JP5008990B2 - Button type gastrostomy tube - Google Patents

Description

  The present invention relates to a button-type gastrostomy tube used when injecting nutrients directly into the stomach through a gastrostomy (fistula).

  Conventionally, for patients who cannot take food orally, a fistula (gastric fistula) that penetrates the stomach from the outside of the body is drilled in the patient, and a gastrostomy tube is inserted there to supply nutrition directly to the stomach Has been done. There are two types of gastrostomy tubes: the button type and the tube type. The button type gastrostomy tube has a merit that the tube length is fixed, but there is little protrusion from the body surface and it does not get in the way. However, since the length of the tube of the button type gastrostomy tube is fixed, there is a problem that a buried bumper syndrome occurs when the abdominal wall or stomach wall becomes thick due to weight gain or the like and the gastrostomy length becomes long.

  Therefore, a button-type gastrostomy tube is known that can cope with the abdominal wall and stomach wall becoming thicker to some extent without replacement (for example, see Patent Document 1). The button-type gastrostomy tube of Patent Document 1 includes a tube main body, a bumper portion, and a body surface locking portion, and the bumper portion is movably connected to the tube main body. When the abdominal wall becomes thicker, the bumper moves to the stomach inner side with respect to the tube main body, and the substantial length of the tube main body becomes longer, so that the increase in the thickness of the abdominal wall can be accommodated.

  When the button-type gastrostomy tube is inserted into the gastrostomy tube, a rod-shaped obturator is inserted into the tube body and engaged with the tip of the bumper portion. Then, the obturator is further pushed to deform the bumper portion into an elongated shape. In this state, a button-type gastrostomy tube is inserted into the gastrostomy. When the bumper portion reaches the stomach, the obturator is removed from the tube body, and the bumper portion returns to its original shape and is locked to the stomach inner wall.

Here, in the button type gastrostomy tube configured as described above, when the button type gastrostomy tube is inserted, the bumper portion is pressed and deformed by the obturator toward the end. And the substantial length of the tube body may become too long. Therefore, the button-type gastrostomy tube of Patent Document 1 needs to be handled with care so that the bumper portion does not move when inserted into the gastrostomy, and there is a disadvantage that skill is required for operation.
JP 2004-215804 A (pages 5 to 6, FIGS. 4, 5, and 6)

  In view of the above background, an object of the present invention is to provide a button-type gastrostomy tube that is easy to handle and can be used even when the length of the gastrostoma is increased to some extent.

  In order to achieve the above object, the present invention provides a tube main body to be inserted into a gastrostoma, a flexible bumper portion provided at the distal end of the tube main body and locked to the inner wall of the stomach, and a base of the tube main body. In a button type gastrostomy tube having a body surface locking portion provided at the end and locked to the body surface, the bumper portion includes a continuous portion connected to the distal end of the tube body, and a proximal end from the continuous portion. A curved portion extending so as to bend outward in the radial direction, and a sliding portion provided at the base end of the curved portion and slidably provided on the outer peripheral surface of the tube body. Features.

  According to the invention, since the connecting portion on the distal end side of the bumper portion is connected to the tube main body and the sliding portion on the proximal end side is slidable on the outer peripheral surface of the tube main body, the button type gastrostomy When the tube is inserted into the gastrostoma, the bumper portion is pushed toward the proximal end by the body surface, gastrostoma or the like, and is deformed to be elongated along the outer peripheral surface of the tube body. For this reason, the button-type gastrostomy tube can be smoothly inserted into the gastrostomy.

  In addition, since the connecting part on the tip side of the bumper part is connected to the tip of the tube body, when the button type gastrostomy tube is inserted into the gastrostomy and the bumper part is elongated and deformed, the bumper part is restored. A force to return to the original shape by the force, that is, a force to return to the distal end side of the tube body works. For this reason, when the distal end portion of the tube body protrudes into the stomach to some extent, the bumper portion returns to its original shape by its own restoring force and is locked to the inner wall of the stomach.

  Further, since the connecting portion on the tip end side of the bumper portion is connected to the tip end of the tube main body, the bumper portion does not move to the tip end side with respect to the tube main body unlike the conventional product. For this reason, when the button type gastrostomy tube is inserted into the gastrostoma as in the conventional product, the bumper moves to the tip of the tube main body by the obturator and the substantial length of the tube main body is less than the fistula length. It will not be too long and will be easy to handle.

