EP0853937A1 - Tube de gastrostomie pour nutrition entérale - Google Patents

Tube de gastrostomie pour nutrition entérale Download PDF

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Publication number
EP0853937A1
EP0853937A1 EP97203914A EP97203914A EP0853937A1 EP 0853937 A1 EP0853937 A1 EP 0853937A1 EP 97203914 A EP97203914 A EP 97203914A EP 97203914 A EP97203914 A EP 97203914A EP 0853937 A1 EP0853937 A1 EP 0853937A1
Authority
EP
European Patent Office
Prior art keywords
tubular body
duct
gastrostomic
tube device
balloon
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.)
Granted
Application number
EP97203914A
Other languages
German (de)
English (en)
Other versions
EP0853937B1 (fr
Inventor
Daniele Franchi
Francesco Greco
Giampiero Porro
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sis Ter SpA
Original Assignee
Sis Ter SpA
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Sis Ter SpA filed Critical Sis Ter SpA
Publication of EP0853937A1 publication Critical patent/EP0853937A1/fr
Application granted granted Critical
Publication of EP0853937B1 publication Critical patent/EP0853937B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61JCONTAINERS 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
    • A61J15/00Feeding-tubes for therapeutic purposes
    • A61J15/0026Parts, details or accessories for feeding-tubes
    • A61J15/003Means for fixing the tube inside the body, e.g. balloons, retaining means
    • A61J15/0034Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
    • A61J15/0038Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type
    • A61J15/0042Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61JCONTAINERS 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
    • A61J15/00Feeding-tubes for therapeutic purposes
    • A61J15/0015Gastrostomy feeding-tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61JCONTAINERS 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
    • A61J15/00Feeding-tubes for therapeutic purposes
    • A61J15/0026Parts, details or accessories for feeding-tubes
    • A61J15/0053Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin
    • A61J15/0065Fixing means and tube being one part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61JCONTAINERS 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
    • A61J15/00Feeding-tubes for therapeutic purposes
    • A61J15/0026Parts, details or accessories for feeding-tubes
    • A61J15/008Sensor means, e.g. for sensing reflux, acidity or pressure
    • A61J15/0088Sensor means, e.g. for sensing reflux, acidity or pressure for sensing parameters related to the device

