Diverting Jejunostomy Tube

Categories: “Medical & Research Devices“

Reference #: 2018-025

OTC Contact: Zeinab Abouissa M.S. (Directory Information | Send a Message)

Summary

Enteral feeding tubes permit nutrients, fluids, and other materials including medicines to be delivered directly into the gastrointestinal tract (i.e. stomach or small bowel) in patients who are too ill to feed themselves or swallow. Depending on their site of insertion, such enteral tubes can be nasogastric tubes (NG-tubes), gastrostomy tubes (G-tubes), or jejunostomy tubes (J-tubes), and each have their advantages and disadvantages.

J-tubes are used when there is a need to bypass the stomach and to feed a patient directly into the intestinal tract, and is installed surgically or endoscopically through a feeding tract or stoma created in the anterior abdominal wall. A common problem with J-tubes is that leakage of gastrointestinal fluid around the J-tube at the stoma is common and such leakage is a frequent cause of morbidity and recurrent hospital admissions. It has been reported that 60% of patients report having leakage around the tube site, and 45% report having stomal infections. Current treatment options include enlarging the tube to seal the leak, replacing the tube with longer tubes allowing feedings to enter the gastrointestinal tract further downstream, removing the tube and permitting the tract to close down around a wire and then starting again at the same site with a smaller tube, and placing a new J-tube. Each option has risks and is rarely effective. Therefore, a need exists for a way to reduce leakage around the exiting J-tube and related morbidity and recurrent hospitalizations.

Researchers at Georgetown University Hospital have invented a new J-tube which solves these problems by providing an alternative pathway for fluid seeking to flow past the J-tube. Their observation was that most all the J-tube leakage was bilious and that the majority of the fluid leakage came from the afferent direction. By putting another tube arm into the J-tube, the afferent fluid is diverted away from the leakage site. The alternative pathway permits fluid from upstream to flow from an afferent limb to an efferent limb of the device, thus reducing leakage around the tube. The afferent limb opens into an upstream location within the gastrointestinal tract, and the downstream limb opens into a downstream location within the gastrointestinal tract. The two limbs are connected to each other, thus providing a bypass tract. The two limbs can be transiently isolated for purposes of delivering material, via the efferent limb, to the downstream location within the gastrointestinal tract. This new
configuration can become the standard for J-tube construction,

Applications

Reduces leakage around the exiting J-tube and related morbidity and recurrent hospitalizations

Advantages

• The technology presents a new standard for J-tube construction, providing a safe way to reduce the reported 60 percent of patients reported as experiencing leakage around the tube site, and 45 percent reported as having stomal infections. 
• Reduced hospital and ER admissions

Stage of Development

Data collection and device development continue.

Relevant Publications

No references or resources available.

Patent Status

PCT Application filed, Serial No. PCT/US19/024784

Inventor

Emil Cohen, M.D., Vascular & Interventional Radiology