  In addition, since the sliding portion of the pan bar portion is slidably provided on the outer peripheral surface of the tube body, the abdominal wall, stomach wall, and the like become thick due to an increase in the weight of the patient and the base end portion of the bumper portion is The outer peripheral surface slides and moves to the tip side, and the bumper portion is crushed, so that the substantial length of the tube main body is increased. As a result, even if the abdominal wall or stomach wall becomes thick to some extent and the length of the gastrostoma becomes long, it is possible to cope with it, and there is no need to frequently replace the button type gastrostomy tube.

  In addition, the bending portion is constituted by a plurality of bending pieces provided at intervals in the circumferential direction of the tube body, the sliding portion is formed in an annular shape, and the base end of each bending piece is connected to the annular sliding portion. It is preferable to install. With this configuration, the bumper portion can be easily deformed, and the button-type gastrostomy tube can be more easily inserted into the gastrostoma.

  An embodiment of the present invention will be described with reference to FIGS. FIG. 1 is an explanatory view showing an embodiment of a button-type gastrostomy tube of the present invention, FIGS. 2 and 3 are explanatory views showing a method for inserting the button-type gastrostomy tube of the present embodiment, and FIGS. It is explanatory drawing which shows the use condition of the button type gastrostomy tube of embodiment.

  As shown in FIG. 1, a button-type gastrostomy tube 1 according to an embodiment of the present invention includes a tube main body 2, a flexible silicon rubber bumper portion 3 provided at the tip of the tube main body 2, and a tube main body. 2 and a body surface engaging portion 4 extending radially outward at the base end.

  The bumper portion 3 includes a continuous portion 31 provided at the tip of the tube body 2 so as to extend radially outward, and an annular sliding portion 32 that can slide on the outer peripheral surface of the tube body 2. The continuous portion 31 and the sliding portion 32 are connected by four curved pieces 33 that are curved outward in the radial direction of the tube body and are provided at equal intervals in the circumferential direction. In addition, the bending piece of this invention should just be plural, and can be made into arbitrary numbers, such as three and five.

  As shown in FIG. 2, a tubular body 21 is inserted and fixed to the distal end portion of the tube body 2 from the front. A cap 5 is connected to the body surface locking portion 4. The cap 5 is provided with a protrusion 5 a that can be inserted into the tube body 2 from the base end and can close the base end of the tube body 2.

  When inserting the button type gastrostomy tube 1 of the present embodiment into the gastrostomy 6, first, in order to facilitate the insertion of the tube body 2 into the gastrostomy 6, a rod-shaped obturator 7 is inserted into the tube main body 2. . A diameter-expanded portion 7 a is provided at the distal end portion of the obturator 7, and the diameter-expanded portion 7 a comes into contact with the base end 21 a of the cylindrical body 21. Thereby, the obturator 7 is inserted too much and protrudes forward from the tube body 2, and when the button-type gastrostomy tube 1 is inserted into the gastrostoma 6, the tip of the obturator 7 comes into contact with the gastric wall on the side facing the gastrostomy 6. This can avoid the possibility of causing ulcers and the like.

  Next, the button-type gastrostomy tube 1 is inserted into the gastrostoma 6 together with the obturator 7. At this time, as shown in FIG. 3, the bumper portion 3 comes into contact with the abdominal wall 81 and the gastrostoma 6 and is pushed to the proximal end side of the tube main body 2, while the sliding portion 32 slides on the tube main body 2. By moving to the side, it is elongated and deformed. For this reason, the button type gastrostomy tube 1 can be smoothly inserted into the gastrostoma 6. Moreover, since the bumper part 3 is comprised by the connection part 31, the sliding part 32, and the four curved pieces 33 which connect these, for example, the bumper part 3 is toward the base end side from the front-end | tip of the tube main body 2. The bumper portion 3 can be easily deformed as compared to the one formed in a bowl shape so as to be curved outward in the radial direction, and the button-type gastrostomy tube 1 can be easily inserted into the gastrostoma 6.

  Here, since the connecting portion 31 located at the tip of the bumper portion 3 is continuously provided at the tip of the tube body 2, when the bumper portion 3 is elongated and deformed, the original shape is obtained by the restoring force of the bumper portion 3. The force which tries to return to, ie, the force which returns to the front end side of the tube main body 2, acts. Therefore, when the tip side of the bumper part 3 protrudes from the gastrostoma 6 into the stomach to some extent, the bumper part 3 returns to its original shape by its own restoring force as shown in FIG. Thereby, the bumper part 3 is latched by the inner wall of the stomach.

