EP0287998A2 - Gastric duodenal jejunal catheter for enteral percutaneous feeding - Google Patents

Gastric duodenal jejunal catheter for enteral percutaneous feeding Download PDF

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Publication number
EP0287998A2
EP0287998A2 EP88106177A EP88106177A EP0287998A2 EP 0287998 A2 EP0287998 A2 EP 0287998A2 EP 88106177 A EP88106177 A EP 88106177A EP 88106177 A EP88106177 A EP 88106177A EP 0287998 A2 EP0287998 A2 EP 0287998A2
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EP
European Patent Office
Prior art keywords
catheter
balloon
tube
channel
stomach
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP88106177A
Other languages
German (de)
French (fr)
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EP0287998A3 (en
Inventor
Michael Dr. Kreiskrankenhaus Keymling
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Fresenius SE and Co KGaA
Original Assignee
Fresenius SE and Co KGaA
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Publication date
Application filed by Fresenius SE and Co KGaA filed Critical Fresenius SE and Co KGaA
Publication of EP0287998A2 publication Critical patent/EP0287998A2/en
Publication of EP0287998A3 publication Critical patent/EP0287998A3/en
Withdrawn legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0015—Gastrostomy feeding-tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0026—Parts, details or accessories for feeding-tubes
    • A61J15/003—Means for fixing the tube inside the body, e.g. balloons, retaining means
    • A61J15/0034—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters
    • A61J15/0038—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type
    • A61J15/0042—Retainers adjacent to a body opening to prevent that the tube slips through, e.g. bolsters expandable, e.g. umbrella type inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0026—Parts, details or accessories for feeding-tubes
    • A61J15/0053—Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin
    • A61J15/0061—Means for fixing the tube outside of the body, e.g. by a special shape, by fixing it to the skin fixing at an intermediate position on the tube, i.e. tube protruding the fixing means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
    • A61J15/00—Feeding-tubes for therapeutic purposes
    • A61J15/0026—Parts, details or accessories for feeding-tubes
    • A61J15/0069—Tubes feeding directly to the intestines, e.g. to the jejunum

