US20090306627A1 - Universal percutaneous endoscopic gastrostomy tube - Google Patents
Universal percutaneous endoscopic gastrostomy tube Download PDFInfo
- Publication number
- US20090306627A1 US20090306627A1 US12/484,452 US48445209A US2009306627A1 US 20090306627 A1 US20090306627 A1 US 20090306627A1 US 48445209 A US48445209 A US 48445209A US 2009306627 A1 US2009306627 A1 US 2009306627A1
- Authority
- US
- United States
- Prior art keywords
- tube
- elongated
- lumen
- pull
- proximal end
- 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.)
- Abandoned
Links
Images
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
- A61J15/0015—Gastrostomy feeding-tubes
- A61J15/0019—Gastrostomy feeding-tubes inserted by using a pull-wire
Definitions
- This invention relates to a percutaneous endoscopic gastrostomy tubes generally, and is more specifically directed to a device and methods for positioning a percutaneous endoscopic gastrostomy (PEG) tube.
- PEG percutaneous endoscopic gastrostomy
- PEG tubes are known and used in the art. PEG tubes are used to provide nutrition to patients who are unable to swallow, or are otherwise unable to receive food by normal bodily processes due to disease or injury. PEG tubes may be positioned within the stomach, or they may be positioned within the intestine.
- the pull and push techniques differ only in the method of insertion of the gastrostomy tube.
- the proximal portion of the tube is pulled through the mouth, esophagus, stomach and abdominal wall; whereas, during the push technique the tube is pushed over a guide wire.
- the device that is used for the push method differs from the device that is used for the pull method. Since the method is a matter of physician preference and training 1 , hospitals keep a supply of each of the devices in inventory. This necessity represents an inventory expense to the hospital, and the administrative burden of tracking inventory. 1 These techniques have been shown to be substantially equivalent in safety and insertion success rates
- the device that is used for the pull technique has a wire loop formed on one end that enables the PEG tube to be connected to an insertion wire and pulled through the mouth and esophagus, and into the stomach.
- the device that is used for the push technique has no such wire loop; rather, the insertion wire is inserted into the orifice in the tube, through an opening at the proximal end of the tube, and the tube is pushed along the wire, which acts as a guide, until the tube is in position.
- the present invention is a universal PEG tube that may be used with either the push or the pull insertion method.
- a loop extends from an end the tube.
- a void is formed in the tube at or near the proximal end of the tube. The void communicates with the internal void that acts as a conduit for material that is transported by the tube.
- FIG. 1 a shows a partial view of a first embodiment of the device.
- FIG. 1 b shows an isolation of a proximal end of the first embodiment of the device.
- FIG. 1 c shows an enlarged and sectioned proximal end of the first embodiment of the device
- FIG. 2 shows a second embodiment of the device.
- FIG. 3 shows a third embodiment of the device.
- FIG. 4 shows a fourth embodiment of the device.
- FIG. 5 shows a PEG tube that is being tied to an insertion wire for use with the pull method.
- FIGS. 6 a - 6 c show a series of steps for tying a PEG tube to an insertion wire for use with the pull method.
- the first embodiment of the universal PEG tube 2 has a void 4 that is formed near the proximal end 6 of the tube.
- the tube has an elongated lumen 7 that extends though a central portion of the tube.
- the lumen is preferred to be tapered toward the proximal end of the tube.
- the tube may be tapered toward the proximal end of the tube.
- Void 4 is formed in a side of the tube, such as by skiving the tube, or by molding a void in the tube during the tube formation process, or by forming a void in the tube after the tube is produced.
- a loop 8 is present within a void that is formed in the proximal end of the PEG tube.
- the loop has a pair of generally parallel legs 10 , 12 that extend from the loop. The generally parallel legs are inserted into the void 14 which forms the conduit for the tube, and through the void, and which is present in the proximal end of the tube.
- the generally parallel legs are of unequal length, with the longer leg 12 extending at least to the void 4 , and positioned within the tube so that it is generally opposite the void.
- the shorter leg does not extend to the void, since it would interfere with use of the void if it were as long as the longer leg.
- the longer leg reinforces the tube at the void, and prevents the tube from being punctured or otherwise damaged when the wire guide is inserted through the void and into the conduit of the tube. Without the longer leg, the wire may inadvertently be forced through the void, into the conduit, and puncture the opposite side of the tube, which would reduce the structural integrity of the tube, if not irreparably damage it.
- the hole in loop 8 the void 4 are generally perpendicular to the lumen.
- the embodiment shown in is used according to the push method as demonstrated in FIGS. 1 b - c .
