Trans-abdominal intra-gastric tube
11439572 · 2022-09-13
Assignee
Inventors
Cpc classification
A61J15/0034
HUMAN NECESSITIES
A61J15/0057
HUMAN NECESSITIES
International classification
Abstract
The present disclosure provides a device that includes a tube having a first end and a second end. The device also includes a stopper coupled to a surface of the tube adjacent to the second end of the tube. The stopper is configured to extend radially from the surface of the tube. The device also includes a first rib coupled to the surface of the tube. The device also includes a second rib coupled to the surface of the tube. The first rib and the second rib are positioned opposite one another on the surface of the tube between the first end of the tube and the stopper.
Claims
1. A device comprising: a tube having a first end and a second end; a stopper coupled to a surface of the tube adjacent to the second end of the tube, wherein the stopper extends radially from the surface of the tube; a first rib coupled to the surface of the tube, wherein the first rib includes a first plurality of through-holes; a second rib coupled to the surface of the tube, wherein the second rib includes a second plurality of through-holes, wherein the first rib and the second rib are positioned opposite one another on the surface of the tube between the first end of the tube and the stopper, wherein the first rib and the second rib are configured to be positioned perpendicular to a skin of a patient, and wherein the first plurality of through-holes and the second plurality of through-holes correspond to a plurality of depths of the tube through the skin of the patient; a first component having a first end and a second end, the first component including a first depression on a mating face of the first component; and a second component having a first end and a second end, the second component including a second depression on a mating face of the second component, wherein the first depression and the second depression are configured to be positioned around the surface of the tube such that the mating face of the first component contacts the mating face of the second component, and wherein the first rib and the second rib of the device are configured to be pinched between the mating face of the first component and the mating face of the second component.
2. The device of claim 1, wherein the stopper comprises two helical blades.
3. The device of claim 2, wherein the two helical blades are flexible.
4. The device of claim 1, wherein the first rib and the second rib are each tapered at one end arranged nearest the first end of the tube.
5. The device of claim 1, further comprising: a conical tip coupled to the first end of the tube; and a loop coupled to a tapered end of the conical tip.
6. The device of claim 1, wherein at least a portion of the tube has an adjustable length.
7. The device of claim 1, wherein the tube has a first lumen and a second lumen.
8. The device of claim 1, wherein the first component and the second component each have a length ranging from about 25 mm to about 40 mm.
9. The device of claim 1, wherein at least one of a bottom surface of the first component and a bottom surface of the second component includes an adhesive.
10. The device of claim 1, wherein the first component further comprises a third depression on the mating face of the first component, and wherein the second component further comprises a fourth depression on the mating face of the second component.
11. The device of claim 1, wherein the first rib and the second rib each comprise a flexible material.
12. The device of claim 1, wherein the first rib and the second rib each comprise a material that is more flexible than a material of the tube.
13. The device of claim 1, wherein the first component further comprises: a first protrusion coupled to the mating face of the first component and positioned between the first depression and the first end of the first component; and a second protrusion coupled to the mating face of the first component and positioned between the first depression and the second end of the first component; and wherein the second component further comprises: a first cavity arranged on the mating face of the second component and positioned between the second depression and the first end of the second component, wherein the first cavity is configured to receive the first protrusion; and a second cavity arranged on the mating face of the second component and positioned between the second depression and the second end of the second component, wherein the second cavity is configured to receive the second protrusion, wherein the first protrusion is configured to be positioned at least partially within the first cavity, and wherein the second protrusion is configured to be positioned at least partially within the second cavity.
14. The device of claim 13, wherein a free end of the first protrusion has a first radially extending rim and a free end of the second protrusion has a second radially extending rim, wherein the first cavity is configured to receive the first protrusion and engage the first radially extending rim, and wherein the second cavity is configured to receive the second protrusion and engage the second radially extending rim.
15. The device of claim 13, wherein the first protrusion is positioned at least partially within the first cavity, and wherein the second protrusion is positioned at least partially within the second cavity such that the first component and the second component are coupled to one another to form a collar.
16. The device of claim 13, wherein the first component further comprises: a third protrusion coupled to the mating face of the first component and positioned between the first depression and the first protrusion; and a fourth protrusion coupled to the mating face of the first component and positioned between the first depression and the second protrusion; and wherein the second component further comprises: a third cavity within the mating face of the second component and positioned between the second depression and the first cavity, wherein the third cavity is configured to receive the third protrusion; and a fourth cavity within the mating face of the second component and positioned between the second depression and the second cavity, wherein the fourth cavity is configured to receive the fourth protrusion.
