Gastroenteric feeding tube for endoscopic placement and method of use

• US 5,665,064 A
• Filed: 05/12/1995
• Issued: 09/09/1997
• Est. Priority Date: 12/06/1993
• Status: Expired due to Term

• Current Assignee: Sherwood Medical Company (Medtronic Plc)
• Original Assignee: Sherwood Medical Company (Medtronic Plc)
• Inventors: Crouther, Ronald, Bodicky, Raymond O.
• Primary Examiner(s): Bockelman, Mark
• Application Number:
  US08/439,610
• Time in Patent Office: 851 Days
• Field of Search: 604/27, 604/30-31, 604/34, 604/35, 604/170, 604/270, 604/49, 604/54, 600/120, 600/117, 600/104, 600/101, 600/153-154, 600/156
• US Class Current: 604/516
• CPC Class Codes: A61J 15/0007 inserted by using a guide-wire guide wires A61M25/09
• CPC Class Codes: A61J 15/0069 Tubes feeding directly to the intestines, e.g. to the jejunum

Abstract

A gastroenteric feeding tube is provided which is ideally adapted for endoscopic placement through an endoscope having a working channel and a steerable tip. The feeding tube is provided with a longitudinal length sufficient to allow the endoscope to be removed from about the feeding tube without disturbing the distal placement of the feeding tube within the patient'"'"'s intestines. After the feeding tube has been properly positioned within the patient and the endoscope has been removed from about the feeding tube, a connector is securely attached to the proximal end of the feeding tube to allow it to be connected to a feeding pump, or the like, to provide nourishment to the patient.

Claims

1. A gastroenteric feeding tube in combination with an endoscope for endoscopic placement of the feeding tube within the gastrointestinal tract of a living being, said combination comprising:

the elongated endoscope having an instrument channel, an illumination means and a viewing means throughout its entire length;

the feeding tube having an elongated flexible tubular body having a longitudinally extending lumen therein, the tubular body having distal and proximal ends and at least one side aperture therein which extends between the lumen and the exterior of the tubular body adjacent the distal end of said lumen, the tubular body adapted to be inserted within the instrument channel of the endoscope; and

the overall longitudinal length of the feeding tube being greater than twice the length of the instrument channel of the endoscope so that the endoscope can be removed from about the feeding tube without disturbing the position of the side aperture and distal end of the tubular body of said feeding tube within the gastrointestinal tract of the living beings,

said elongated tubular body further comprising an elongated flexible main portion having the longitudinally extending lumen therein, the main portion having distal and proximal ends and at least one side aperture which extends between the lumen and the exterior surface of the main portion adjacent the distal end of the main portion; and

a weighted bolus portion extending in substantially aligned relation from the distal end of the main portion and terminating in a free end, the weighted bolus portion and elongated main portion adapted to be inserted within the instrument channel of the endoscope,

said feeding tube further comprising a wire stylet having a distal and a proximal end, the distal end adapted to be inserted within the proximal end of and extending within the lumen of the elongated main portion to provide the feeding tube with additional stiffness during insertion of the feeding tube within either of the instrument channel of the endoscope or the living being,

said wire stylet further comprising an enlarged distal end having a diameter greater than the diameter of the wire stylet and smaller than the inside diameter of the main portion lumen,

the proximal end of the main portion of the feeding tube further including a closure means which closes the inside diameter of the lumen about the wire stylet to capture the enlarged end of the wire stylet within the lumen without preventing longitudinal movement of the wire stylet within the lumen of the feeding tube.

2. The combination of claim 1, wherein the enlarged distal end of the wire stylet includes a soft flexible tip to provide a cushion to protect the inside surface of the lumen of the tubular body during insertion of the wire stylet into said lumen.

3. The combination of claim 1, the closure means comprising a heat shrinkable sleeve positioned about the main portion of the feeding tube adjacent its proximal end such that upon application of heat the sleeve contracts about the outside surface of the main portion to compress the inside surface of the lumen about the wire stylet.

4. The combination of claim 3, the wire stylet further comprising a plurality of wire strands wrapped together to form a single wire strand such that the wire stylet has a spiraled outer configuration.

5. The combination of claim 4, wherein the contracted inside surface of the main feeding tube portion has a matching spiraled configuration to the outer configuration of the wire stylet so that upon rotation of the wire stylet relative to the main feeding tube portion, the wire stylet will travel either further into or out of the lumen depending whether the wire stylet is rotated in a clockwise or counterclockwise direction.