Definitions

  • the invention relates to a gastral / duodenal / jejunal catheter for percutaneous enteral nutrition according to the preamble of claim 1. It relates in particular to the percutaneous artificial nutrition of patients in the stomach, in the duodenum or jejunum.
  • EP-OS 182539 describes a possible embodiment of a gastric or gastrojejunal feeding tube which can be inserted through a stoma in the stomach wall of the patient and is secured on both sides against the abdominal wall. This probe or catheter can be used for feeding into the stomach or into the jejunum.
  • a jejunal catheter is also described as a further variant, which is placed directly into the jejunum for the purpose of jejunal nutrition.
  • the well-known feeding probe is provided with an inflatable balloon at one end, which secures the probe against slipping out of the stomach.
  • a movable locking ring which is pushed against the patient's outer abdominal wall and thus secures the probe from sliding into the stomach.
  • the balloon In its initial position, the balloon has collapsed completely and slightly exceeds the diameter of the catheter. After the catheter has been inserted from the outside through the stoma into the stomach, an air supply device is connected to a connector provided for this purpose, and the air is passed into an additional channel in the catheter, which has an outlet opening inside the balloon. blown in. As a result, the balloon expands and closes the stoma from the inside.
  • a disadvantage of this solution is that the spherical shape of the balloon does not offer sufficient contact surface on the inner wall of the stomach and therefore does not offer comprehensive protection against leakage.
  • a spherical balloon takes up a relatively large amount of space, which is why a corresponding balloon catheter can be placed in the large-lumen stomach without problems, but not, or only in large spaces, in the small intestine.
  • EP 182539 Another positioning of the invention is then also provided in EP 182539 for positioning in the jejunum. It is a jejunal catheter that is fixed in the stoma by a small plastic ring. While this solution avoids lumen narrowing of the small intestine, it offers less protection against leaks and against accidental catheter extraction.
  • the object of the invention is therefore to create a gastral / duodenal / jejunal catheter for percutaneous enteral nutrition, which offers adequate protection against leakage with minimal space requirements.
  • the object is achieved according to the features of claim 1 in that the balloon of the catheter is bulged in an elliptical shape.
  • Elliptical in the sense of the invention means an oval cross-section, the short axis of the oval coinciding with the longitudinal axis of the catheter.
  • the preferred embodiment of the present invention also provides for a filling of the elliptical balloon with an elastically compressible, also elliptical foam body.
  • an evacuation device preferably a syringe
  • the filling medium present in the balloon or the foam body is drawn off.
  • the resulting negative pressure causes the balloon envelope and the flexible foam body to collapse and lie on the outside of the catheter tube. Its diameter is not significantly increased.
  • the separate delivery channel is opened. Due to the expansion efforts of the compressed foam body, air is sucked in through the conveying channel, as a result of which the foam body and consequently also the balloon envelope expand back into their normal shape.
  • the elliptical shape of the foam body and the balloon saves space, in particular within the small intestine, and ensures that there is sufficient contact and thus sealing on the stomach wall or intestinal wall.
  • this variant of the invention avoids problems which can occur with the gastral or gastrojejunal probe described in EP-OS 182539.
  • This already cited solution is problematic in that the balloon envelope can tear both during insertion and when inflating or feeding and then no longer secures the catheter against slipping out of the stoma in the collapsed state.
  • the foam body of the balloon according to the present invention also in this case continues to provide protection against dislocation for the catheter, since collapse of the balloon is avoided.
  • the catheter consists of a flexible catheter tube 1, in or on the wall of which a separate, also flexible and tubular air channel 3 is arranged. This leads to the front mouth 5, but is closed in this frontal area 7. At the point 9, the separate air duct 3 emerges from the sheath of the catheter tube 1 and has at its end a Luer lock connector or a funnel connector or similar connector 11 with a closure cap 13.
  • the catheter tube 1 is enveloped in a section 15 by a balloon 17, in which there is a foam body 19 which completely fills it out in the balanced state.
  • the balloon 17 and the foam body have an elliptical shape in the normal state, as shown in the figure.
  • Tube 1 of the catheter is in front of the balloon a slidable disc 23 which is placed outside on the abdominal wall.
  • the hose 1 has a Luer lock connector 25 to which hoses or containers for artificial nutrition can be connected.
  • the balloon 17 and the foam body 19 have a lenticular-filled design.
  • a disposable syringe with an adapted internal volume is preferably placed on the connecting part 11, with which the air is sucked out of the separate air duct 3 and thus out of the foam body 19 and the balloon 17.
  • the connecting part 11 is closed again in an airtight manner by the closure cap 13.
  • the closure cap 13 of the connection part 11 is opened. Due to the expansion efforts of the foam body 19, it emanates by suction of air into its original elliptical shape, the balloon 17 adapting to this shape. This foam body 19 inevitably increases and lies against the stomach wall. The elliptical shape of the foam body 19 and the balloon 17 does not take up any unnecessary space inside the organs.
  • the catheter is thus fixed in its inner position. Now the disc 23 is pushed onto the abdominal wall of the patient in order to prevent the catheter from slipping into the stomach or small intestine. Enteral nutrition can now take place via the Luer lock connector 25 at the rear end 27 of the catheter tube 1.
  • the catheter tube 1 would be connected to a further tube, not shown, which is inserted into a peristaltic pump and is connected at its other end to a container containing nutrient solution.
  • the balloon is also pre-bulged in an elliptical shape, but has no foam filling.
  • the balloon 17 lies in the deflated state of the outside of the catheter tube 1 so far that its diameter does not increase significantly.
  • the balloon 17 is inflated with a filling medium such as air or liquid of a defined volume.
  • a filling medium such as air or liquid of a defined volume.
  • the corresponding medium is introduced into the balloon 17 by means of a syringe via the valve 31 connected to the balloon 17 via the channel 3.
  • the valve 31 prevents this Escape of the filling medium from the balloon 17.
  • the lumen, in particular of the small intestine is only minimally constricted according to the invention, and at the same time a sufficiently large area of contact with the inner wall of the stomach or intestine is ensured.

Abstract

The invention relates to a gastric/duodenal/jejunal catheter for enteral percutaneous feeding. This has a catheter tube (1) with a first channel for the supply of a nutrient solution and a second tube (3) with a channel for conveying a filling medium, which opens into a balloon (17) which surrounds the catheter tube (1) at a section (15). According to the invention, the balloon (17) of the catheter is bulged in elliptic shape and, in the preferred embodiment, is provided with an elliptic-shaped foamed article (17). The balloon (17) in this case has such a cross-section that the short axis of the oval coincides with the longitudinal axis of the catheter. In this way, with minimal space, a sufficient protection is ensured against leakages and against the slipping-out of the catheter from the stomach or the small intestine of the patient.

