Gastrostomy and other percutaneous transport tubes

• US 4,393,873 A
• Filed: 06/29/1981
• Issued: 07/19/1983
• Est. Priority Date: 03/10/1980
• Status: Expired due to Fees

• Current Assignee: Mason, Robert S., Michael S. Nawash, Stillman, Suzanne
• Original Assignee: Mason, Robert S., Michael S. Nawash, Stillman, Suzanne
• Inventors: Mason, Robert S., Stillman, Suzanne, Nawash, Michael S.
• Primary Examiner(s): Pellegrino, Stephen C.
• Application Number:
  US06/278,329
• Time in Patent Office: 750 Days
• Field of Search: 128/348, 128/347, 128/349, 128/350, 128/239, 128/242-245, 128/DIG. 9, 128/DIG. 16, 128/DIG. 26, 128/303 R, 128/349 BV, 128/248, 128/283
• US Class Current: 604/151
• CPC Class Codes: A61J 15/0015 Gastrostomy feeding-tubes insertion tools or methods A61B17/34
• CPC Class Codes: A61J 15/0038 expandable, e.g. umbrella type
• CPC Class Codes: A61J 15/0057 fixing a tube end, i.e. tube not protruding the fixing means
• CPC Class Codes: A61J 15/0092 Valves on feeding tubes tube valves A61M39/22
• CPC Class Codes: A61M 2025/0233 specifically adapted for attaching to a body wall by means which are on both sides of the wall, e.g. for attaching to an abdominal wall
• CPC Class Codes: A61M 2039/0255 for access to the gastric or digestive system
• CPC Class Codes: A61M 2039/0261 Means for anchoring port to the body, or ports having a special shape or being made of a specific material to allow easy implantation/integration in the body
• CPC Class Codes: A61M 2039/0276 for introducing or removing fluids into or out of the body
• CPC Class Codes: A61M 2039/0297 at least part of it being inflatable, e.g. for anchoring, sealing or removing
• CPC Class Codes: A61M 2210/1053 Stomach
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053
• CPC Class Codes: Y10S 128/26 Cannula supporters

Abstract

An improved gastrostomy or like percutaneous transport tube includes, at the end exterior to the abdominal wall, a nutrient supply coupling assembly including a mechanically simple one-way valve. A threaded cap closes the assembly, and may be replaced by a coupling member having a fitting for disconnectable attachment to a nutrient or other fluid supply. A tool is provided for preventing rotation of the assembly during removal and replacement of the cap and coupling member.

The assembly body includes a flange that extends parallel to the exterior abdominal wall. An annular skin protector disc seats between the flange and the abdominal wall, and includes spaced ridges arranged to permit the entry of air between the disc and the skin.

In another gastrostomy tube embodiment, an enlargement at the end emplaced in the stomach is of dome shape and acts as a one-way valve. A slit across the enlargement divides the dome into two sections. Nutrient fed through the tube to the dome interior forces open the sections to permit nutrient flow into the stomach. The pressure of fluid from the stomach against the exterior of the dome forces the two sections to seal the slit, preventing backflow through the tube.

Emplacement of a percutaneous transport tube is simplified by compressing the enlarged end (which is to be inserted into the stomach or other bodily region) into a capsule or binding of a material that dissolves in the body. The bound or encapsulated tube end then is insertable through a gastrostomy or like opening without the use of a stylet.

Claims

1. In a gastrostomy or like percutaneous transport tube of the type having a length of tubing with a first end configured for enlargement when inserted into the stomach or other bodily region of a patient, and apertured for the passage of fluids, an assembly at the other end of said tubing, comprising:

a rigid, generally cylindrical member having a certain shoulder portion, having at one end an axial projection engaging said tubing, and having at the other end a radially extending flange, there being an axial passageway through said member and communicating with said tubing, and

an annular skin protector disc formed of resilient material, said disc having a central aperture through which said shoulder portion extends, said disc thus seating between said flange and the external skin of the abdominal wall when said percutaneous transport tube is emplaced in a patient,

said skin protector disc having a set of raised ridges integral therewith on the side facing said skin, said ridges being arranged so as to permit the entry of air between said disc and the exterior abdominal wall.

2. A percutaneous transport tube according to claim 1 further comprising:

a one-way valve disposed in said cylindrical member and operative to enable the flow of fluids in one direction only through said assembly.

3. In a percutaneous transport tube of the type having a length of tubing with one end configured for enlargement when inserted into the stomach or other bodily region of a patient and apertured for the passage of fluids, an assembly at the other end of said tubing comprising:

a rigid body attached to said tubing other end, said body having a flow channel therethrough communicating to said tubing,

a flange on said body extending in closely spaced parallel relationship to the patient'"'"'s external skin surface when said percutaneous transport tube is emplaced in a patient,

a threaded counterbore in said body extending from the exterior of said body to said flow channel,

a threaded cap removably inserted in said counterbore, and

at least one coupling member threadingly insertable into said body in place of said cap, each of said coupling members having a flow path therethrough and including a coupling adapted for disconnectable fluid communicating attachment to a cooperating connector associated with a nutrient or other fluid supply.

4. A percutaneous transport tube according to claim 3 wherein said rigid body has a central shoulder portion between said flange and the portion of said body which is attached to said tubing other end, together with:

an annular skin protector disc formed of resilient material, said disc having a central aperture through which said shoulder portion extends, said disc thus seating between said flange and the patient'"'"'s external skin surface when said percutaneous transport tube is emplaced in a patient, said skin protector disc having a set of raised ridges integral therewith on the side facing said surface, said ridges being arranged so as to permit the entry of air between said disc and said external skin surface,

said gastrostomy tube being emplaceable by inserting a stylet through one of said holes in said flange, through said disc central aperture with said disc resiliently extended to permit such stylet passage, and through an aperture in said first end to the tip of said first end, forward pressure exerted by said stylet causing said first end to extend in reduced diameter configuration for insertion into the patient through an opening in the skin, subsequent removal of the stylet enabling resilient enlargement of said tubing first end within the stomach or other bodily region of the patient.