- the insertion or guide wire 16 is threaded through the loop, and into the void.
- the PEG tube is then pushed along the wire, which acts as a guide, until the PEG tube is in the desired position within the stomach or intestine.
- FIG. 1 The embodiment shown in FIG. 1 is used according to the pull method as shown in FIG. 5 and FIGS. 6 a through 6 c.
- the insertion wire 18 is threaded through the loop, and over the enlarged opposite end 20 of the tube, and the tube is pulled through the loop of the insertion wire so that a knot is formed between the loop and the insertion wire.
- the PEG tube is then pulled into place by means of the insertion wire.
- FIG. 2 shows an additional embodiment of the device.
- the PEG tube 22 of has a push adapter 24 and a pull adapter 26 .
- the adapter is selected according to the method to be used.
- the adapters engage the PEG tube by a threaded engagement 28 or other attachment means. If the push method is to be used, then the push adapter is threaded onto the proximal end of the PEG tube.
- the push adapter has a concentric longitudal void 30 that aligns with the opening 32 in the proximal end of the PEG tube and aligns with the conduit of the PEG tube.
- the insertion wire may be threaded into the void in the end of the push tube, and the PEG tube pushed along the guide wire until the PEG tube is properly positioned.
- the pull adapter is threaded or other attachment means onto the PEG tube.
- a loop 34 is provided in the end of the pull adapter, and the insertion wire may be tied to the PEG tube in the manner shown in FIG. 5 and FIGS. 6 a through 6 c for insertion.
- FIG. 3 shows a third embodiment of the universal PEG tube 42 , wherein a loop 44 is provided on the end of the PEG tube. Also, a void 46 is present in the proximal end of the PEG tube. If the push method is to be used, the insertion wire is inserted through the void, and the PEG tube is pushed along the wire which acts as a guide. If the pull method is to be used, the insertion wire is tied to the loop as discussed above.
- FIG. 4 shows an embodiment of the PEG tube 52 having an outer sheath 54 that covers the loop 56 which may be used for the pull method.
- the device With a sheath positioned over the loop, the device may be used as a PEG tube for the push method.
- the guide wire is inserted through a void 58 in the end of the sheath. Void 58 communicates with the conduit of the PEG tube, and allows the guide wire to enter the PEG tube.
- the sheath may be removed, so that the loop is available for tying the insertion wire to the PEG tube.
- the sheath may be circumscribed with a knife near X to expose the loop, so that the loop is available for attachment to the insertion wire.
Abstract
A universal percutaneous endoscopic gastrostomy (PEG) tube that may be used with either the push or the pull insertion method. A loop extends from the tube. A void is formed in the tube at or near the proximal end of the tube. The void communicates with the internal void that acts as a conduit for material that is transported by the tube. The tube of the invention provides the option of changing technique from push method to pull method, or from pull method to push method. The device provides a mechanism at the tip or at mid catheter, thereby allowing for change over of method.
Description
- This application is a divisional of pending application Ser. No. 10/760,926, filed Jan. 20, 2004. Applicant Claims priority from U.S. Provisional Application Ser. No. 60/440,901 filed Jan. 17, 2003 and from U.S. Provisional Application Ser. No. 60/452,403 filed Mar. 6, 2003.
- This invention relates to a percutaneous endoscopic gastrostomy tubes generally, and is more specifically directed to a device and methods for positioning a percutaneous endoscopic gastrostomy (PEG) tube.
- PEG tubes are known and used in the art. PEG tubes are used to provide nutrition to patients who are unable to swallow, or are otherwise unable to receive food by normal bodily processes due to disease or injury. PEG tubes may be positioned within the stomach, or they may be positioned within the intestine.
- Two predominant methods for positioning PEG tubes are the Ponsky-Gauderer ‘pull’ technique and the Sachs-Vine ‘push’ technique. The pull and push techniques differ only in the method of insertion of the gastrostomy tube. In the pull technique, the proximal portion of the tube is pulled through the mouth, esophagus, stomach and abdominal wall; whereas, during the push technique the tube is pushed over a guide wire.
- Currently, the device that is used for the push method differs from the device that is used for the pull method. Since the method is a matter of physician preference and training1, hospitals keep a supply of each of the devices in inventory. This necessity represents an inventory expense to the hospital, and the administrative burden of tracking inventory. 1 These techniques have been shown to be substantially equivalent in safety and insertion success rates
- In particular, the device that is used for the pull technique has a wire loop formed on one end that enables the PEG tube to be connected to an insertion wire and pulled through the mouth and esophagus, and into the stomach. The device that is used for the push technique has no such wire loop; rather, the insertion wire is inserted into the orifice in the tube, through an opening at the proximal end of the tube, and the tube is pushed along the wire, which acts as a guide, until the tube is in position.