Description

Die Erfindung betrifft einen Gastral/duodenal/jejunal-­Katheter für die percutane enterale Ernährung gemäß dem Oberbegriff des Anspruches 1. Sie betrifft insbesondere die percutane künstliche Ernährung von Patienten in den Magen, in das Duodenum oder Jejunum.The invention relates to a gastral / duodenal / jejunal catheter for percutaneous enteral nutrition according to the preamble of claim 1. It relates in particular to the percutaneous artificial nutrition of patients in the stomach, in the duodenum or jejunum.

In der EP-OS 182539 wird als eine mögliche Ausführung eine gastrale bzw. gastrojejunal Ernährungssonde beschrieben, die durch ein Stoma in der Magenwand des Patienten einsetzbar ist und beidseitig gegen die Bauchwand gesichert wird. Diese Sonde bzw. der Katheter ist verwendbar zur Ernährung in den Magen oder ins Jejunum.EP-OS 182539 describes a possible embodiment of a gastric or gastrojejunal feeding tube which can be inserted through a stoma in the stomach wall of the patient and is secured on both sides against the abdominal wall. This probe or catheter can be used for feeding into the stomach or into the jejunum.

Als eine weitere Variante wird darüber hinaus ein Jejunalkatheter beschrieben, der zum Zweck der jejunalen Ernährung direkt ins Jejunum platziert wird.A jejunal catheter is also described as a further variant, which is placed directly into the jejunum for the purpose of jejunal nutrition.

Die bekannte Ernährungssonde ist in der Ausführung zur gastralen Applikation an einem Ende mit einem aufblasbaren Ballon versehen, welcher die Sonde gegen Herausrutschen aus dem Magen sichert. An ihrem anderen Ende ist ein bewegbarer Verschlußring angeordnet, der gegen die äußere Bauchwand des Patienten geschoben wird und somit die Sonde vor dem Hereinrutschen in den Magen sichert.In the version for gastric application, the well-known feeding probe is provided with an inflatable balloon at one end, which secures the probe against slipping out of the stomach. At its other end there is a movable locking ring which is pushed against the patient's outer abdominal wall and thus secures the probe from sliding into the stomach.

Der Ballon ist in seiner Ausgangsstellung völlig in sich zusammengefallen und übersteigt den Durchmesser des Katheters unwesentlich. Nach Einführung des Katheters von außen durch das Stoma in den Magen wird eine Luftzufuhrvorrichtung an ein dafür vorgesehenes Anschlußstück angeschlossen und die Luft in einen zusätzlich im Katheter befindlichen Kanal, der eine Auslaßöffnung innerhalb des Ballons besitzt, eingeblasen. Dadurch weitet sich der Ballon auf und verschließt das Stoma von innen.In its initial position, the balloon has collapsed completely and slightly exceeds the diameter of the catheter. After the catheter has been inserted from the outside through the stoma into the stomach, an air supply device is connected to a connector provided for this purpose, and the air is passed into an additional channel in the catheter, which has an outlet opening inside the balloon. blown in. As a result, the balloon expands and closes the stoma from the inside.

Nachteilig bei dieser Lösung ist, daß die Kugelform des Ballons keine ausreichende Auflagefläche an der Mageninnenwand und damit keinen umfassenden Schutz gegen eine Leckage bietet. Im übrigen beansprucht ein kugelförmiger Ballon relativ viel Platz, weshalb ein entsprechender Ballonkatheter zwar problemlos in den großlumigen Magen, nicht aber, oder nur unter großer Raumforderung, in den engräumigen Dünndarm plaziert werden kann.A disadvantage of this solution is that the spherical shape of the balloon does not offer sufficient contact surface on the inner wall of the stomach and therefore does not offer comprehensive protection against leakage. In addition, a spherical balloon takes up a relatively large amount of space, which is why a corresponding balloon catheter can be placed in the large-lumen stomach without problems, but not, or only in large spaces, in the small intestine.

