve via the ga~ line.
The locking ring 33 includes a collar 40 and plurality of raised, concentric ribs 41, air vents 42, and air gaps 43 between the legs to permit clrculation ' ' ' ':
' ~79799 of air between the ring and stoma area. The central portlon of the locking ring defines a bore 44 through which paqqes the feeding tube 31. The frictlonal contact between the bore wall and collar 40 with the tube ls sufficiently great to permit the locking ring to remain in contact with the patient's abdominal wall during uqe. However, the frictional contact between the tube and locking ring i9 sufficiently low so as to permit outward movement of the locking ring from the patient if the peristaltic pressure o~ the stomach becomes too great. Also, the frictional contact between the locking ring 33 and tube is su~ficiently low to permit the locking ring to be moved away from the abdominal wall and enable the stoma area to be cleaned.
As in Fig. 1, the feed inlet 36 includes an attached cover plug 45 which can be inserted into the inlet and remain in place by means of a ring 46 ~hat engages a corresponding groove (not shown) on the inside oY the bore at the inlet.
The ~ejunal feeding tube 30 is inserted into the patient in the same manner as for the gastrostomy tube shown in Fig. l. Since the jejunal tube is about 2 feet (600mm) longer than the gastrostomy tube, it can be fed directly into the ~ejunum through a simple gastrostomy stoma.
_ 12 ~ 7~9 The embodiments shown in Figs. 58 and 6 represent a considerable advantage to a patient who has a problem with gastric rePlux or vomiting,.but does not require gastric decompre~sion or drainage. In Fig. 6, the jejunal feeding tube device 50 includes a Jejunal feeding tube 51, having an outlet end portion 51a which extends through the stomach into the jejunum1 and which is perforated at 52 to permit liquid food to be passed therethrough. The tube 51 connect~ at its inlet end 51b to a food inlet port 53 having a connecting plug cover 54 bearing one or more circular ridges 55. The plug cover can be inserted into the inlet port and will be secured therein by corresponding grooves (not shown) that engage the ridges 55.
Surrounding the feeding tube 51 i~ a shorter length gastrostomy tube 56 having a plurality of drainage inletq or ~ood outlet ports, one such port 57 being shown~ The drainage outlet (or food inlet) end 56a is enlarged to form a port 59 having an attached cover plug 60. One or more circular ridges 61 formed on the plug engages corresponding grooves (not shown) on the inside of the entry port to ensure a tight fit when the entry port 59 i9 closed.
An inflatable balloon 65 is provided near the end of the gastrostomy tube and is inflatable through a 1~79~79~3 valve 66 bonded lnto the drainage (or inlet) end 56aO
The valve is used to 3upply air to the balloon through a connecting line 67 and outlet port 68 under the balloon.
A connector 69 ia employed to ~oin the jejunum tube 51, inlet end 51b, gastrostomy tube 56, and drainage (or feeding) end 56a into a rigid package.
An ad~ustable, silicone locking ring 70 is provlded with a plurality of vent holes 71 to permit air to contact the entry to the stoma and reduce infection and skin irridation. This is aided by a series of concentric ribs 72 being spaced at 73 for circulation of air therebetween. The central portion of the locking ring defines a bore 74 through which pass the jejunal and gastrostomy tubes 51 and 5~.
Frictional contact between the bore 74 and collar 75 with the gastrostomy tube 56 is sufficiently great to permit the locking ring to remain in contact with the patient's abdominal wall during use. However, the frictional contact between the tube and locking ring is sufficiently low so as to permit outward movement of the locking ring from the patient Lf the peristaltic pressure of the stomach becomes too great. Also the frictional contact between the locking ring 70 ls sufficiently low to enable the locking ring to be 1 4 - ~ 9799 retracted ~rom the abdominal wall and permit the stoma area to be cleaned. As in Fig. 5B, the already existing ~toma can ~erve either as an entry for a ~e~unal tube of ~or a ga~troqtomy tube without any additlonal surgery being required.
In Fig. 7, use o~ an inflatable balloon is elimirlated~ and a plate is employed instead. The ~e~unum feeding device 80 is shown providing a je~unal tube 81, retaining plate 82, locking ring 83 and food inlet 84. The device is secured permanently by means of the plate 82 constructed of say a silicone material, which presses against the entrance to the stoma on the inside of the jejunal wall, and by the locking ring 83 which is pressed against the wearer's abdomen at the stoma entry. As in the other embodiments, the extent of frictional engagement between the locking ring 83 and the tube 81 i~ sufficient to prevent the device from being drawn into the user by peristalsis, while still enabling the ring to move outwardly due to expansion, or to be retracted so that the stoma may be cleaned.
The present device is inexpensive and can be readily manufactured by conventional extrusion and injection molding techniques. Also, it can be easily inserted for use without generally requiring the , .. ' ., ', ~9 7~
~ervices of a physiclan or even outpatient services.
Furthermore, when in a hospital, nursing time with lt~
attendant co~ts have been found to be reduced signlficantly.
The device may be cleaned during u~e anclcan be manipulated to permlt cleaning of the stom2 area.
Finally, the device i9 safe in that it cannot be drawn into the u~er, which can be particularly dangerous to unsu~pecting in~ant~ and incoherent or unconscious patients, or the like. During use, it will not inadvertently drain the contents of the stomach of jejunum because of the end plug.
Claims (31)
1. A gastrostomy catheter device for feeding into a patient's stomach, comprising:
a) an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food;
b) an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c) an inflation valve mounted near the inlet end of the tube;
d) a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e) a closure plug for the feeding inlet and secured to the feeding tube by an integral band; and f) an adjustable ring slidably mounted along the feeding tube and medially thereof; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the balloon is inflated through the valve and the valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. adjustment of the ring will secure the device to the patient's body and prevent the device from being drawn into the patient's stomach;
iv. loosening of the ring enables the stoma and adjacent areas to be cleaned; and v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
a) an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food;
b) an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c) an inflation valve mounted near the inlet end of the tube;
d) a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e) a closure plug for the feeding inlet and secured to the feeding tube by an integral band; and f) an adjustable ring slidably mounted along the feeding tube and medially thereof; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the balloon is inflated through the valve and the valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. adjustment of the ring will secure the device to the patient's body and prevent the device from being drawn into the patient's stomach;
iv. loosening of the ring enables the stoma and adjacent areas to be cleaned; and v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
2. A device for feeding into a patient's jejunum, comprising:
a) an elongate jejunal feeding tube, including an outer extension from the patient's stomach, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's stomach;
b) an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c) an inflation valve mounted near the inlet end of the tube.
d) a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e) a closure plug for the feeding inlet and secured to the feeding tube by an integral band; and f) a locking ring positioned medially along the outer extension of the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stomach placed stoma and into the patient's jejunum;
ii. when the balloon is inflated through the valve and valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. adjustment of the ring will secure the device to the patient's body by frictional engagement with the feeding tube and prevent the device from being drawn into the patient's stomach;
iv. retraction of the ring against the force of frictional engagement enables the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
a) an elongate jejunal feeding tube, including an outer extension from the patient's stomach, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's stomach;
b) an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c) an inflation valve mounted near the inlet end of the tube.
d) a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e) a closure plug for the feeding inlet and secured to the feeding tube by an integral band; and f) a locking ring positioned medially along the outer extension of the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stomach placed stoma and into the patient's jejunum;
ii. when the balloon is inflated through the valve and valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. adjustment of the ring will secure the device to the patient's body by frictional engagement with the feeding tube and prevent the device from being drawn into the patient's stomach;
iv. retraction of the ring against the force of frictional engagement enables the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
3. The device of claim 2, in which the device provides a gastrostomy tube surrounding the jejunal tube, the gastrostomy tube including a feeding inlet and closure plug therefor, the gastrostomy tube being adapted to feed and drain the stomach.
4. The device of claim 3, comprising a connector for securing the jejunal and gastrostomy feeding tubes and their respective inlet ends.
