UNIVERSAL PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE
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.
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.
FIELD OF THE INVENTIONThis 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.
BACKGROUND OF THE INVENTIONPEG 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.
SUMMARY OF THE INVENTIONThe 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.
Referring now to
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. In the preferred embodiment, 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. In the preferred embodiment, 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
The embodiment shown in
If the pull method is to be used with the embodiment shown in
Claims
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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.
Type: Application
Filed: Jun 15, 2009
Publication Date: Dec 10, 2009
Inventor: Rebecca DeLegge (Mt. Pleasant, SC)
Application Number: 12/484,452
International Classification: A61M 39/00 (20060101);