Für eine Positionierung im Jejunum ist in der EP 182539 dann auch eine andere Variante der Erfindung vorgesehen. Dabei handelt es sich um einen Jejunalkatheter, der durch einen kleinen Kunststoffring im Stoma fixiert wird. Diese Lösung vermeidet zwar eine Lumeneinengung des Dünndarms, bietet aber weniger Schutz gegen Leckagen und gegen eine unbeabsichtigte Katheterextraktion.Another positioning of the invention is then also provided in EP 182539 for positioning in the jejunum. It is a jejunal catheter that is fixed in the stoma by a small plastic ring. While this solution avoids lumen narrowing of the small intestine, it offers less protection against leaks and against accidental catheter extraction.

Aufgabe der Erfindung ist es daher, einen Gastral/Duodenal/Jejunal-Katheter für die percutane enterale Ernährung zu schaffen, der bei minimaler Raumforderung einen ausreichenden Schutz gegen Leckagen bietet.The object of the invention is therefore to create a gastral / duodenal / jejunal catheter for percutaneous enteral nutrition, which offers adequate protection against leakage with minimal space requirements.

Erfindungsgemäß wird die Aufgabe nach den Merkmalen des Anspruchs 1 dadurch gelöst, daß der Ballon des Katheters ellipsenförmig vorgebaucht ist. Ellipsenförmig im Sinne der Erfindung bedeutet eine ovale Ausbildung im Querschnitt, wobei die kurze Achse des Ovals mit der Katheterlängsachse zusammenfällt.According to the invention, the object is achieved according to the features of claim 1 in that the balloon of the catheter is bulged in an elliptical shape. Elliptical in the sense of the invention means an oval cross-section, the short axis of the oval coinciding with the longitudinal axis of the catheter.

Die bevorzugte Ausführung der vorliegenden Erfindung sieht zusätzlich eine Füllung des ellipsenförmigen Ballons mit einem elastisch komprimierbaren, ebenfalls ellipsenförmigen Schaumstoffkörper vor.The preferred embodiment of the present invention also provides for a filling of the elliptical balloon with an elastically compressible, also elliptical foam body.

Durch das Ansetzen einer Evakuierungsvorrichtung, vorzugsweise einer Spritze in das Anschlußteil eines mit dem Ballon verbundenen Kanals, wird das im Ballon bzw. den Schaumstoffkörper vorhandene Füllmedium abgezogen. Durch den entstehenden Unterdruck kollabieren die Ballonhülle und der flexible Schaumstoffkörper und legen sich an der Außenseite des Katheterschlauches an. Dessen Durchmesser wird dabei nicht wesentlich vergrößert.By placing an evacuation device, preferably a syringe, in the connection part of a channel connected to the balloon, the filling medium present in the balloon or the foam body is drawn off. The resulting negative pressure causes the balloon envelope and the flexible foam body to collapse and lie on the outside of the catheter tube. Its diameter is not significantly increased.

Nachdem der Katheter percutan in den Magen oder Dünndarm eingebracht worden ist, wird der separate Förderkanal geöffnet. Durch das Expansionsbestreben des komprimierten Schaumstoffkörpers wird durch den Förderkanal Luft angesaugt, wodurch der Schaumstoffkörper und folglich auch die Ballonhülle in ihre Normalform zurückexpandieren. Durch die Ellipsenform des Schaumstoffkörpers und des Ballons wird insbesondere innerhalb des Dünndarms Platz eingespart und ein ausreichend großflächiges Anliegen und somit Abdichten an der Magenwand bzw. Darmwand gesichert.After the catheter has been inserted percutaneously into the stomach or small intestine, the separate delivery channel is opened. Due to the expansion efforts of the compressed foam body, air is sucked in through the conveying channel, as a result of which the foam body and consequently also the balloon envelope expand back into their normal shape. The elliptical shape of the foam body and the balloon saves space, in particular within the small intestine, and ensures that there is sufficient contact and thus sealing on the stomach wall or intestinal wall.

Insbesondere bei dieser Variante der Erfindung werden Probleme vermieden, wie sie bei der in der EP-OS 182539 beschriebene Gastral- bzw. Gastrojejunalsonde auftreten können. Diese bereits zitierte Lösung stellt sich insofern als problematisch dar, als daß die Ballonhülle sowohl beim Einführen als auch beim Aufblasen oder Ernähren reißen kann und dann im kollabrierten Zustand dem Katheter nicht mehr gegen ein Herausrutschen aus dem Stoma sichert.In particular, this variant of the invention avoids problems which can occur with the gastral or gastrojejunal probe described in EP-OS 182539. This already cited solution is problematic in that the balloon envelope can tear both during insertion and when inflating or feeding and then no longer secures the catheter against slipping out of the stoma in the collapsed state.

Hingegen stellt der Schaumstoffkörper des Ballons gemäß vorliegender Erfindung auch in diesem Fall weiterhin einen Dislokationsschutz für den Katheter dar, da ein Kollabieren des Ballons vermieden wird.On the other hand, the foam body of the balloon according to the present invention also in this case continues to provide protection against dislocation for the catheter, since collapse of the balloon is avoided.

Anhand von Ausführungsbeispielen soll die Erfindung näher erläutert werden. Dabei zeigt in den Zeichnungen:

  • Fig. 1 den erfindungsgemäßen Katheter in einer bevorzugten Ausführungsform mit dem Ballon in Schnittdarstellung und
  • Fig. 2 den erfindungsgemäßen Katheter ohne Schaumstoffkörper.
The invention will be explained in more detail with the aid of exemplary embodiments. The drawings show:
  • Fig. 1 shows the catheter according to the invention in a preferred embodiment with the balloon in a sectional view and
  • Fig. 2 shows the catheter according to the invention without a foam body.

Der Katheter besteht aus einem flexiblen Katheterschlauch 1, in oder an dessen Wand ein separater, ebenfalls flexibler und schlauchförmiger Luftkanal 3 angeordnet ist. Dieser führt bis zur vorderen Mündung 5, ist jedoch in diesem Frontalbereich 7 verschlossen. An der Stelle 9 tritt der separate Luftkanal 3 aus der Hülle des Katheterschlauches 1 und weist an seinem Ende einen Luerlock-Anschlußteil oder einen Trichteranschluß oder ähnlichen Anschluß 11 mit Verschlußkappe 13 auf.The catheter consists of a flexible catheter tube 1, in or on the wall of which a separate, also flexible and tubular air channel 3 is arranged. This leads to the front mouth 5, but is closed in this frontal area 7. At the point 9, the separate air duct 3 emerges from the sheath of the catheter tube 1 and has at its end a Luer lock connector or a funnel connector or similar connector 11 with a closure cap 13.

Oberhalb seines distalen Endes wird der Katheterschlauch 1 an einen Abschnitt 15 umhüllt von einem Ballon 17, in dem sich ein Schaumstoffkörper 19 befindet, der diesen im ausgeglichenen Zustand völlig ausfüllt. Der Ballon 17 und der Schaumstoffkörper besitzen im Normalzustand eine Ellipsenform, wie dies in der Figur gezeigt ist. Im Bereich des Schaumstoffkörpers 19 befindet sich eine Mündung 21 des separaten Luftkanals 3 vor seinem Verschlußbereich 7. Auf dem Schlauch 1 des Katheters befindet sich vor dem Ballon eine verschiebbare Scheibe 23, die außen auf der Bauchdecke angelegt wird.Above its distal end, the catheter tube 1 is enveloped in a section 15 by a balloon 17, in which there is a foam body 19 which completely fills it out in the balanced state. The balloon 17 and the foam body have an elliptical shape in the normal state, as shown in the figure. In the area of the foam body 19 there is an opening 21 of the separate air duct 3 in front of its closure area 7 Tube 1 of the catheter is in front of the balloon a slidable disc 23 which is placed outside on the abdominal wall.

An seinem hinteren Ende 27 besitzt der Schlauch 1 ein Luerlock-Anschlußteil 25, an das Schläuche bzw. Behälter zur künstlichen Ernährung angeschlossen werden können.At its rear end 27, the hose 1 has a Luer lock connector 25 to which hoses or containers for artificial nutrition can be connected.