17. The device of claim 16, wherein the first protrusion is positioned at least partially within the first cavity, wherein the second protrusion is positioned at least partially within the second cavity, wherein the third protrusion is positioned at least partially within the third cavity, and wherein the fourth protrusion is positioned at least partially within the fourth cavity such that the first component and the second component are coupled to one another to form a collar.
18. The device of claim 13, wherein an outer portion of the first component and an outer portion of the second component are rotatable with respect to the first protrusion and the second protrusion when the first protrusion is positioned in the first cavity and the second protrusion is positioned in the second cavity.
19. The device of claim 13, wherein the first protrusion is configured to be positioned through a first through-hole of the first plurality of through holes in the first rib, and wherein the second protrusion is configured to be positioned through a second through-hole of the second plurality of through holes in the second rib.
20. The device of claim 13, wherein the first protrusion is permanently positioned at least partially within the first cavity such that the first protrusion cannot be removed from the first cavity, and wherein the second protrusion is permanently positioned at least partially within the second cavity such that the second protrusion cannot be removed from the second cavity.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
(18) Exemplary devices, kits, systems and methods are described herein. It should be understood that the word “exemplary” is used herein to mean “serving as an example, instance, or illustration.” Any embodiment or feature described herein as “exemplary” is not necessarily to be construed as preferred or advantageous over other embodiments or features. The exemplary embodiments described herein are not meant to be limiting. It will be readily understood that certain aspects of the disclosed devices, kits, systems and methods can be arranged and combined in a wide variety of different configurations, all of which are contemplated herein.
(19) Furthermore, the particular arrangements shown in the Figures should not be viewed as limiting. It should be understood that other embodiments may include more or less of each element shown in a given Figure. Further, some of the illustrated elements may be combined or omitted. Yet further, an exemplary embodiment may include elements that are not illustrated in the Figures.
(20) As used herein, with respect to measurements, “about” means +/−5%.
(21) As used herein, “French” refers to a unit of measurement for a catheter. A round catheter of 1 French has an external diameter of ⅓ mm, and therefore the diameter of a round catheter in millimeters can be determined by dividing the French size by 3.
(22) As used herein, “coupled” means associated directly, as well as indirectly. For example, a member A may be directly associated with a member B, or may be indirectly associated therewith, via another member C. It will be understood that not all relationships among the various disclosed elements are necessarily represented.
(23) Unless otherwise indicated, the terms “first,” “second,” etc. are used herein merely as labels, and are not intended to impose ordinal, positional or hierarchical requirements on the items to which these terms refer. Moreover, reference to, e.g., a “second” item does not require or preclude the existence of, e.g., a “first” or lower-numbered item, and/or, e.g., a “third” or higher-numbered item.
(24) Reference herein to “one embodiment” or “one example” means that one or more feature, structure, or characteristic described in connection with the example is included in at least one implementation. The phrases “one embodiment” or “one example” in various places in the specification may or may not be referring to the same example.
(25) As used herein, a system, apparatus, device, structure, article, element, component, or hardware “configured to” perform a specified function is indeed capable of performing the specified function without any alteration, rather than merely having potential to perform the specified function after further modification. In other words, the system, apparatus, structure, article, element, component, or hardware “configured to” perform a specified function is specifically selected, created, implemented, utilized, programmed, and/or designed for the purpose of performing the specified function. As used herein, “configured to” denotes existing characteristics of a system, apparatus, structure, article, element, component, or hardware which enable the system, apparatus, structure, article, element, component, or hardware to perform the specified function without further modification. For purposes of this disclosure, a system, apparatus, structure, article, element, component, or hardware described as being “configured to” perform a particular function may additionally or alternatively be described as being “adapted to” and/or as being “operative to” perform that function.
(26) In the following description, numerous specific details are set forth to provide a thorough understanding of the disclosed concepts, which may be practiced without some or all of these particulars. In other instances, details of known devices and/or processes have been omitted to avoid unnecessarily obscuring the disclosure. While some concepts will be described in conjunction with specific examples, it will be understood that these examples are not intended to be limiting.