- The present invention is a universal PEG tube that may be used with either the push or the pull insertion method. A loop extends from an end the tube. A void is formed in the tube at or near the proximal end of the tube. The void communicates with the internal void that acts as a conduit for material that is transported by the tube.
-
FIG. 1 a shows a partial view of a first embodiment of the device. -
FIG. 1 b shows an isolation of a proximal end of the first embodiment of the device. -
FIG. 1 c shows an enlarged and sectioned proximal end of the first embodiment of the device -
FIG. 2 shows a second embodiment of the device. -
FIG. 3 shows a third embodiment of the device. -
FIG. 4 shows a fourth embodiment of the device. -
FIG. 5 shows a PEG tube that is being tied to an insertion wire for use with the pull method. -
FIGS. 6 a-6 c show a series of steps for tying a PEG tube to an insertion wire for use with the pull method. - Referring now to
FIGS. 1 a-1 c, the first embodiment of theuniversal PEG tube 2 has avoid 4 that is formed near theproximal end 6 of the tube. The tube has anelongated lumen 7 that extends though a central portion of the tube. The lumen is preferred to be tapered toward the proximal end of the tube. The tube may be tapered toward the proximal end of the tube. -
Void 4 is formed in a side of the tube, such as by skiving the tube, or by molding a void in the tube during the tube formation process, or by forming a void in the tube after the tube is produced. Aloop 8 is present within a void that is formed in the proximal end of the PEG tube. In the preferred embodiment, the loop has a pair of generallyparallel legs void 14 which forms the conduit for the tube, and through the void, and which is present in the proximal end of the tube. In the preferred embodiment, the generally parallel legs are of unequal length, with thelonger leg 12 extending at least to thevoid 4, and positioned within the tube so that it is generally opposite the void. The shorter leg does not extend to the void, since it would interfere with use of the void if it were as long as the longer leg. The longer leg reinforces the tube at the void, and prevents the tube from being punctured or otherwise damaged when the wire guide is inserted through the void and into the conduit of the tube. Without the longer leg, the wire may inadvertently be forced through the void, into the conduit, and puncture the opposite side of the tube, which would reduce the structural integrity of the tube, if not irreparably damage it. The hole inloop 8 thevoid 4 are generally perpendicular to the lumen. - The embodiment shown in is used according to the push method as demonstrated in
FIGS. 1 b-c. The insertion orguide wire 16 is threaded through the loop, and into the void. The PEG tube is then pushed along the wire, which acts as a guide, until the PEG tube is in the desired position within the stomach or intestine. - The embodiment shown in
FIG. 1 is used according to the pull method as shown inFIG. 5 andFIGS. 6 a through 6 c. Theinsertion wire 18 is threaded through the loop, and over the enlargedopposite end 20 of the tube, and the tube is pulled through the loop of the insertion wire so that a knot is formed between the loop and the insertion wire. The PEG tube is then pulled into place by means of the insertion wire. -
FIG. 2 shows an additional embodiment of the device. The PEG tube 22 of has a push adapter 24 and apull adapter 26. The adapter is selected according to the method to be used. The adapters engage the PEG tube by a threadedengagement 28 or other attachment means. If the push method is to be used, then the push adapter is threaded onto the proximal end of the PEG tube. The push adapter has a concentriclongitudal void 30 that aligns with theopening 32 in the proximal end of the PEG tube and aligns with the conduit of the PEG tube. The insertion wire may be threaded into the void in the end of the push tube, and the PEG tube pushed along the guide wire until the PEG tube is properly positioned. - If the pull method is to be used with the embodiment shown in
FIG. 2 , the pull adapter is threaded or other attachment means onto the PEG tube. Aloop 34 is provided in the end of the pull adapter, and the insertion wire may be tied to the PEG tube in the manner shown inFIG. 5 andFIGS. 6 a through 6 c for insertion. -
FIG. 3 shows a third embodiment of theuniversal PEG tube 42, wherein aloop 44 is provided on the end of the PEG tube. Also, avoid 46 is present in the proximal end of the PEG tube. If the push method is to be used, the insertion wire is inserted through the void, and the PEG tube is pushed along the wire which acts as a guide. If the pull method is to be used, the insertion wire is tied to the loop as discussed above. -
FIG. 4 shows an embodiment of thePEG tube 52 having anouter sheath 54 that covers theloop 56 which may be used for the pull method. With a sheath positioned over the loop, the device may be used as a PEG tube for the push method. The guide wire is inserted through a void 58 in the end of the sheath.Void 58 communicates with the conduit of the PEG tube, and allows the guide wire to enter the PEG tube. When used with the pull method, the sheath may be removed, so that the loop is available for tying the insertion wire to the PEG tube. Alternatively, the sheath may be circumscribed with a knife near X to expose the loop, so that the loop is available for attachment to the insertion wire.