Definitions

  • the present invention relates in general to gastrostomic devices for medical use, in particular for the long-term enteric nutrition of patients incapable of the natural ingestion of food and/or medicaments.
  • a solution generally adopted is that of introducing nasally one or more tubes extending as far as the inside of the gastric or intestinal cavity (nasogastric probe or nasojejunal probe).
  • PEG Percutaneous Endoscopic Gastrostomy
  • the gastrostomic tubes or “buttons” currently in use are principally of two types, namely the “balloon” and “mushroom” types, and they differ from one another principally in the form of the retaining element inside the gastric cavity and in the methods of insertion into the above-mentioned tissue passageway or "stoma" of the patient.
  • the tube is introduced by means of an obturator inserted into the internal hole of the gastrostomic tube and urged in such a manner as to confer on the mushroom-head retaining element an elongate, substantially conical, profile in order to reduce its diameter and thus to facilitate passage through the stoma, releasing it when it has passed completely into the gastric cavity.
  • an obturator inserted into the internal hole of the gastrostomic tube and urged in such a manner as to confer on the mushroom-head retaining element an elongate, substantially conical, profile in order to reduce its diameter and thus to facilitate passage through the stoma, releasing it when it has passed completely into the gastric cavity.
  • the introduction of the balloon device is easier because it is carried out with the balloon completely deflated and adhering to the tube walls.
  • the balloon is inflated and it thus maintains the end of the gastrostomic tube inside the stomach.
  • the external end of the gastrostomic tube is for its part provided with a plug or a non-return valve which enables the end to be connected periodically to a supply of nutrient material or the like to be introduced into the stomach (in addition to permitting the expulsion of air or gas present in the gastric cavity).
  • the length of the gastrostomic tube is of course chosen in accordance with the length of the stoma.
  • the balloon-type gastrostomic devices or tubes known and constructed hitherto comprise several components assembled at the manufacturing stage, and therefore require substantial labour, but, in particular, the regions of adhesion of the various components are the critical points of the device, compromising its aesthetic and functional quality.
  • tubular part a longitudinal strip produced from co-extruded radiopaque material which usually involves the entire thickness of the tube wall.
  • This solution involves a weakening of that portion of the device and a reduction in the adhesiveness of the material in the regions where the expanding balloon is to be adhesively bonded.
  • the principal aim of the present invention is to provide a gastrostomic tube device which is improved both from the structural point of view and from the functional point of view.
  • the aim of the present invention is to provide a gastrostomic tube device of which the structure permits practical industrial manufacture and, at the same time, easy location of the position of the device using radiographic techniques.
  • a device of the type comprising a tubular element which can be inserted through a stoma in the patient's abdominal wall, the tubular element having a first end provided with an inflatable balloon in order to be maintained inside the gastric cavity, and a second end which has a base resting and maintained on the patient's epidermis and which is provided with removable closure means and on-off valve means, characterised in that the tubular element is divided into two ducts, the first duct, having the larger diameter, being used for the passage of the nutritional material and being connected to the removable closure means and to the on-off valve means, and the second duct, having walls produced from radiopaque material, being connected to the inflatable balloon and being provided with a non-return valve arranged at the external end relative to the patient's epidermis, and position-marking means of material opaque to X-rays are provided on the outer surface of the gastrostomic tube.
  • the second duct is formed, with a small diameter, in the thickness of the wall of the first duct, the balloon, in the non-inflated state, is constituted by a tubular extension, of variable thickness, of the first end of the tubular element, and the tubular extension is folded back onto the outer surface of the first end of the tubular element and is secured in a sealing manner to the outer surface of the tubular element in such a manner as to envelop the lower outlet mouth of the second duct.
  • the position-marking means are preferably constituted by a thin silver ring which, during the manufacture of the tubular element, is anchored to the outer surface thereof; and is covered by the tubular extension forming the balloon during the adhesive bonding stage.
  • the silver ring is used to indicate exactly the position of the proximal point of attachment of the balloon, while a further tube of small thickness produced from radiopaque material is inserted coaxially in the small-diameter duct in order to indicate the position of the tubular portion of the device.
  • the gastrostomic tube device which, as shown by the Figures, is produced in a single piece from biocompatible plastics material (for example by means of injection or "transfer") comprises a tubular element or body, generally indicated 10, which comprises a first duct or principal duct 12 having a distal end 14 and a proximal end 16.
  • the proximal end 16 starts from a cylindrical or discoidal body 18 and more precisely from a chamber 20 which accommodates a separate and removable non-return valve 22 which can be connected to a bayonet coupling 24 of an elbow connector 26 which can in turn be connected to a supply of nutrient material.
  • the upper end of the chamber 20 is shaped in such a manner as to permit the releasable connection of a plug 28 formed with a strip 30 which is in a single piece with the discoidal body 18 and which is provided with a notch 32 promoting the bending of the strip.
  • the discoidal body 18 has a flat base 34, which is to rest on the patient's epidermis in the area of the outer mouth of the stoma or tissue duct of the patient, and, in addition to the chamber 20, comprises a second chamber 36 which accommodates an inflating and non-return valve 38 communicating with the proximal end of a second duct 40 which extends parallel to the duct 12 over a portion of its length and which is formed in the thickness of the wall of the tubular body 10.
  • the distal end of the duct 40 has a hole 42 which, as shown in Figure 1, communicates with the inside of the balloon 44, which is shown in that Figure in the inflated position and thus in the position in which it maintains the tubular body 10 inside the gastric cavity.
  • the balloon 44 is formed by a tubular extension 50 or 60 of the tubular body 10.
  • the upstream or proximal end 51 of the tubular extension 50 which is shown in the state before the balloon is inflated, is fixed firmly to the outer surface of the tubular body 10, while the distal end 53 is secured in position when the device is being finished (for example by adhesive bonding or heat-sealing) in the region of the distal end 14 of the tubular body 10.
  • the proximal end 51 of the tubular extension 50 envelops the outlet mouth 42 of the second duct 40.
  • FIG. 4 An alternative embodiment of the device is that represented in Figure 4 which shows how the balloon 44 is in this case formed by a tubular jacket 60 of reduced thickness which is concentric with the tubular body 10.
  • the tubular jacket 60 is secured permanently to the outer surface of the tubular body (for example, by heat-sealing or by means of a suitable adhesive) in the area of its distal end 61 once it has been folded back onto the tubular body 10 to the extent that it envelops the mouth 42 of the duct 40.
  • the proximal end 63 of the balloon 60 like the proximal end 51 of the embodiment of Figure 3, is fixed firmly to the outer surface of the tubular body 10.
  • a ring of material opaque to X-rays for example a silver ring 48
  • a ring of material opaque to X-rays is positioned on the outer surface of the tubular body at a predetermined distance from the base 34 of the discoidal body 18, and is simultaneously secured by adhesive bonding to the end 61 of the tubular extension 60 in the case of the embodiment of Figure 4.
  • the ring is adjacent to the limit of the balloon 44 and therefore, using simple radiography, it is possible to establish from the position of the ring 48 whether the balloon 44 and thus the gastrostomic device is positioned correctly in the gastric cavity.
EP97203914A 1996-12-16 1997-12-12 Tube de gastrostomie pour nutrition entérale Expired - Lifetime EP0853937B1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITMI962627 1996-12-16
IT96MI002627A IT1289453B1 (it) 1996-12-16 1996-12-16 Dispositivo a tubo gastrostomico per nutrizione enterale