  When the body surface locking portion 4 is locked to the body surface, there may be a gap of about 5 to 10 mm between the bumper portion 3 and the stomach wall 82. With such a gap, the button-type gastrostomy tube 1 can function without problems, and a button-type gastrostomy tube with a length that allows a certain amount of clearance can be selected from the past. It is used.

  Next, the obturator 7 is removed from the tube body 2, and the base end of the tube body 2 is closed by the cap 5. When injecting nutrients from the button-type gastrostomy tube 1 into the stomach, the cap 5 is removed and a tube or the like (not shown) for injecting nutrients into the tube body 2 is connected.

  According to the button type gastrostomy tube 1 of the present embodiment, since the sliding portion 32 of the bumper portion 3 is configured to be slidable on the outer peripheral surface of the tube body 2, as shown in FIG. Even when the thickness of the gastric wall 82 is increased and the length of the gastrostoma 6 is increased, the sliding portion 32 slides to the distal end side along the outer peripheral surface of the tube body 2 and the bumper portion 3 is crushed. . Thereby, even if the length of the gastrostoma 6 becomes long to some extent, the button-type gastrostomy tube 1 of the present embodiment can increase the substantial length of the tube body 2 accordingly, such as a bumper buried syndrome. It is not necessary to exchange frequently to avoid the occurrence, and it can be used for a long time.

  Further, unlike the conventional product, the button type gastrostomy tube 1 of the present embodiment is not configured such that the bumper portion 3 is movable with respect to the tube body 2, and the tip of the bumper portion 3 is the tip of the tube body 2. It is connected to. For this reason, when the obturator is inserted and the bumper part is deformed to be elongated like the conventional product, the bumper part moves to the distal end side of the tube main body, and the substantial length of the tube main body is less than the gastrostomy. There is no inconvenience of being too long.

  Therefore, according to the button type gastrostomy tube 1 of the present embodiment, the operation when inserting the button type gastrostomy tube 1 into the gastrostoma 6 as in the conventional product can be easily inserted without requiring skill. it can.

  In the present embodiment, the bumper portion 3 is configured by the continuous portion 31, the sliding portion 32, and the four curved pieces 33 that connect them. However, the configuration of the bumper portion 3 is not limited thereto. For example, even if the bumper portion 3 is formed in a bowl shape so as to curve radially outward from the distal end of the tube body 2 toward the proximal end side, the effect of the present invention can be obtained. .

Explanatory drawing which showed embodiment of the button type gastrostomy tube of this invention. Explanatory drawing which shows the insertion method of the button type gastrostomy tube of this embodiment. Explanatory drawing which shows the insertion method of the button type gastrostomy tube of this embodiment. Explanatory drawing which shows the use condition of the button type gastrostomy tube of this embodiment. Explanatory drawing which shows the use condition of the button type gastrostomy tube of this embodiment.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Button type gastrostomy tube, 2 ... Tube main body, 21 ... Cylindrical body, 3 ... Bumper part, 31 ... Connection part, 32 ... Sliding part, 33 ... Curved piece (curved part), 4 ... Body surface Stop part, 5 ... Cap, 5a ... Projection, 6 ... Gastric fistula, 7 ... Obturator, 7a ... Expanded part, 81 ... Abdominal wall, 82 ... Gastric wall.

Claims (2)

A tube body to be inserted into the gastrostoma, a flexible bumper portion provided at the distal end of the tube body and locked to the inner wall of the stomach, and provided at the proximal end of the tube body and locked to the body surface In a button-type gastrostomy tube having a body surface locking portion,
The bumper portion includes a continuous portion continuously provided at a distal end of the tube main body, a curved portion extending so as to be curved radially outward from the continuous portion to the proximal end side, and A button-type gastrostomy tube comprising a sliding portion which is a proximal end and is slidably provided on an outer peripheral surface of the tube main body.   The curved portion is composed of a plurality of curved pieces provided at intervals in the circumferential direction of the tube body, the sliding portion is configured in an annular shape, and the base end of each curved piece is connected to the annular sliding portion. The button-type gastrostomy tube according to claim 1, which is provided.

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