(27) With respect to the Figures,
(28) The tube 102 may have a length ranging from about 15 cm to about 30 cm, and the tube 102 may have a diameter ranging from about 4 mm (12 French) to about 8 mm (24 French). The length of the tube 102 accommodates variable thickness abdominal walls to hold the tube 102 securely in place when in use. The length of the intra-gastric portion of the tube 102 may range from about 1 cm to about 3 cm. The first rib 112 and the second rib 114 may have a length (in a direction parallel to a longitudinal axis of the tube) ranging from about 10 cm to about 15 cm, a width (in a direction perpendicular to a longitudinal axis of the tube) ranging from about 4 mm to about 8 mm, and a thickness ranging from about 1 mm to about 3 mm. In one example, the tube 102 has an adjustable length. In particular, as shown in
(29) In one example, the tube 102 comprises a material capable of being compressed and returned to an original shape, including, but not limited to, a polymer material such as PLGA (poly-pactic-co-glycolic acid), PCL (poly-caprolactone) or PMMA (poly-methyl-methacrylate), rubber, silicone or combinations thereof. In one example, the first and second ribs 112, 114 and/or the stopper 108 may comprise the same material as the tube 102. In another example, the first and second ribs 112, 114 and/or the stopper 108 may comprise a different material than the tube 102. For example, the first and second ribs 112, 114 may comprise a more flexible material than the other components of the device 100. In yet another example, the stopper 108 may comprise a less flexible material than the other components of the device 100. Other examples are possible as well.
(30) The stopper 108 may be configured to sit within the stomach and hold the stomach against the abdominal wall. The stopper 108 is configured to resist external dislodgment forces, yet may be flexible enough to allow the tube 102 to be extracted when it is no longer needed. The stopper 108 may be composed of a radio-opaque material such that computed tomography imaging or fluoroscopy can delineate how much of the tube 102 is positioned within the stomach if concern about extraction exists or to confirm accurate placement.
(31) In one particular example, the stopper 108 comprises a single helical blade. In another example, as shown in
(32) In one example, the first rib 112 and the second rib 114 are configured to be pierceable, as discussed in additional detail below. In another example, the first rib 112 and the second rib 114 include a plurality of through-holes. In another example, the first rib 112 and the second rib 114 each include a single channel. Further, the first rib 112 and the second rib 114 may be tapered at one end arranged nearest the first end 104 of the tube 102, as shown in
(33) The device 100 may further include a plurality of measurement markings 118 on the surface 110 of the tube 102. These measurement markings 118 may provide an indication to a medical professional of a depth of the tube 102 within the patient. The device 100 may further include a conical tip 120 coupled to the first end 104 of the tube 102, and a loop 122 coupled to a tapered end 124 of the conical tip 120. This configuration may be used to assist in percutaneous placement and removal of the device 100. In particular, during placement of the device 100, the device 100 is positioned in the mouth of the patient and down the throat into the stomach. Once the device 100 is located in the stomach of the patient, the medical professional makes a small incision to provide an access cite to the stomach from outside of the patient. The medical professional then snags the loop 122 of the device 100 through the access site, and pulls the device 100 through the access site. The stopper 108 then abuts the abdominal wall from inside the stomach of the patient, thereby preventing the device 100 from being pulled completely out of the stomach of the patient.
(34) The device 100 described above and shown in
(35) In another example, the first component 202 may include a first protrusion 212 coupled to the mating face 210 of the first component 202 and positioned between the first depression 208 and the first end 204 of the first component 202. The first component 202 may also include a first cavity 226 arranged on the mating face 210 of the first component 202 and positioned between the first depression 208 and the second end 204 of the first component 202. In such an example, the second component 216 may also include a second protrusion 214 arranged on the mating face 224 of the second component 216 and positioned between the second depression 222 and the first end 218 of the second component 216. The second component 216 may also include a second cavity 228 arranged on the mating face 224 of the second component 216 and positioned between the second depression 222 and the second end 220 of the second component 216. In use, the first cavity 226 is configured to receive the first protrusion 212 and the second cavity 228 is configured to receive the second protrusion 214.
(36) In one example, a system is provided that includes the device 100, as described above, coupled to the locking member 200, as described above. Specifically, the first protrusion 212 is configured to pierce the first rib 112 and is positioned at least partially within the first cavity 226 and the second protrusion 214 is configured to pierce the second rib 114 and is positioned at least partially within the second cavity 228. In addition, the first depression 208 and the second depression 222 are positioned around the surface 110 of the tube 102 such that the mating face 210 of the first component 202 contacts the mating face 224 of the second component 216.
(37) In another example, the first rib 112 and the second rib 114 include a plurality of through-holes. In such an example, the first protrusion 212 is configured to be positioned through one of the plurality of through-holes of the first rib 112 and is positioned at least partially within the first cavity 226. The second protrusion 214 is likewise configured to be positioned through one of the plurality of through-holes of the second rib 114 and is positioned at least partially within the second cavity 228. And the first depression 208 and the second depression 222 are positioned around the surface 110 of the tube 102 such that the mating face 210 of the first component 202 contacts the mating face 224 of the second component 216.
(38) In another example, the first rib 112 and the second rib 114 each include a single channel. In such an example, the first protrusion 212 is configured to be positioned through the single channel of the first rib 112 and is positioned at least partially within the first cavity 226, the second protrusion 214 is configured to be positioned through the single channel of the second rib 114 and is positioned at least partially within the second cavity 228, and the first depression 208 and the second depression 222 are positioned around the surface 110 of the tube 102 such that the mating face 210 of the first component 202 contacts the mating face 224 of the second component 216.
(39) In yet another example, the first rib 112 and the second rib 114 are configured to be pinched between the mating face 210 of the first component 202 and the mating face 224 of the second component 216. In such an example, the first depression 208 and the second depression 222 are positioned around the surface 110 of the tube 102. Further, a first portion of the mating face 210 of the first component 202 contacts a first side of the first rib 112, and a first portion of the mating face 224 of the second component 216 contacts a second side of the first rib 112 to thereby pinch the first rib 112 between the mating face 210 of the first component 202 and the mating face 224 of the second component 216. Further, a second portion of the mating face 210 of the first component 202 contacts a first side of the second rib 114, and a second portion of the mating face 224 of the second component 216 contacts a second side of the second rib 114 to thereby pinch the second rib 114 between the mating face 210 of the first component 202 and the mating face 224 of the second component 216.
(40) In one example, the first component 202 and the second component 216 each have a length ranging from about 25 mm to about 40 mm. Further, the first component 202 and the second component 216 independently range in width from about 10 mm to about 40 mm. In one example, the width of the first component 202 is equal to the width of the second component 216. In another example, the width of the first component 202 is different than the width of the second component 216. For example, the first component 202 may have a width ranging from about 25 mm to about 40 mm, and the width of the second component 216 may have a width ranging from about 10 mm to about 25 mm. Further, the first component 202 and the second component 216 each have a width ranging from about 10 mm to about 15 mm. In addition, the first depression 208 and the second depression 222 each have a diameter ranging in size from about 4 mm to about 10 mm to accept tubes ranging from, but not limited to, 12 French to 24 French size. In one example, the bottom surface 230 of the first component 202 and the bottom surface 232 of the second component 216 include an adhesive, which may be used to further secure the locking mechanism 200 to the stomach of the patient when the system is in use. In another example, the first component 202 may include through holes 221A, 221B and the second component may include through holes 221C, 221D, through which a suture 223 can be placed to further secure the location of the locking device 200 to the skin of the patient. Such an arrangement further secures the locking mechanism 200 to the skin of the patient and helps to prevent extraction when changing caps 300.
(41) As described above, when in use, the first protrusion 212 is configured to be positioned at least partially within the first cavity 226, and the second protrusion 214 is positioned at least partially within the second cavity 228 such that the first component 202 and the second component 216 are coupled to one another to form a collar 203 around a tube 102 that has been placed at least partially in vivo. The coupling of the first component 202 to the second component 216 may be a permanent coupling, such that once the first protrusion 212 is positioned within the first cavity 226 and the second protrusion 214 is positioned within the second cavity 228, the protrusions 212, 214 cannot be removed from the cavities 226, 228. In such an example, the entire device 100 and locking mechanism 200 system may be pulled in a direction away from the body of the patient to remove the tube 102 when the tube 102 is no longer needed, and the entire system is discarded. In another example, the coupling of the first component 202 to the second component 216 may be a temporary coupling such that the first component 202 can be separated from the second component 216 after use. In such an example, only the tube 102 is discarded, and the locking mechanism 200 can be reused.
