Method of gastrostomy, and an infection preventive cover, kit or catheter kit, and a gastrostomy catheter kit

• US 20050288652A1
• Filed: 09/02/2005
• Published: 12/29/2005
• Est. Priority Date: 08/17/1998
• Status: Active Grant

• Current Assignee: Yutaka Suzuki
• Original Assignee: Yutaka Suzuki
• Inventors: Suzuki, Yutaka
• Granted Patent: US 7,727,200 B2
• Time in Patent Office: Days
• US Class Current: 604/516
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 46/00 Surgical drapes
• CPC Class Codes: A61B 46/17 closed at the distal end
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61J 15/0019 inserted by using a pull-wire
• CPC Class Codes: A61J 15/0023 inserted by using a sheath
• CPC Class Codes: A61J 15/0034 Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
• CPC Class Codes: A61M 25/0111 Aseptic insertion devices
• CPC Class Codes: Y10S 128/24 Medical-surgical bags

Abstract

A PEG catheter is prevented from being infected. An infection preventive cover includes an elongated sheath having one opening end. The opening end is embroidered with a ligature at its circumferential section. A guide wired which is inserted through an abdominal wall into a stomach and which is then drawn out of an oral cavity is linked with a joint wire of a PEG catheter. Thereafter, the PEG catheter is covered with the infection preventive cover. The opening end of the sheath is tied up by the ligature. By pulling the guide wire on the abdomen wall side, the PEG catheter covered with the cover is delivered into the stomach. By pulling a cutting wire exposed through the abdomen wall, the ligature is cut off and the opening end of the cover is opened. Further in order to make it easy to close tightly and to loose an opening end, another infection preventive cover is provided. A closing thread which is embroidered along a circumferential edge of the opening end of a sheath is apart from the embroidered portion and loosely passes through a tightening tube to be led outside from an outer end of the tube. when a portion of the thread which is led outside the tube is pulled out, the opening end of the sheath is closed by the closing thread. The thread is kept in its tightened state. When the tightened thread is loosened, the opening end of the sheath is naturally opened or becomes openable state.

Claims

1. A method of gastrostomy comprising the steps of inserting a guide wire into a stomach through an outer tube pierced through a wall of an abdomen and a wall of the stomach of a patient and pulling the guide wire through an esophagus and an oral cavity into a space outside the patient, joining one end of a percutaneous endoscopic gastrostomy catheter to the guide wire, delivering the catheter into the stomach by pulling or pushing the guide wire, drawing the catheter together with the outer tube through a hole in the wall of the stomach and the abdomen wall into a space outside the patient, and keeping another end of the catheter staying in the stomach, characterized by further comprising the steps of:

enclosing entirely the catheter with an infection preventive cover having a sheath, the sheath having one opening end;

closing the opening end of the sheath in the vicinity of the position of a joint between the catheter and the guide wire;

delivering the catheter through the oral cavity into the stomach with the catheter covered with the infection preventive cover;

opening the opening end of the sheath in the stomach;

drawing the catheter into a space outside the patient, while drawing the catheter through the opening end of the sheath opened; and

removing thereafter the infection preventive cover from the oral cavity into a space outside the patient.

2. An infection preventive cover comprising a sheath having at least one opening end, a binding thread embroidered along a circumferential edge of the opening end of the sheath, and a cutting thread linked to the binding thread, the both ends of the binding thread being led outside the sheath at positions near to each other, and the cutting thread being stronger than the binding thread.

3. An infection preventive cover kit, comprising:

a sheath having at least one opening end;

a binding thread to close the opening end of the sheath; and

a cutting thread linked to the binding thread, the cutting thread being stronger than the binding thread.

4. A percutaneous endoscopic gastrostomy catheter kit, comprising:

a percutaneous endoscopic gastrostomy catheter;

a sheath, into which the catheter has been inserted, having at least one opening end;

a binding thread to close the opening end of the sheath; and

a cutting thread linked to the binding thread, the cutting thread being stronger than the binding thread.

5. The catheter kit according to claim 4, wherein the binding thread is embroidered along a circumferential edge of the opening end of the sheath, and both ends of the binding thread are led outside the sheath at positions near to each other.

6. A percutaneous endoscopic gastrostomy catheter kit, comprising:

a percutaneous endoscopic gastrostomy catheter;

a sheath entirety enclosing the catheter;

a fixing device integrally provided to an end of the sheath, an end of the catheter being arranged at the fixing device; and

a breaking thread for breaking a portion of the fixing device and a portion of the sheath.

7. A percutaneous endoscopic gastrostomy catheter kit, comprising:

a percutaneous endoscopic gastrostomy catheter;

a sheath substantially enclosing the catheter, an end of the sheath being closed; and

a breaking thread, an end portion of which is fixed to the closed end portion of the sheath, for breaking the closed end portion of the sheath when the other end of the breaking thread is pulled.