Publications (2)

Publication Number Publication Date
EP0853937A1 true EP0853937A1 (fr) 1998-07-22
EP0853937B1 EP0853937B1 (fr) 2003-04-02

Family

ID=11375400

Family Applications (1)

Application Number Title Priority Date Filing Date
EP97203914A Expired - Lifetime EP0853937B1 (fr) 1996-12-16 1997-12-12 Tube de gastrostomie pour nutrition entérale

Country Status (4)

Country Link
EP (1) EP0853937B1 (fr)
DE (1) DE69720400T2 (fr)
ES (1) ES2191810T3 (fr)
IT (1) IT1289453B1 (fr)

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003039383A1 (fr) 2001-11-08 2003-05-15 Fresenius Kabi Deutschland Gmbh Mandrin pour catheter, instrument de mesure de longueur permettant de determiner la longueur d'une stomie et ensemble pour alimentation enterale
WO2003101522A1 (fr) * 2002-05-31 2003-12-11 Kimberly-Clark Worldwide, Inc. Systeme extra plat pour la jejunostomie transpylorique
WO2005016222A1 (fr) * 2003-08-06 2005-02-24 Kimberly-Clark Worldwide, Inc. Virole et tube enteral integrant cette virole
WO2005016221A1 (fr) * 2003-08-06 2005-02-24 Kimberly-Clark Worldwide, Inc. Connecteur comprenant un mecanisme de connexion permettant un raccordement amovible avec un tube
US7582072B2 (en) 2004-09-09 2009-09-01 Kimberly-Clark Worldwide, Inc. Artificial stoma and method of use
WO2012134196A2 (fr) * 2011-04-01 2012-10-04 관동대학교 산학협력단 Sonde naso-gastrique qui permet d'apprendre à avaler en utilisant un ballonnet, et procédé qui permet d'apprendre à avaler en utilisant celle-ci
WO2013059558A1 (fr) * 2011-10-20 2013-04-25 Covidien Lp Cathéter à fistule
WO2014009824A1 (fr) * 2012-07-13 2014-01-16 Kimberly-Clark Worldwide, Inc. Renfort de bout de sonde d'alimentation
EP1974685A4 (fr) * 2006-01-13 2015-05-27 Olympus Medical Systems Corp Dispositif médical à demeure
US10071026B2 (en) 2012-05-25 2018-09-11 Cook Medical Technologies Llc Low profile gastrostomy tubes
JP2021037347A (ja) * 2020-11-26 2021-03-11 株式会社ジェイ・エム・エス オスコネクタ

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112754814A (zh) * 2021-01-12 2021-05-07 李香珍 一种消化科护理用流食喂食装置

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4225371A (en) * 1979-04-24 1980-09-30 The Kendall Company Method of making a catheter
US4323071A (en) * 1978-04-24 1982-04-06 Advanced Catheter Systems, Inc. Vascular guiding catheter assembly and vascular dilating catheter assembly and a combination thereof and methods of making the same
US4702252A (en) * 1983-10-13 1987-10-27 Smiths Industries Public Limited Company Catheters
EP0318918A2 (fr) * 1987-12-01 1989-06-07 Terumo Kabushiki Kaisha Cathéter à balonnet gonflable
US4863424A (en) * 1983-11-18 1989-09-05 Blake Joseph W Iii Tubular medical device and method of making and using the same
EP0408198A1 (fr) * 1989-07-14 1991-01-16 Smiths Industries Public Limited Company Cathéter
US5342321A (en) * 1993-05-18 1994-08-30 Teleflex, Inc. Low profile gastrostomy catheter
US5556385A (en) * 1994-12-06 1996-09-17 Corpak, Inc. Improved percutaneous access device