Claims (13)
1. (cancel)
2. (cancel)
3. (cancel)
4. (cancel)
5. (cancel)
6. A percutaneous endoscopic gastrostomy tube comprising:
an elongated tube, said elongated tube having an elongated lumen therein and having opening formed therein at a proximal end of said elongated tube that communicates with said elongated lumen and with an exterior of said elongated tube, and
a pull adapter that is formed to mount to a proximal end of said elongated tube, said pull adapter having a loop that extends from a proximal end of said pull adapter, and having a lumen therein that communicates with said elongated lumen of said elongated tube,
wherein said lumen of said pull adapter and said elongated lumen of said elongated tube are formed to traverse a guide wire.
7. A percutaneous endoscopic gastrostomy tube as described in claim 6 , further comprising a push adapter that is formed to mount to a proximal end of said elongated tube, said having a lumen therein that communicates with said elongated lumen of said tube, wherein said lumen of said push adapter and said elongated lumen of said elongated tube are formed to traverse a guide wire.
8. A percutaneous endoscopic gastrostomy tube as described in claim 6 , wherein said pull adapter mounts to said elongated tube by a male-female mounting.
9. A percutaneous endoscopic gastrostomy tube as described in claim 6 , wherein said pull adapter mounts to said elongated tube by threaded engagement between said elongated tube and said pull adapter.
10. A percutaneous endoscopic gastrostomy tube as described in claim 6 , wherein said push adapter is tapered toward said proximal end.
11. A percutaneous endoscopic gastrostomy tube as described in claim 6 , wherein said guide wire extends through said loop.
12. A percutaneous endoscopic gastrostomy tube comprising:
an elongated tube, said elongated tube having an elongated lumen therein and having opening formed therein at a proximal end of said elongated tube that communicates with said elongated lumen and with an exterior of said elongated tube, and
a pull adapter comprising a loop, said pull adapter formed to mount to said proximal end of said elongated tube.
13. A percutaneous endoscopic gastrostomy tube as described in claim 12 , wherein said pull adapter engages said opening formed in said proximal end of said elongated tube.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/484,452 US20090306627A1 (en) | 2003-01-17 | 2009-06-15 | Universal percutaneous endoscopic gastrostomy tube |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US44090103P | 2003-01-17 | 2003-01-17 | |
US45240303P | 2003-03-06 | 2003-03-06 | |
US10/760,926 US7563254B2 (en) | 2003-01-17 | 2004-01-20 | Universal percutaneous endoscopic gastrostomy tube |
US12/484,452 US20090306627A1 (en) | 2003-01-17 | 2009-06-15 | Universal percutaneous endoscopic gastrostomy tube |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/760,926 Division US7563254B2 (en) | 2003-01-17 | 2004-01-20 | Universal percutaneous endoscopic gastrostomy tube |
Publications (1)
Publication Number | Publication Date |
---|---|
US20090306627A1 true US20090306627A1 (en) | 2009-12-10 |
Family
ID=34084449
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/760,926 Expired - Fee Related US7563254B2 (en) | 2003-01-17 | 2004-01-20 | Universal percutaneous endoscopic gastrostomy tube |
US12/484,452 Abandoned US20090306627A1 (en) | 2003-01-17 | 2009-06-15 | Universal percutaneous endoscopic gastrostomy tube |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/760,926 Expired - Fee Related US7563254B2 (en) | 2003-01-17 | 2004-01-20 | Universal percutaneous endoscopic gastrostomy tube |
Country Status (1)
Country | Link |
---|---|
US (2) | US7563254B2 (en) |
Families Citing this family (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP4163190B2 (en) * | 2005-04-12 | 2008-10-08 | 和 夫 花ヶ崎 | Anti-contamination cover |
US7896848B2 (en) * | 2005-06-29 | 2011-03-01 | Samvel Artavazovich Charukhchian | Ostomy tube device, ostomy placement kit and method for an ostomy tube placement |
CA2619463C (en) * | 2005-08-31 | 2012-02-14 | Wilson-Cook Medical Inc. | Peg tube with wireless pull tip |
