US20120078039A1 - Dilation Device for Placing Catheter Tubes - Google Patents
Dilation Device for Placing Catheter Tubes Download PDFInfo
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- US20120078039A1 US20120078039A1 US13/245,577 US201113245577A US2012078039A1 US 20120078039 A1 US20120078039 A1 US 20120078039A1 US 201113245577 A US201113245577 A US 201113245577A US 2012078039 A1 US2012078039 A1 US 2012078039A1
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- dilation
- balloon
- stoma
- inflation
- tubular support
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- 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
-
- 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
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
-
- 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
-
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M13/00—Insufflators for therapeutic or disinfectant purposes, i.e. devices for blowing a gas, powder or vapour into the body
- A61M13/003—Blowing gases other than for carrying powders, e.g. for inflating, dilating or rinsing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/08—Tubes; Storage means specially adapted therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
- A61M2025/1013—Multiple balloon catheters with concentrically mounted balloons, e.g. being independently inflatable
Definitions
- This disclosure relates to catheters such as feeding tubes and their placement in the body of a patient.
- a stoma is formed in the stomach or intestinal wall and a catheter is placed through the stoma. This surgical opening and/or the procedure to create the opening is commonly referred to as “gastrostomy”. Feeding solutions can be injected through the catheter to provide nutrients directly to the stomach or intestines (known as enteral feeding).
- enteral feeding A variety of different catheters intended for enteral feeding have been developed over the years, including some having a “low profile” relative to the portion of the catheter which sits on a patient's skin, as well as those having the more traditional or non-low profile configuration.
- percutaneous transconduit catheters (sometimes referred to as “percutaneous transconduit tubes”) are frequently referred to as “gastrostomy catheters”, “percutaneous gastrostomy catheters”, “PEG catheters” or “enteral feeding catheters”.
- gastrostomy catheters “percutaneous gastrostomy catheters”
- PEG catheters percutaneous gastrostomy catheters”
- enteral feeding catheters enteral feeding catheters.
- PEG percutaneous endoscopic gastrostomy
- a PEG tube is placed using endoscopic guidance or x-ray guidance.
- an endoscope is used to observe that the patient's esophagus is unobstructed and to inspect and inflate the stomach to see that the area selected for the gastrostomy can be distended.
- this spot is selected.
- the anterior wall of the gastric lumen e.g., the stomach
- Insufflation of the gastric lumen has also been found to be successful in maintaining the lumen in close proximity of the abdominal wall in some procedures. This procedure is also applicable to jejunostomy or gastro-jejunostomy as well as the gastrostomy procedure referred to above. Similar procedures may also be applicable or desirable for other catheter tubes such as peritoneal drainage tubes.
- a needle is inserted into the patient in the area in the appropriate location. Additionally, a small incision may be made in the skin.
- An endoscopist will then typically watch through the endoscope as a needle pushes through the patient's skin, then through the abdominal wall, and enters the gastric lumen in the selected area to form a needle tract.
- a guide wire is passed through the needle into the gastric lumen (e.g., the stomach).
- the endoscopist will use an endoscopic snare to grasp the guide wire firmly.
- the snare passed through the working channel of the endoscope, firmly grabs the guide wire.
- Both the endoscope and snare are then withdrawn together through the patient's mouth, pulling the guide wire with them.
- the end of the guide wire that extends out from the patient's mouth is subsequently attached to a PEG tube and the other end of the guide wire remains outside the patient's skin in the abdominal region.
- the PEG tube is guided into the patient's mouth (while the endoscope is completely removed from the patient) and pulled into the patient's gastric lumen as the guide wire is pulled from the end that remains outside the patient's skin.
- the PEG tube is pulled partially through the gastric and abdominal walls until a bumper of the PEG tube is snug against the gastric mucosa.
- the original needle tract must be dilated. This dilation is carried out with conventional dilation devices that employ a tapered dilator at the distal end of the PEG tube so that it dilates the opening as it is pulled through the gastric mucosa.
- the endoscope is again passed into the patient and subsequently used to visually observe that the bumper of the PEG tube is snug against the gastric mucosa.
- x-ray techniques are used to help select a particularly suitable location in the patient's body (e.g., the stomach) for the introduction of the PEG tube.