5. The device of claim 2, in which a mushroom tip is employed to secure the device within the patient's stomach.
6. A device for feeding into a patient's jejunum, comprising:
a) an elongate, jejunal feeding tube, including an outer extension from the patient's jejunum, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet and positioned within the patient's jejunum;
b) a flexible plate mounted around the table and positioned about midway, thereof;
c) a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, d) a locking ring positioned medially along the outer extension of the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the feeding tube is inserted through a jejunal placed stoma it will be secured within the stoma by means of the plate which forms a seal with the stoma;
ii. adjustment of the ring will secure the device to the patient's body by frictional engagement with the feeding tube and prevent the device from being drawn into the patient's stomach; and iii. retraction of the ring against the force of frictional engagement enables the stoma and adjacent area to be cleaned.
a) an elongate, jejunal feeding tube, including an outer extension from the patient's jejunum, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet and positioned within the patient's jejunum;
b) a flexible plate mounted around the table and positioned about midway, thereof;
c) a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, d) a locking ring positioned medially along the outer extension of the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the feeding tube is inserted through a jejunal placed stoma it will be secured within the stoma by means of the plate which forms a seal with the stoma;
ii. adjustment of the ring will secure the device to the patient's body by frictional engagement with the feeding tube and prevent the device from being drawn into the patient's stomach; and iii. retraction of the ring against the force of frictional engagement enables the stoma and adjacent area to be cleaned.
7. The catheter or device of any of claims 1, 2 or 3 in which the spaced ridges of the locking ring are arranged radially of the ring.
8. The device of claim 1, 2 or 3 constructed of a medical grade silicone elastomer.
9. A device for feeding into a patient's jejunum, comprising:
a. an elongate, jejunal feeding tube, including an outer extension from the patient's stomach, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's stomach;
b. an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c. an inflation valve mounted near the inlet end of the tube;
d. a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, f. a locking ring positioned medially along the outer extension of the tube, and sized to frictionally engage the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stomach placed stoma and into the patient's jejunum;
ii. when the balloon is inflated through the valve and valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state ox when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring being entirely against the force of frictional engagement to enable the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
a. an elongate, jejunal feeding tube, including an outer extension from the patient's stomach, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's stomach;
b. an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c. an inflation valve mounted near the inlet end of the tube;
d. a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, f. a locking ring positioned medially along the outer extension of the tube, and sized to frictionally engage the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the balloon is deflated, the feeding tube may be inserted through a stomach placed stoma and into the patient's jejunum;
ii. when the balloon is inflated through the valve and valve line, it will secure the device within the patient's stomach and form a seal adjacent the stoma;
iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state ox when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring being entirely against the force of frictional engagement to enable the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring enables the device to be removed from the patient.
10. The device of claim 9, which provides a gastrostomy tube surrounding the jejunal tube, the balloon and locking ring being mounted on the gastrostomy tube, the gastrostomy tube including a feeding inlet and closure plug therefor, the gastrostomy tube being adapted to feed and drain the stomach.
11. The device of claim 10, comprising a connector for securing the jejunal tube and gastrostomy tube and their respective inlet ends.
12. The device of claim 9, constructed of a medical grade silicone elastomer, and the like.
13. The device of claim 9, in which the spaced ridges of the locking ring are arranged radially of the ring.
14. A device for feeding into a patient's jejunum, comprising:
a. an elongate, jejunal feeding tube, including an outer extension from the patient's jejunum, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's jejunum;
b. a flexible plate mounted around the tube and positioned about midway, thereof;
c. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, d. a locking ring positioned medially along the outer extension of the tube, and sized to frictionally engage the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the feeding tube is inserted through a jejunal placed stoma it will be secured within the stoma by means of the plate which forms a seal with the stoma;
ii. securement of the ring to the tube being provided solely by frictional engagement therebetween, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient; and, iii. retraction of the ring against the force of frictional engagement enables the stoma and adjacent areas to be cleaned.