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4323071A (en) * 1978-04-24 1982-04-06 Advanced Catheter Systems, Inc. Vascular guiding catheter assembly and vascular dilating catheter assembly and a combination thereof and methods of making the same
US4323071B1 (fr) * 1978-04-24 1990-05-29 Advanced Cardiovascular System
US4225371A (en) * 1979-04-24 1980-09-30 The Kendall Company Method of making a catheter
US4702252A (en) * 1983-10-13 1987-10-27 Smiths Industries Public Limited Company Catheters
US4863424A (en) * 1983-11-18 1989-09-05 Blake Joseph W Iii Tubular medical device and method of making and using the same
EP0318918A2 (fr) * 1987-12-01 1989-06-07 Terumo Kabushiki Kaisha Cathéter à balonnet gonflable
EP0408198A1 (fr) * 1989-07-14 1991-01-16 Smiths Industries Public Limited Company Cathéter
US5342321A (en) * 1993-05-18 1994-08-30 Teleflex, Inc. Low profile gastrostomy catheter
US5556385A (en) * 1994-12-06 1996-09-17 Corpak, Inc. Improved percutaneous access device

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003039383A1 (fr) 2001-11-08 2003-05-15 Fresenius Kabi Deutschland Gmbh Mandrin pour catheter, instrument de mesure de longueur permettant de determiner la longueur d'une stomie et ensemble pour alimentation enterale
WO2003101522A1 (fr) * 2002-05-31 2003-12-11 Kimberly-Clark Worldwide, Inc. Systeme extra plat pour la jejunostomie transpylorique
WO2005016222A1 (fr) * 2003-08-06 2005-02-24 Kimberly-Clark Worldwide, Inc. Virole et tube enteral integrant cette virole
WO2005016221A1 (fr) * 2003-08-06 2005-02-24 Kimberly-Clark Worldwide, Inc. Connecteur comprenant un mecanisme de connexion permettant un raccordement amovible avec un tube
US7582072B2 (en) 2004-09-09 2009-09-01 Kimberly-Clark Worldwide, Inc. Artificial stoma and method of use
EP1974685A4 (fr) * 2006-01-13 2015-05-27 Olympus Medical Systems Corp Dispositif médical à demeure
KR101264670B1 (ko) 2011-04-01 2013-05-15 관동대학교산학협력단 풍선을 이용한 삼킴 훈련용 비위관 및 이를 이용한 삼킴훈련방법
WO2012134196A3 (fr) * 2011-04-01 2012-12-27 관동대학교 산학협력단 Sonde naso-gastrique qui permet d'apprendre à avaler en utilisant un ballonnet, et procédé qui permet d'apprendre à avaler en utilisant celle-ci
WO2012134196A2 (fr) * 2011-04-01 2012-10-04 관동대학교 산학협력단 Sonde naso-gastrique qui permet d'apprendre à avaler en utilisant un ballonnet, et procédé qui permet d'apprendre à avaler en utilisant celle-ci
WO2013059558A1 (fr) * 2011-10-20 2013-04-25 Covidien Lp Cathéter à fistule
WO2013070414A1 (fr) * 2011-10-20 2013-05-16 Covidien Lp Cathéter à fistule
US8961456B2 (en) 2011-10-20 2015-02-24 Covidien Lp Fistula catheter
US10071026B2 (en) 2012-05-25 2018-09-11 Cook Medical Technologies Llc Low profile gastrostomy tubes
WO2014009824A1 (fr) * 2012-07-13 2014-01-16 Kimberly-Clark Worldwide, Inc. Renfort de bout de sonde d'alimentation
CN104507443A (zh) * 2012-07-13 2015-04-08 阿文特公司 饲管端头加强结构
JP2015521934A (ja) * 2012-07-13 2015-08-03 キンバリー クラーク ワールドワイド インコーポレイテッド 栄養チューブの先端強化
US9700489B2 (en) 2012-07-13 2017-07-11 Avent, Inc. Feeding tube tip reinforcement
JP2021037347A (ja) * 2020-11-26 2021-03-11 株式会社ジェイ・エム・エス オスコネクタ

Also Published As

Publication number Publication date
ES2191810T3 (es) 2003-09-16
DE69720400T2 (de) 2003-10-09
ITMI962627A0 (it) 1996-12-16
DE69720400D1 (de) 2003-05-08
ITMI962627A1 (it) 1998-06-16
EP0853937B1 (fr) 2003-04-02
IT1289453B1 (it) 1998-10-15

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