- X-ray is used for guiding the PEG tube placement and for inspecting the PEG tube's final position.
- a needle is used to pierce a patient's abdominal wall to place one or more fasteners in a patient's gastric lumen.
- a fastener such as a “T-bar” fastener, carried at or near the tip of the needle is desirably deployed by the needle so that it can be positioned against an inner wall of the gastric lumen.
- a tensioning suture is connected to the fastener and, at an opposite end of the suture on the outer surface of the patient's body, the suture is desirably also connected to a suture holder, which permits adjustment of the tension on the suture.
- a patient's gastric lumen wall is more closely positioned to the outer surface of the patient's body, and the gastric lumen is stabilized in a position.
- at least three and desirably four fasteners are placed in a triangular, square, or diamond-shaped configuration through a patient's skin and into the gastric lumen.
- the dilation device is an inflatable device that is used for placing catheter tubes in a non-vascular lumen, desirably under direct visualization using an endoscope.
- a conventional endoscope is advanced into the stomach to insufflate and allow palpation to locate an appropriate site.
- a needle is inserted into the stomach through the abdomen from outside the body to form a needle tract.
- a guide wire is then introduced into the stomach through the needle, and a system is provided for: positioning a dilation device in the needle tract; maintaining the dilation device in the desired position; dilation of the needle tract, and removal of the dilation device.
- the dilation device includes an inflatable balloon including a dilation region forming a first portion of the device and a retention region forming a second portion of the device, an inflation lumen to inflate and deflate the inflatable balloon, a tubular support, and a continuous pathway through the device that accommodates a guide wire.
- the inflatable balloon may be compliant, semi-compliant, or non-compliant.
- the inflatable balloon (also referred to as a “dilation balloon”) is located towards the distal end of the device.
- the dilation balloon includes a distal section and an opposing proximal section.
- the dilation balloon has a length with a pre-determined diameter upon full inflation to fit a specific sized catheter tube device. Alternatively, the dilation balloon may be dilated to various effective diameters using respectively different inflation pressures to fit various catheter tubes.
- the proximal section of the dilation balloon (that portion of the dilation balloon that is positioned in the non-vascular lumen) may be designed to have substantially the same diameter features of the distal section or it may have a section with a larger diameter than any diameters of the distal section.
- the balloon section with the largest diameter is referred to as the “retention section” or the proximal retention balloon component”. Once this section is inflated, it functions to provide retention of the dilation device within the non-vascular lumen (e.g., the stomach).
- the proximal retention balloon component may be compliant, semi-compliant, or non-compliant.
- the inflatable balloon i.e., the dilation balloon
- the tubular support of the dilation device supports the dilation balloon.
- the dilation device also has at least one inflation lumen to inflate and deflate the dilation balloon component. It is contemplated that any of the inflation lumens included in the dilation device can serve as the tubular support for the dilation balloon. In other words, the tubular support may define the relevant inflation lumens.
- the dilation device may have a continuous single pathway through its entirety to accommodate a guide wire.
- This pathway may include the inflation lumen for the dilation balloon and the tubular support; or it may be a separate lumen that is contained within the walls of an inflation lumen, the tubular support; or combinations thereof.
- the dilation device may be utilized in “inside-out” or “outside-in” dilation procedures.
- Inside-out dilation procedures involve attachment of the dilation device to the guide wire outside of the patient's mouth or inside the non-vascular lumen (e.g., the stomach or other space).
- a non-limiting example of attachment outside the patient's mouth may involve the following steps: insertion of an endoscope that extends from outside the mouth to inside the stomach; conventional placement of a guide wire through the skin, abdominal wall and stomach wall utilizing a needle; insertion of a standard endoscopic forceps or an endoscopic snare through the working channel of the endoscope; using the forceps or snare to grasp the guide wire portion that is in the stomach and then pulling the guide wire through the working channel of the endoscope and out of the patient's mouth (unlike current practice where the entire endoscope is removed from the patient); securely attaching the end of the dilation device that is closest to the dilation balloon (not the retention balloon portion of the dilation device) to the end of the guide wire that extends from the patient's mouth; pulling the guide wire and attached dilation device back through the working channel of the endoscope so that the dilation balloon exits the working channel into the stomach via the guide wire portion that remains outside the skin.