WO2007028009A1 (en) * | 2005-09-01 | 2007-03-08 | Boston Scientific Scimed, Inc. | Medical device assembly including a protective sheath |
US8834370B2 (en) | 2011-12-15 | 2014-09-16 | Cook Medical Technologies Llc | Ultrasonic percutaneous enteral feeding tube |
US9763857B2 (en) | 2012-04-25 | 2017-09-19 | Delegge Medical, Inc. | Device, kit and method for placing jejunal tube device through stomach and into small intestine related application |
US20130317439A1 (en) * | 2012-05-25 | 2013-11-28 | Arstasis, Inc. | Vascular access configuration |
US9775782B2 (en) * | 2013-03-14 | 2017-10-03 | Cook Medical Technologies Llc | Elongated dilator for pull PEG tube without a loop |
US9554932B2 (en) | 2013-03-15 | 2017-01-31 | Ez-Off Weight Loss, Llc | System and method for gastric restriction and malabsorption |
US9833350B2 (en) | 2013-03-15 | 2017-12-05 | Ez-Off Weightloss, Llc | Anchorable size-varying gastric balloons for weight loss |
US10219799B2 (en) | 2013-08-05 | 2019-03-05 | Endo-Tagss, Llc | Transabdominal gastric device and method |
CA2919658A1 (en) | 2013-08-05 | 2015-02-12 | Mary PATTISON | Transabdominal gastric surgery system and method |
EP3522826B1 (en) | 2016-10-04 | 2022-05-11 | EZ-OFF Weight loss, LLC | Sleeve-anchorable gastric balloon for weight loss |
US20230149266A1 (en) * | 2020-05-04 | 2023-05-18 | Werd, Llc | Enternal feeding tube |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4824435A (en) * | 1987-05-18 | 1989-04-25 | Thomas J. Fogarty | Instrument guidance system |
US6997900B2 (en) * | 2002-12-09 | 2006-02-14 | Scimed Life Systems, Inc. | Connector for use with a medical catheter and medical catheter assembly |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5904648A (en) * | 1996-06-18 | 1999-05-18 | Cook Incorporated | Guided endobronchial blocker catheter |
US5807314A (en) * | 1996-10-11 | 1998-09-15 | Abbott Laboratories | Feeding tube and method for placing same |
-
2004
- 2004-01-20 US US10/760,926 patent/US7563254B2/en not_active Expired - Fee Related
-
2009
- 2009-06-15 US US12/484,452 patent/US20090306627A1/en not_active Abandoned
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4824435A (en) * | 1987-05-18 | 1989-04-25 | Thomas J. Fogarty | Instrument guidance system |
US6997900B2 (en) * | 2002-12-09 | 2006-02-14 | Scimed Life Systems, Inc. | Connector for use with a medical catheter and medical catheter assembly |
Also Published As
Publication number | Publication date |
---|---|
US20050020875A1 (en) | 2005-01-27 |
US7563254B2 (en) | 2009-07-21 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20090306627A1 (en) | Universal percutaneous endoscopic gastrostomy tube | |
US8048062B2 (en) | Catheter assembly and method for internally anchoring a catheter in a patient | |
US6582395B1 (en) | Feeding tube device and method | |
US7976495B2 (en) | Peg tube with wireless pull tip | |
JP3347148B2 (en) | Fistula formation device | |
US6743207B2 (en) | Apparatus and method for the insertion of a medical device | |
US8172801B2 (en) | Method for positioning a catheter guide element in a patient and kit for use in said method | |
US7578801B2 (en) | Connector for use with a medical catheter and medical catheter assembly including said connector | |
US6458106B1 (en) | Low profile jejunal adapter for a gastrojejunal feeding system | |
US8021338B2 (en) | Percutaneous endoscopic jejunostomy access needle | |
US5807314A (en) | Feeding tube and method for placing same | |
US20120095405A1 (en) | Method for implanting a percutaneous endoscopic gastrostomy/jejunostomy tube in a patient and access needle for use in said method | |
US6808519B2 (en) | Percutaneous gastrostomy device and method | |
US20120010570A1 (en) | Method for percutaneously implanting a medical catheter and medical catheter implanting assembly | |
US6960199B2 (en) | Method for feeding with a tube | |
US20090024091A1 (en) | Catheter assembly including coiled internal bolster | |
US9775782B2 (en) | Elongated dilator for pull PEG tube without a loop | |
AU2004202304A1 (en) | Feeding tube device and method |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |