- A novel J-tube novel that provides a solution for situations requiring the bypassing of the stomach, allowing direct feeding into the intestinal tract for patients in need.
- Overcomes the issue of leakage commonly encountered by a significant number of patients who require the use of feeding tubes.
- Potential to reduce infections and recurrent hospitalization, besides increasing the effectiveness of the feeding regimen of patients.
OVERVIEW
Researchers at Georgetown University Hospital have invented a new J-tube which overcomes the leakage experienced by a large percentage of patients 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 the 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.
BACKGROUND
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 has its 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.
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