8. The catheter kit according to claim 7, wherein the catheter includes a joint wire extending from a top of the catheter, and the end of the sheath closes at a position of the joint wire.

9. An infection preventive cover comprising a sheath having at least one opening end, a closing thread embroidered along a circumferential edge of the opening end of the sheath, and a tube for tightening, wherein two portions of the closing thread having ends are apart from the embroidered portion thereof at positions near to each other, the tightening tube is disposed such that one end of the tube is in the vicinity of the embroidered portion, and at least one portion of the closing thread is inserted into the one end of the tightening tube and passed loosely through inside of the tightening tube to be led outside from the other end of the tightening tube.

10. The infection preventive cover according to claim 9, wherein the tightening tube extends along the sheath in the longitudinal direction of the sheath and is covered by a cover provided on the sheath except for at least the other end of the tightening tube.

11. The infection preventive cover according to claim 9, wherein the closing thread is turned back on the circumferential edge of the opening end of the sheath, and the two portions of the closing thread having ends are passed through the tightening tube.

12. The infection preventive cover according to claim 9, wherein the closing thread is turned back on the circumferential edge of the opening end of the sheath, an end of a portion of the closing thread is fixed to the one end of the tightening tube, and the other portion of the closing thread having the other end is passed the tightening tube.

13. The infection preventive cover according to claim 9, wherein the closing thread is turned back on the circumferential edge of the opening end of the sheath, an end of a portion of the closing thread is fixed to a ring, and the other portion of the closing thread having the other end is passed through the ring and further through the tightening tube.

14. An infection preventive kit, comprising:

a sheath having at least one opening end;

a closing thread embroidered along a circumferential edge of the opening end of the sheath;

a tube for tightening through which the closing thread is loosely passed; and

a clamping member for keeping a state in which the opening end of the sheath is closed by the closing thread.

15. The infection preventive kit according to claim 14, wherein the clamping member is an elastic member which a portion of the closing thread led outside the tightening tube penetrates.

16. The infection preventive kit according to claim 14, wherein the tightening tube extends along the sheath in the longitudinal direction thereof, one end of the tightening tube is disposed in the vicinity of the circumferential edge of the opening end of the sheath, and the tightening tube is covered by a cover provided on the sheath except for at least the other end thereof.

17. The infection preventive kit according to claim 14, wherein the closing thread is turned back on the circumferential edge of the opening end of the sheath, and the two portions of the closing thread having ends are passed through the tightening tube.

18. An infection preventive catheter kit comprising:

a percutaneous endoscopic gastrostomy catheter;

a sheath, into which the catheter has been inserted, having at least one opening end;

a closing thread embroidered along a circumferential edge of the opening end of the sheath;

a tightening tube inside of which the closing thread is loosely passed through; and

a clamping member for keeping a state in which the opening end of the sheath is closed by the closing thread.

19. The infection preventive catheter kit according to claim 18, wherein the tightening tube extends along the sheath in the longitudinal direction thereof, one end of the tightening tube is disposed in the vicinity of the circumferential edge of the opening end of the sheath, and the tightening tube is covered with a cover provided on the sheath except for at least the other end thereof.

20. The infection preventive catheter kit according to claim 18, wherein the closing thread is turned back on the circumferential edge of the opening end of the sheath, and the two portions of the closing thread having ends are passed through the tightening tube.

21. The infection preventive catheter kit according to claim 18, wherein the clamping member is an elastic member which a portion of the closing thread led outside the tightening tube penetrates.

22. A percutaneous endoscopic gastrostomy catheter having a top portion of conical shaped, wherein the conical top portion is hollow and has an opening formed at the top end thereof, the opening has such size that an engaging head formed at a top end of a guide wire passes there through, the inside of the conical hollow top portion is larger than the opening in diameter, and the hollow conical top portion is provided with an engaging piece on the inside thereof, the engaging piece allowing the head of the guide wire which is inserted through the opening to pass therethrough and preventing the head from being pulled out.

23. The catheter according to claim 22, wherein the engaging piece is disposed inside of the conical hollow top portion obliquely with respect to an axial direction of the conical hollow top portion, and the engaging piece is formed with a first slit for passing having a width larger than the head of the guide wire at an end portion of the piece which is directed to in the guide wire insertion direction and a second shit for pull-out prevention having a width smaller than the head of the guide wire and being coupled with the first slit.

24. The catheter according to claim 22, further having a connecting member linked to a base of the conical top portion at one end thereof and a dome provided to the other end of the connecting member.

25. The catheter according to claim 24, wherein the connecting member is a tube.