Im Normalzustand besitzt der Ballon 17 und der Schaum­stoffkörper 19 eine linsenförmig gefüllte Ausbildung. Nach Öffnen der Verschlußkappe 13 wird am Anschlußteil 11 vorzugsweise eine Einwegspritze mit einem angepaßten Innenvolumen angelegt, mit der die Luft aus dem separatem Luftkanal 3 und somit aus dem Schaumstoffkörper 19 und dem Ballon 17 abgesaugt wird. Nachdem die Einwegspritze entfernt und der Luftkanal 3 mittels einer Klemme 29 entsprechend abgeklemmt wurde, wird der Anschlußteil 11 durch die Verschlußkappe 13 wieder luftdicht verschlossen. Durch das Anlegen dieses Unterdruckes sind der Ballon 17 und der Schaumstoffkörper 19 völlig kollabiert und übersteigen den Durchmesser des Katheterschlauchs minimal am entsprechenden Abschnitt 15. Nun wird der Katheter auf die übliche bekannte Weise durch die Bauchdecke in den Magen bzw. den Dünndarm des Patienten eingeführt.In the normal state, the balloon 17 and the foam body 19 have a lenticular-filled design. After opening the cap 13, a disposable syringe with an adapted internal volume is preferably placed on the connecting part 11, with which the air is sucked out of the separate air duct 3 and thus out of the foam body 19 and the balloon 17. After the disposable syringe has been removed and the air duct 3 has been correspondingly clamped off by means of a clamp 29, the connecting part 11 is closed again in an airtight manner by the closure cap 13. By applying this negative pressure, the balloon 17 and the foam body 19 are completely collapsed and minimally exceed the diameter of the catheter tube at the corresponding section 15. Now the catheter is inserted through the abdominal wall into the patient's stomach or small intestine in the usual known manner.

Befindet sich der Katheter in der gewünschten Position, wird die Verschlußkappe 13 des Anschlußteiles 11 geöffnet. Durch das Expansionsbestreben des Schaumstoffkörpers 19 begibt sich dieser durch Ansaugen von Luft in seine ursprüngliche Ellipsenform, wobei sich der Ballon 17 dieser Form anpaßt. Zwangsläufig vergrößert sich dieser Schaumstoffkörper 19 und legt sich an die Magenwand an. Durch die Ellipsenform des Schaumstoffkörpers 19 und des Ballons 17 wird kein unnötiger Platz im Innern der Organe beansprucht. Damit ist der Katheter in seiner körperinneren Lage fixiert. Nun wird die Scheibe 23 an die Bauchdecke des Patienten geschoben, um ein Hineinrutschen des Katheters in den Magen bzw. Dünndarm zu verhindern. Über das Luerlock-Anschlußteil 25 am hinteren Ende 27 des Katheterschlauches 1 kann nun die enterale Ernährung erfolgen. Hierzu würde der Katheterschlauch 1 mit einem weiteren nicht gezeigten Schlauch verbunden, der in eine peristaltische Pumpe eingelegt ist und an seinem anderen Ende mit einem Nährlösung enthaltenden Behälter verbunden ist.If the catheter is in the desired position, the closure cap 13 of the connection part 11 is opened. Due to the expansion efforts of the foam body 19, it emanates by suction of air into its original elliptical shape, the balloon 17 adapting to this shape. This foam body 19 inevitably increases and lies against the stomach wall. The elliptical shape of the foam body 19 and the balloon 17 does not take up any unnecessary space inside the organs. The catheter is thus fixed in its inner position. Now the disc 23 is pushed onto the abdominal wall of the patient in order to prevent the catheter from slipping into the stomach or small intestine. Enteral nutrition can now take place via the Luer lock connector 25 at the rear end 27 of the catheter tube 1. For this purpose, the catheter tube 1 would be connected to a further tube, not shown, which is inserted into a peristaltic pump and is connected at its other end to a container containing nutrient solution.

In einer anderen Ausführungsform der vorliegenden Erfindung gemäß Figur 2 ist der Ballon ebenfalls ellipsenförmig vorgebaucht, weist jedoch keine Schaumstofffüllung auf. Der Ballon 17 legt sich in deflatiertem Zustand der Außenseite des Katheterschlauches 1 soweit an, daß sich dessen Durchmesser nicht wesentlich vergrößert.In another embodiment of the present invention according to FIG. 2, the balloon is also pre-bulged in an elliptical shape, but has no foam filling. The balloon 17 lies in the deflated state of the outside of the catheter tube 1 so far that its diameter does not increase significantly.

Nachdem der Katheter auf bekannte Weise durch die Bauchdecke in den Magen oder Dünndarm eingebracht worden ist, wird der Ballon 17 mit einem Füllmedium, wie Luft oder Flüssigkeit definierten Volumens inflatiert. Dazu wird das entsprechende Medium mittels einer Spritze über das mit dem Ballon 17 über den Kanal 3 verbundene Ventil 31 in den Ballon 17 eingebracht. Hierbei verhindert das Ventil 31 das Entweichen des Füllmediums aus dem Ballon 17.After the catheter has been introduced into the stomach or small intestine through the abdominal wall in a known manner, the balloon 17 is inflated with a filling medium such as air or liquid of a defined volume. For this purpose, the corresponding medium is introduced into the balloon 17 by means of a syringe via the valve 31 connected to the balloon 17 via the channel 3. The valve 31 prevents this Escape of the filling medium from the balloon 17.