a. an elongate, jejunal feeding tube, including an outer extension from the patient's jejunum, the tube having a feeding inlet end mounted on the outer extension and a perforated outlet end positioned within the patient's jejunum;
b. a flexible plate mounted around the tube and positioned about midway, thereof;
c. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
and, d. a locking ring positioned medially along the outer extension of the tube, and sized to frictionally engage the tube and slidably mounted therealong, and adjustable solely by frictional engagement with the tube to accommodate to the size of the wearer, the locking ring providing a plurality of perforations and spaced ridges to enable air circulation between the locking ring and patient's body; whereby, i. when the feeding tube is inserted through a jejunal placed stoma it will be secured within the stoma by means of the plate which forms a seal with the stoma;
ii. securement of the ring to the tube being provided solely by frictional engagement therebetween, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient; and, iii. retraction of the ring against the force of frictional engagement enables the stoma and adjacent areas to be cleaned.
15. The device of claim 14, in which the spaced ridges of the locking ring are arranged radially of the ring.
16. A gastrostomy catheter device for feeding into a patient's stomach, comprising:
a. an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food, the feeding tube extending outwardly from the patient's stomach to support external components of the device;
b. an expandable structure mounted on the tube near the outlet end;
c. means to expand the expandable structure;
d. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
e. an adjustable ring slidably mounted along the feeding tube, and medially thereof, and sized to frictionally engage the tube; whereby:
i. when the expandable structure is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the expandable structure is inflated, it is adapted to form a seal within the patient's stomach and adjacent the stoma;
iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, the ring and tube both being made of silicone material or the like, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the expandable structure and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring along the feeding tube away from the patient's body being entirely against frictional engagement forces between the ring and tube to enable the stoma and adjacent areas to be cleaned; and, v. when the expandable structure is deflated, retraction of the feeding tube enables the device to be removed from the patient.
a. an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food, the feeding tube extending outwardly from the patient's stomach to support external components of the device;
b. an expandable structure mounted on the tube near the outlet end;
c. means to expand the expandable structure;
d. a closure plug for the feeding inlet and secured to the feeding tube by an integral band;
e. an adjustable ring slidably mounted along the feeding tube, and medially thereof, and sized to frictionally engage the tube; whereby:
i. when the expandable structure is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the expandable structure is inflated, it is adapted to form a seal within the patient's stomach and adjacent the stoma;
iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, the ring and tube both being made of silicone material or the like, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the expandable structure and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring along the feeding tube away from the patient's body being entirely against frictional engagement forces between the ring and tube to enable the stoma and adjacent areas to be cleaned; and, v. when the expandable structure is deflated, retraction of the feeding tube enables the device to be removed from the patient.
17. The catheter device of claim 16, in which the adjustable ring is flak.
18. The catheter device of claim 17, in which the adjustable ring is perforated.
19. The catheter device of claim 16, in which the adjustable ring provides ridge means on one side thereof, adjacent the patient.
20. The catheter device of claim 19, in which the adjustable ring is perforated.
21. The catheter device of claim 16, in which the expandable structure is a balloon mounted around the tube and positioned near the outlet end of the tube, an inflation valve is mounted near the inlet end of the tube, and a valve line is connected to the valve and providing an outlet port within the balloon structure for inflation thereof, the valve line being positioned adjacent the feeding tube.
22. The catheter device of claim 16, in which the catheter is sized 12-20 French and having a wall thickness of about 0.035 inches.
23. The catheter device of claim 16, in which the catheter is sized at least about 12 French.
24. The catheter device of claim 16, in which the catheter is sized about 12-20 French.
25. A gastrostomy catheter device for feeding into a patient's stomach, comprising:
a. an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food, the feeding tube extending outwardly from the patient's stomach to support external components of the device;
b. an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c. an inflation valve mounted near the inlet end of the tube;
d. a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e. a closure plug for the feeding inlet and secured to the feeding tube by an integral band and to prevent stomach drainage;
f. a perforated, adjustable ring slidably mounted along the feeding tube, and medially thereof, and sized to frictionally engage the tube;
whereby:
i. when the balloon is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the balloon is inflated through the valve and valve line, it is adapted to form a seal within the patient's stomach and adjacent the stoma, iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, the ring and tube both being made of silicone material, or the like, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring along the feeding tube away from the patient's body being entirely against frictional engagement forces between the ring and tube to enable the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring along the feeding tube enables the device to be removed from the patient.