(42) In one example, as shown in
(43) In another example, as shown in
(44) In operation, the first component 202 may be snap-fit to the second component 216 via the first protrusion 212 interacting with the first cavity 226 and the second protrusion 214 interacting with the second cavity 228. As such, the first and second depressions 208, 222 of the locking mechanism 200 are configured to be positioned around the surface 110 of the tube 102 such that the mating face 210 of the first component 202 contacts the mating face 224 of the second component 216 after the tube 102 has been placed at least partially in vivo. The third protrusion 238 is configured to pierce the first rib 112 of the device 100, and the third cavity 242 is configured to receive the third protrusion 238. Similarly, the fourth protrusion 240 is configured to piece the second rib 114 of the device 100, and the fourth cavity 244 is configured to receive the fourth protrusion 240.
(45) In such an example, the present disclosure provides a system comprising the device 100 as described above coupled to the locking member 200 as just described in relation to
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(47) In one example, an outer portion 246 of the first component 202 and an outer portion 248 of the second component 216 are rotatable with respect to the first protrusion 212 and the second protrusion 214 when the first protrusion 212 is positioned in the first cavity 226 and the second protrusion 214 is positioned in the second cavity 228. Such an arrangement may help relieve tension and/or tugging on the tube 102 as the patient moves. In one particular example, as shown in
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(49) There are several advantages to the design of the system of the device 100 and locking mechanism 200 as described above, including (i) the accommodation of variable abdominal wall thicknesses, (ii) the tube 102 may be cut flush with the locking mechanism 200 to prevent external forces from inadvertently pulling it out, and (iii) the locking mechanism 200 has a low profile to further protect the integrity of the placement of the tube 102.
(50) The present disclosure also provides a cap 300, as shown in
(51) The tubular structure 302 may have a diameter ranging from about 2 mm to about 5 mm. The flange 310 may have a thickness ranging from about 15 mm to about 30 mm, and a width ranging from about 30 mm to about 40 mm. The cap 300 may comprise a material having shape memory, including, but not limited to, a polymer material such as PLGA (poly-pactic-co-glycolic acid), PCL (poly-caprolactone) or PMMA (poly-methyl-methacrylate), rubber, silicone or combinations thereof.
(52) As shown in
(53) In another embodiment, the cap 300 may also include a first plug 316 removably positioned in the first input port 312 to thereby close access to the first channel 314, as shown in
(54) In one embodiment, the flange 310 is closed to an environment surrounding the cap 300 other than via the first input port 312 and the tubular structure 302. Further, the first input port 312 may be configured to be reversibly opened and closed. In one such embodiment, the first input port 312 may comprise an upper portion 324 and a lower portion 326, as shown in
(55) In another embodiment, as shown in
(56) In one particular example, as shown in
(57) In yet another example, the tubular structure 302 of the cap has a first lumen and a second lumen that is separate from the first lumen. In such an example, the first channel 314 may be in fluid communication with the first lumen, and the second channel 320 may be in fluid communication with the second lumen. As such, a gastronomy tube may be positioned in the first lumen and a jejunostomy tube may be positioned in the second lumen. Other example tubes positioned in the first and second lumens are possible as well.
(58) In use, the tube 102 may be cut flush with the locking mechanism 200 to prevent external forces from inadvertently pulling the tube 102 out of the body of the patient. Once the tube 102 has been cut flush with the locking mechanism 200, the tubular structure 302 of the cap 300 may be press fit into the tube 102. The cap 300 may then provide one or more access ports into which a practitioner can provide food, medication, or other fluids to the stomach of the patient. The cap 300 is designed such that the tubes positioned in the cap 300 remain with a low profile, thereby protecting the integrity of the placement of the tube 102.
(59) In another embodiment, the a kit is provided that includes (i) the device 100 as described above in relation to
(60) In another embodiment, a system is provided that includes the device 100 as described above in relation to
(61) In yet another embodiment, a system is provided that includes the device 100 as described above in relation to
(62) While various aspects and embodiments have been disclosed herein, other aspects and embodiments will be apparent to those skilled in the art. All embodiments within and between different aspects of the invention can be combined unless the context clearly dictates otherwise. The various aspects and embodiments disclosed herein are for purposes of illustration and are not intended to be limiting, with the true scope and spirit being indicated by the claims.