The present invention is an enteral nutrition gastrostomy access device. A permanent or semi-permanent stoma liner is adjustably positioned within a stoma channel extending through a patient's abdominal and stomach walls. The stoma liner is characterized by an adjustable bladder capable of applying variable torsional force to one or more pinch points along the interface between the stoma liner and the stoma. The stoma liner is configured to receive a plug with a central threaded channel, into which a cap or enteral feeding device may be wholly or partially inserted. The central threaded channel is characterized by requiring application of a linear push force to apply but requiring application of both a linear pull force and a torsional force to remove.

Devices, systems, and methods for guidewire placement for a gastrostomy tube are described herein. A system can include an elongated tube, an inflatable member, and a guidewire assembly. The elongated tube can have a first end, a second end, and can define a lumen. The inflatable member can be coupled to the first end of the elongated tube and can be fluidically coupled to the lumen such that the inflatable member can receive fluid via the lumen. The guidewire assembly can include a guidewire having a first end and a second end. The first end of the guidewire assembly can include a coupling member, the coupling member configured to couple to the inflatable member such that translation of the elongated tube translates the guidewire assembly.

In some embodiments a PEG feeding device includes a tube sized to bridge a channel between a stomach and an outer abdominal surface; an internal bolster, and an external bolster. Optionally the bolsters are connected to the tube. The internal bolster may be sized to resist movement out of the stomach through the stoma. The external bolster may be sized to resist movement into the stoma from the outer abdominal surface. The external bolster may include an underside which extends from the tube in a radial direction between the external bolster and the outer abdominal surface. The underside of the outer bolster may contact the outer abdominal surface at a distance from an external opening of the stoma. Optionally the distance between the internal bolster and the external bolster is adjustable. Optionally an angle between one or both of the bolsters and the tube is adjustable.

A feeding tube and method for introducing a feeding tube within the gastrointestinal tract of a patient, whereby the feeding tube is introduced by using a variation of the Ponsky “pull” method of feeding tube placement. The feeding tube comprises an elongate shaft having a distal end and proximal end. The feeding tube also comprises a coupling structure for coupling the feeding tube to a pull wire, the coupling structure being internal to and proximal of the distal end of the feeding tube shaft. The coupling structure is configured to engage an outwardly biased anchor member affixed to the end of the pull wire. The feeding tube is introduced within the patient by attaching the anchor member of the previously placed pull wire to the coupling structure of the feeding tube, and then pulling the pull wire so as to pull the feeding tube into and through the gastrointestinal tract of the patient.

A method for creating a tract for percutaneous endoscopic guided gastrointestinal tube creation including the steps of providing a puncture wire having a sharp tissue penetrating tip shielded in a sheath, the puncture wire slidable within the sheath and releasably lockingly engaged thereto; inserting the puncture wire and sheath in a first direction through a working channel of an endoscope to exit the channel of the endoscope, then releasing the puncture wire from the sheath and advancing the puncture wire from the sheath while visualizing via the endoscope the position of the puncture wire, and further advancing the puncture wire through the visceral wall and then the abdominal wall of a patient. Subsequent methods to position a percutaneous gastrointestinal catheter after initial wire puncture are described.

A device and method for placing a jejunal feeding tube through a stomach and into a small intestine. A mechanism is formed to a shape that contacts walls of the small intestine along a length of the small intestine to grip the walls and anchor the jejunal feeding tube. The mechanism is present on a distal end of the jejunal feeding tube that is present in the small intestine after placement of the jejunal feeding tube. The mechanism is straightened for placement into the small intestine with a stiffening apparatus.

A gastrostomy tube for enteral nutrition or medication of a subject, comprising a dual lumen first flexible tube with an internal retention device at an internal end and a substantially Y-shaped connector at an external end. A single lumen second flexible tube is connected at a first end to a main longitudinal channel of the dual lumen tube via the substantially Y-shaped connector. A second end of the second flexible tube is connectable to a nutrient or medicine source. The invention also relates to a kit of parts comprising a gastrostomy tube and a nutrient/medicine container attachable to the gastrostomy tube.

An enteral feeding device permitting diversion of gastrointestinal fluid from an afferent limb to an efferent limb of gastrointestinal tract in a subject is provided. The device can be used to reduce leakage from around device and thus reduce morbidity associated with such leakage. In certain embodiments the enteral feeding device is a jejunostomy tube (J-tube). Also provided are methods for positioning and using the enteral feeding device. Also provided are kits for positioning and using the enteral feeding device.

In some embodiments a PEG feeding device includes a tube sized to bridge a channel between a stomach and an outer abdominal surface; an internal bolster, and an external bolster. Optionally the bolsters are connected to the tube. The internal bolster may be sized to resist movement out of the stomach through the stoma. The external bolster may be sized to resist movement into the stoma from the outer abdominal surface. The external bolster may include an underside which extends from the tube in a radial direction between the external bolster and the outer abdominal surface. The underside of the outer bolster may contact the outer abdominal surface at a distance from an external opening of the stoma. Optionally the distance between the internal bolster and the external bolster is adjustable. Optionally an angle between one or both of the bolsters and the tube is adjustable.

Devices, systems, and methods for guidewire placement for a gastrostomy tube are described herein. A system can include an elongated tube, an inflatable member, and a guidewire assembly. The elongated tube can have a first end, a second end, and can define a lumen. The inflatable member can be coupled to the first end of the elongated tube and can be fluidically coupled to the lumen such that the inflatable member can receive fluid via the lumen. The guidewire assembly can include a guidewire having a first end and a second end. The first end of the guidewire assembly can include a coupling member, the coupling member configured to couple to the inflatable member such that translation of the elongated tube translates the guidewire assembly.