6. A gastroenteric feeding tube in combination with an endoscope for endoscopic placement of the feeding tube within the gastrointestinal tract of a living being, said combination comprising:

the elongated endoscope having an instrument channel, an illumination means and a viewing means throughout its entire length;

the feeding tube having an elongated flexible tubular body having a longitudinally extending lumen therein, the tubular body having distal and proximal ends and at least one side aperture adjacent the lumen'"'"'s distal end and extending between the lumen and the exterior surface of the tubular body;

a wire stylet having distal and proximal ends, the distal end adapted to be inserted within the proximal end of and extending within the lumen of the elongated tubular body such that the distal end of the wire stylet is positioned adjacent the distal end of the lumen to provide the feeding tube with additional stiffness during insertion of the feeding tube within the instrument channel of the endoscope or the living being; and

the overall longitudinal length of the feeding tube with wire stylet fully inserted within the tubular body being greater than twice the length of the instrument channel of the endoscope so that the endoscope can be removed from about the feeding tube without disturbing the position of the side aperture and distal end of the tubular body of said feeding tube withing the gastrointestinal tract of a living being,

the wire stylet further comprising an enlarged distal end having a diameter greater than the diameter of the wire stylet and smaller than the inside diameter of the lumen of the tubular body,

wherein the enlarged distal end of the wire stylet has a diameter larger than the size of the side aperture in the tubular body,

the proximal end of the tubular body of the feeding tube further including a closure means which closes the inside diameter of the lumen about the wire stylet to capture the enlarged end of the wire stylet within the lumen without preventing longitudinal movement of the wire stylet within the lumen of the feeding tube,

the closure means comprising a heat shrinkable sleeve positioned about the tubular body of the feeding tube adjacent its proximal end such that upon application of heat the sleeve contracts about the outside surface of the tubular body to compress the inside surface of the lumen about the wire stylet.

7. The combination of claim 6, the elongated tubular body further comprising:

an elongated flexible main portion having the longitudinal extending lumen therein, the main portion having distal and proximal ends and the at least one side aperture which extends between the lumen and the exterior surface of the main portion adjacent the distal end of the main portion; and

a weighted bolus portion extending in substantially aligned relation from the distal end of the main portion and terminating in a free end, the weighted bolus portion and elongated main portion adapted to be inserted within the instrument channel of the endoscope.

8. The combination of claim 6, wherein the enlarged distal end of the wire stylet includes a soft flexible tip to provide a cushion to protect the inside surface of the lumen of the tubular body during insertion of the wire stylet into said lumen.

9. The combination of claim 6, the wire stylet further comprising a plurality of wire strands wrapped together to form a single wire strand such that the wire stylet has a spiraled outer configuration.

10. The combination of claim 9, wherein the contracted inside surface of the tubular body has a matching spiraled configuration to the outer configuration of the wire stylet so that upon rotation of the wire stylet relative to the main feeding tube portion, the wire stylet will travel either further into or out of the lumen depending whether the wire stylet is rotated in a clockwise or counterclockwise direction.

11. A method of endoscopically inserting a feeding tube within the gastrointestinal tract of a living being comprising the steps:

placing a feeding tube into an instrument channel of an endoscope, the feeding tube having an elongated flexible tubular body with a longitudinally extending lumen therein, the tubular body having distal and proximal ends and at least one side aperture which extends between the lumen and the exterior of the tubular body adjacent the distal end of the lumen, the endoscope further including an illumination means and a viewing means and having a steerable distal tip, the feeding tube being positioned within the instrument channel of the endoscope such that the distal end of the tubular body is adjacent a distal end of the instrument channel of the endoscope, the feeding tube having a longitudinal length which is greater than twice the length of the endoscope'"'"'s instrument channel;

inserting the distal end of the endoscope through a living being'"'"'s mouth and down the living being'"'"'s alimentary tract to the living being'"'"'s stomach, and positioning the steerable tip of the endoscope so that it is facing the pyloric valve of the living being;

advancing the feeding tube within the instrument channel past the pyloric valve and into the intestinal tract of the living being;

removing the endoscope from about the feeding tube while holding the proximal end of the feeding tube stationary so as to not disturb the position of the distal end of the feeding tube within the intestinal tract of the living being;

attaching a connector to the proximal end of the feeding tube so that it is in fluid communication with the lumen of the feeding tube; and

connecting the connector to a source of fluid whereby fluid passes from the source of fluid through the connector and lumen to the side aperture adjacent the distal end of the feeding tube where the fluid leaves the tube and enters the intestinal tract of the living being.

12. The method of claim 11 wherein the feeding tube further comprises:

an elongated flexible main portion having the longitudinally extending lumen therein, the main portion having distal and proximal ends and the at least one side aperture which extends between the lumen and the exterior surface of the main portion adjacent the distal end of the main portion; and

a weighted bolus portion extending in substantially aligned relation from the distal end of the main portion and terminating in a free end, the weighted bolus portion and elongated main portion adapted to be inserted within the instrument channel of the endoscope.

13. The method of claim 12 wherein the feeding tube further comprises:

a wire stylet having distal and proximal ends, the distal end adapted to be inserted within the proximal end of and extending within the lumen of the elongated tubular body to provide the feeding tube with additional stiffness during insertion of the feeding tube within either of the instrument channel of the endoscope or the living being.

14. The method of claim 13 including the step of removing the wire stylet from the lumen while leaving the feeding tube in position through the living being'"'"'s mouth, alimentary tract and intestinal tract after the step of removing the endoscope from about the feeding tube.