Durch die Ellipsenform des Ballons 17 wird erfindungsgemäß das Lumen insbesondere des Dünndarms nur minimal eingeengt und zugleich ein ausreichend großflächiges Anliegen an der Mageninnenwand bzw. Darmwand gesichert.Due to the elliptical shape of the balloon 17, the lumen, in particular of the small intestine, is only minimally constricted according to the invention, and at the same time a sufficiently large area of contact with the inner wall of the stomach or intestine is ensured.

Claims (3)

1. Gastral/duodenal/jejunal-Katheter für die percutane enterale Ernährung aufweisend einen Katheterschlauch (1) mit einem ersten Kanal zur Zuführung einer Nährlösung und einem zweiten Schlauch (3) mit einem Kanal zur Förderung eines Füllmediums, der in einen Ballon (17) mündet, welcher den Katheterschlauch (1) an einen Abschnitt (15) umhüllt, dadurch gekennzeichnet, daß der Ballon (17) des Katheters ellipsenförmig vorgebaucht ist.1. Gastral / duodenal / jejunal catheter for percutaneous enteral nutrition comprising a catheter tube (1) with a first channel for supplying a nutrient solution and a second tube (3) with a channel for conveying a filling medium which is inserted into a balloon (17) opens, which envelops the catheter tube (1) at a section (15), characterized in that the balloon (17) of the catheter is bulged in an elliptical shape. 2. Katheter nach Anspruch 1, dadurch gekennzeichnet, daß der Ballon (17) einen solchen ovalen Querschnitt aufweist, daß die kurze Achse des Ovals mit der Katheterlängsachse zusammenfällt.2. Catheter according to claim 1, characterized in that the balloon (17) has an oval cross section such that the short axis of the oval coincides with the longitudinal axis of the catheter. 3. Katheter nach Anspruch 1, dadurch gekennzeichnet, daß der Ballon (17) mit einem elastisch komprimierbaren, ebenfalls ellipsenförmigen Schaumstoffkörper (19) gefüllt ist.3. Catheter according to claim 1, characterized in that the balloon (17) is filled with an elastically compressible, also elliptical foam body (19).
EP88106177A 1987-04-23 1988-04-19 Gastric duodenal jejunal catheter for enteral percutaneous feeding Withdrawn EP0287998A3 (en)

Applications Claiming Priority (2)

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DE8705894U DE8705894U1 (en) 1987-04-23 1987-04-23
DE8705894U 1987-04-23

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EP0287998A3 EP0287998A3 (en) 1989-10-11

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US (1) US5009639A (en)
EP (1) EP0287998A3 (en)
JP (1) JPS6446474A (en)
DE (1) DE8705894U1 (en)
DK (1) DK220288A (en)
FI (1) FI881864A (en)
NO (1) NO881665L (en)
PT (1) PT87299A (en)

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DE8808484U1 (en) * 1988-07-01 1988-08-18 Roewer, Norbert, Dr., 2000 Hamburg, De
US5295994A (en) * 1991-11-15 1994-03-22 Bonutti Peter M Active cannulas
US8845687B2 (en) 1996-08-19 2014-09-30 Bonutti Skeletal Innovations Llc Anchor for securing a suture
US8808329B2 (en) 1998-02-06 2014-08-19 Bonutti Skeletal Innovations Llc Apparatus and method for securing a portion of a body
US8845699B2 (en) 1999-08-09 2014-09-30 Bonutti Skeletal Innovations Llc Method of securing tissue
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Also Published As

Publication number Publication date
DK220288D0 (en) 1988-04-22
PT87299A (en) 1989-05-12
FI881864A (en) 1988-10-24
FI881864A0 (en) 1988-04-21
EP0287998A3 (en) 1989-10-11
NO881665D0 (en) 1988-04-18
US5009639A (en) 1991-04-23
DK220288A (en) 1988-10-24
DE8705894U1 (en) 1987-06-19
JPS6446474A (en) 1989-02-20
NO881665L (en) 1988-10-24

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