- the dilation device contains a fixture (magnet, hook, loop, snare, etc.) at the end that is closest to the dilation balloon (the side that enters the mouth first); the dilation device is pushed through the working channel of the endoscope so that the fixture exits the working channel; the fixture is attached under visualization of the endoscope by connecting the fixture to the guide wire (that was inserted through the needle); pulling the guide wire portion that remains outside the skin so that the dilation device pulls through the working channel and into the stomach.
- a fixture magnet, hook, loop, snare, etc.
- the dilation device after placement in the stomach it is pulled into and partially through the needle tract so that at least a portion of the deflated dilation balloon extends through the abdominal tissue and the skin and the retention balloon resides in the stomach.
- Outside-in dilation procedures differ from inside-out procedures in that they do not pass the dilation device through the working channel of the endoscope in order to position the dilation device in the stomach, nor is there any need to attach the dilation device to a guide wire that extends from the patient's stomach through the mouth.
- Outside-in procedures may involve the following steps: insertion of an endoscope that extends through the mouth to inside of the stomach; conventional initial placement of a guide wire through the skin, abdominal wall, and stomach wall through an inserted needle and then removal of the needle with the guide wire in place; mounting the dilation device over the end of the guide wire that is outside of the patient's skin; partial insertion of the dilation device into the needle tract so that the retention balloon enters the stomach before any portion of the dilation balloon.
- the dilation balloon In positioning the dilation device, the dilation balloon must be in a deflated state so that the dilation device easily slides through the working channel of the endoscope and/or it penetrates the needle tract without excessive force.
- the dilation device in this deflated state desirably wraps and folds around the tubular support as much as possible to minimize the effective cross-sectional area of the dilation device during insertion through the endoscope and/or needle tract.
- Such folding and wrapping is achieved by intentionally folding the balloon walls in pre-planned arrangements, via the use of a pleater and/or folder manufacturing apparatus, or by random overlapping and folding afforded by the flexible nature and thinness of the balloon walls.
- the dilation device contains only one balloon.
- the dilation balloon of the dilation device is inflated by gradually introducing controlled amounts of fluid (e.g., liquid or gas) to increase pressure in this balloon.
- the dilation balloon may have a length of a single diameter or it may have varying diameters.
- the portion of the balloon that has a length of a single diameter is placed in the needle tract and inflates radially to provide atraumatic dilation (as compared to serial dilation) of the entire needle tract to create the stoma tract.
- the proximal retention balloon component portion of the device inflates inside the stomach and not in the needle tract. It is used to stabilize the device and to help prevent the device from pulling out of the stoma tract during the procedure.
- FIG. 1 is a side cross-sectional view illustrating an exemplary dilation device that has a tubular support upon which is mounted the inflatable dilation balloon.
- FIG. 2 is a side cross-sectional view illustrating the position of an exemplary dilation device pulled through the gastric lumen wall and abdominal wall prior to inflation of the device.
- FIGS. 3A and 3B are side cross-sectional views of an exemplary dilation device showing an inflated dilation balloon and inflated retention stabilizing the lumen wall against the abdominal wall.
- the inflatable dilation balloon is in position with the retention portion within the lumen but the lumen is not snugly against the inside of the abdominal wall.
- the gastric lumen has been pulled snugly against the inside of the abdominal wall.
- stomach is a common example of a non-vascular lumen
- gastric lumen or “stomach” is representative of all other non-vascular lumens or spaces (e.g., duodenum, jejunum, ileum, peritoneal cavity, etc.), unless otherwise specified.
- FIG. 1 in side, cross-sectional view, an exemplary stoma dilation device 100 that includes a tubular support 102 defining at least one continuous pathway 104 through the device.
- the continuous pathway is configured to accommodate a guide wire.
- the tubular support 102 has a length, width and a longitudinal axis “LA”.
- the tubular support 102 should be flexible but not too flexible as to readily collapse or kink when pressure is applied radially or axially.
- the width of the tubular support should be sufficiently small that it may fit in the working channel of an endoscope.
- the tubular support may have a width of from about 0.2 to about 2 millimeters. More desirably, the tubular support may have a width of from about 0.5 to about 1.75 millimeters.