15. The method of claim 14 including the subsequent step of repositioning the feeding tube through the nasal passageway of the living being before attaching the connector to the proximal end of the feeding tube.

16. The method of claim 11 wherein the step of placing the feeding tube within the instrument channel of the endoscope occurs immediately after the step of inserting the endoscope within the mouth and intestinal tract of the living being.

17. A method of inserting a feeding tube within the gastrointestinal tract of a patient through an endoscope having an instrument channel, an illumination means and a viewing means through its entire length and having a steerable distal tip comprising the steps of:

placing the feeding tube into the instrument channel of the endoscope, the feeding tube having an elongated flexible tubular body having a longitudinally extending lumen therein, the tubular body having distal and proximal ends and at least one side aperture adjacent the distal lumen and extending between the lumen and the exterior surface of the tubular body, and a wire stylet having distal and proximal ends, the distal end adapted to be inserted within the proximal end of and extending within the lumen of the elongated tubular body such that the distal end of the wire stylet is positioned adjacent the distal to provide the feeding tube with additional stiffness during insertion of the feeding tube within the instrument channel of the endoscope or the patient, the overall longitudinal length of the feeding tube with wire stylet fully inserted within the tubular body being greater than twice the length of the instrument channel of the endoscope;

inserting the distal end of the endoscope through a patient'"'"'s mouth and down the patient'"'"'s alimentary tract to the patient'"'"'s stomach;

positioning the steerable tip of the endoscope so that it is facing the patient'"'"'s pyloric valve;

advancing the feeding tube within the instrument channel so that its distal end is past the patient'"'"'s pyloric valve and into the patient'"'"'s intestinal tract;

removing the endoscope from about the feeding tube while holding the proximal end of the wire stylet stationary so as to not disturb the position of the distal end of the feeding tube within the patient'"'"'s intestinal tract;

attaching a connector to the proximal end of the feeding tube; and

connecting the connector to a source of fluid whereby fluid passes from the source of fluid through the lumen of the feeding tube and into the intestinal tract of the patient.

18. The method of claim 17 wherein the feeding tube further comprises:

an elongated flexible main portion having the longitudinal extending lumen therein, the main portion having distal and proximal ends and the at least one side aperture which extends between the lumen and the exterior surface of the main portion adjacent the distal end of the main portion;

a weighted bolus portion extending in substantially aligned relation from the distal end of the main portion and terminating in a free end, the weighted bolus portion and elongated main portion adapted to be inserted within the instrument channel of the endoscope;

the wire stylet further comprising an enlarged distal end having a diameter greater than the diameter of the wire stylet and smaller than the inside diameter of the lumen of the main portion; and

the proximal end of the main portion of the feeding tube further including a closure means which closes the inside diameter of the lumen about the wire stylet to capture the enlarged end of the wire stylet within the lumen without preventing longitudinal movement of the wire stylet within the lumen of the feeding tube.

19. The method of claim 18 further including the steps of:

removing the wire stylet from the lumen while leaving the feeding tube in position through the patient'"'"'s mouth, alimentary tract and intestinal tract after the step of removing the endoscope from about the feeding tube;

repositioning the feeding tube'"'"'s main portion and wire stylet through the patient'"'"'s nasal passageway;

pulling the wire stylet proximally from the lumen of the main feeding tube portion until the enlarged distal end is adjacent the constructed proximal end of the main portion;

cutting the main feeding tube portion at a position distal to where the enlarged distal end of the wire stylet is resting so that the wire stylet and main feeding tube position are separated and the connector can be connected to the proximal end of the main feeding tube portion.

20. The method of claim 19 wherein the step of placing the feeding tube within the instrument channel of the endoscope takes place immediately after the step of inserting the endoscope within the patient'"'"'s mouth and intestinal tract.

21. A gastroeteric feeding tube in combination with an endoscope for endoscopic placement of the feeding tube within the gastrointestinal tract of a living being, said combination comprising:

the elongated endoscope having an instrument channel, an illumination means and a viewing means throughout its entire length;

the feeding tube having an elongated flexible tubular body having a longitudinally extending lumen therein, the tubular body having distal and proximal ends and at least one side aperture therein which extends between, the lumen and the exterior of the tubular body adjacent the distal end of said lumen, the tubular body adapted to be inserted within the instrument channel of the endoscope; and

the overall longitudinal length of the feeding tube being greater than twice the length of the instrument channel of the endoscope so that the endoscope can be removed from about the feeding tube without disturbing the position of the side aperture and distal end of the tubular body of said feeding tube within the gastrointestinal tract of the living being, the feeding tube further comprising a wire stylet having distal and proximal ends, the distal end adapted to be inserted within the proximal end of and extending within the lumen of the elongated tubular body to provide the feeding tube with additional stiffness during insertion of the feeding tube within either of the instrument channel of the endoscope or the living being,

the wire stylet further comprising an enlarged distal end having a diameter greater than the diameter of the wire stylet and smaller than the inside diameter of the lumen of the tubular body, wherein the enlarged distal end of the wire stylet has a diameter larger than the size of the side aperture in the tubular body.