a. an elongate feeding tube having a feeding inlet end and a perforated outlet end for discharging food, the feeding tube extending outwardly from the patient's stomach to support external components of the device;
b. an inflatable balloon structure mounted around the tube and positioned near the outlet end of the tube;
c. an inflation valve mounted near the inlet end of the tube;
d. a valve line connected to the valve and providing an outlet port within the balloon structure, the valve line being positioned adjacent the feeding tube;
e. a closure plug for the feeding inlet and secured to the feeding tube by an integral band and to prevent stomach drainage;
f. a perforated, adjustable ring slidably mounted along the feeding tube, and medially thereof, and sized to frictionally engage the tube;
whereby:
i. when the balloon is deflated, the feeding tube may be inserted through a stoma and into the patient's stomach;
ii. when the balloon is inflated through the valve and valve line, it is adapted to form a seal within the patient's stomach and adjacent the stoma, iii. securement of the ring to the tube being provided solely by frictional engagement therebetween, the ring and tube both being made of silicone material, or the like, to secure the device within the patient's body and to prevent undesirable movement of the ring along the tube, whether in the dry state or when lubricated by body fluids, the locking ring being manually adjustable along the tube to accommodate to the size of the patient, and the balloon and ring both functioning to maintain the device in place in the patient;
iv. retraction of the ring along the feeding tube away from the patient's body being entirely against frictional engagement forces between the ring and tube to enable the stoma and adjacent areas to be cleaned; and, v. when the balloon is deflated, retraction of the ring along the feeding tube enables the device to be removed from the patient.
26. The catheter of claim 25, in which the adjustable ring is perforated to admit air to the stoma.
27. The catheter of claim 26, in which the adjustable ring provides a ridge on one side thereof, to increase air circulation between the ring and stoma.
28. The catheter of claim 25, in which the device is constructed of a medical grade silicone elastomer.
29. The catheter of claim 28, having a stability time in the patient of at least about 6 weeks.
30. The catheter of claim 25, in which the valve line is formed integrally with the feeding tube.
31. The device of claim 25, comprising a closure plug and bore fit at the feeding inlet to prevent drainage from the stomach through the catheter.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000536695A CA1279799C (en) | 1987-05-08 | 1987-05-08 | Gastro-jejunal feeding device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000536695A CA1279799C (en) | 1987-05-08 | 1987-05-08 | Gastro-jejunal feeding device |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1279799C true CA1279799C (en) | 1991-02-05 |
Family
ID=4135620
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000536695A Expired - Lifetime CA1279799C (en) | 1987-05-08 | 1987-05-08 | Gastro-jejunal feeding device |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1279799C (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107374808A (en) * | 2017-08-29 | 2017-11-24 | 青岛大学附属医院 | A kind of fistulization bowl of automatic tightness regulating degree |
| GR20170100266A (en) * | 2017-06-09 | 2019-03-20 | Ηλιας Ιωαννη Παπαζησης | Accessory for the fixation of the stomach to the abdominal wall in gastrostomies |
-
1987
- 1987-05-08 CA CA000536695A patent/CA1279799C/en not_active Expired - Lifetime
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GR20170100266A (en) * | 2017-06-09 | 2019-03-20 | Ηλιας Ιωαννη Παπαζησης | Accessory for the fixation of the stomach to the abdominal wall in gastrostomies |
| GR1009893B (en) * | 2017-06-09 | 2021-01-08 | Ηλιας Ιωαννη Παπαζησης | Accessory for the fixation of the stomach to the abdominal wall in gastrostomies |
| CN107374808A (en) * | 2017-08-29 | 2017-11-24 | 青岛大学附属医院 | A kind of fistulization bowl of automatic tightness regulating degree |
| CN107374808B (en) * | 2017-08-29 | 2024-02-20 | 青岛大学附属医院 | Fistulization bowl capable of automatically adjusting tightness |
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| Date | Code | Title | Description |
|---|---|---|---|
| MKLA | Lapsed |