- the tubular support may be made of a variety of suitable materials. Exemplary materials include thermoplastic polyurethanes such as TECOFLEX® medical-grade aliphatic polyether polyurethanes available from Lubrizol Advanced Materials, Inc., ThermedicsTM Polymer Products, Wilmington, Mass.
- the device 100 includes an inflatable dilation balloon 106 located on the tubular support 102 having at least one inflatable dilation section 108 at a distal portion 110 of the device and at least one inflatable retention balloon component 112 located on a proximal portion of the device 114 (i.e., the proximal retention balloon component 112 ).
- the dilation balloon 106 has at least one dilation balloon inflation lumen 116 to inflate and deflate the dilation balloon.
- the inflation lumen 116 is integrated in the tubular support 102 .
- the tubular support 102 may define multiple lumens.
- the tubular support may define a continuous pathway 104 , at least one dilation balloon inflation lumen 116 to inflate and deflate the dilation balloon 106 . It is contemplated that the inflation lumens may be separated from the tubular support and be in the form of pilot tubes or the like.
- the proximal retention balloon component 112 is configured to have an effective cross-section upon full, unrestrained inflation that is greater than the largest cross-sectional diameter of the dilation section 108 upon inflation as is generally illustrated in FIG. 1 .
- the dilation section 108 of the balloon has a length and a circular cross-section with a pre-determined diameter upon full inflation to fit a specific sized catheter tube device.
- the dilation section 108 may be dilated to various effective diameters using respectively different inflation pressures to fit various catheter tubes.
- the effective inflated diameter of the dilation section 108 may range from about 3 to about 10 millimeters.
- the effective inflated diameter of the dilation section 108 may range from about 2 to about 8 millimeters.
- the proximal portion 114 of the dilation balloon 106 incorporates the retention section 112 (also referred to as the “proximal retention balloon component”) having a substantially larger cross section or diameter than any diameters of the dilation section 108 .
- the proximal retention balloon component may have a cross section or diameter that is about 1.5 times to about 3 times the diameter of the dilation section 108 .
- the proximal retention balloon component 112 may have a circular or non-circular cross section as long as it is able to function as described above.
- the retention balloon may have or lack a cross section with one axis of symmetry.
- the proximal retention balloon component 112 may, for example, have a square, rectangular, triangular, elliptical, oval or other geometric.
- the proximal retention balloon component 112 may incorporate lobes, fingers or projections that contribute to its cross-section so it is greater than the diameter of the dilation section 108 .
- the dilation balloon 106 desirably includes two opposing open ends. The open ends may be attached to the tubular support.
- the dilation balloon 106 may have open ends 118 and 120 .
- the dilation balloon may be formed of materials such that the balloons are compliant, semi-compliant, or non-compliant. That is, the balloon may be relatively elastic (e.g., compliant) so that it stretches as well as expands upon inflation. The balloon may also be somewhat elastic (e.g., semi-compliant) so that it expands but has limited stretch upon inflation. The balloon may be inelastic (e.g., non-compliant) so that it expands without significant stretch upon inflation. Desirably, the balloons may be formed of polyurethane material identified as Pellethane® 2363-90A, available from Lubrizol Advanced Materials, Inc., ThermedicsTM Polymer Products.
- Pellethane® 2363-90A available from Lubrizol Advanced Materials, Inc., ThermedicsTM Polymer Products.
- This disclosure also covers a system for dilating a stoma and inserting a non-vascular catheter tube
- the system includes a stoma dilation device as described above.
- the system also includes a non-vascular catheter tube configured to fit over the fully or partially inflated dilation balloon (i.e., the dilation section 108 ) through the dilated stoma tract and into the portion of the non-vascular lumen stabilized by the retention section (i.e., the proximal retention balloon component).
- the stoma dilation device is configured to be deflated and at least a portion of the device withdrawn through the non-vascular catheter tube.
- an endoscope may be advanced into a non-vascular lumen (e.g., the stomach) to insufflate and allow palpation to locate a catheter tube location site (e.g., a PEG location site).
- a catheter tube location site e.g., a PEG location site.
- Standard endoscopic forceps, an endoscopic snare, or a balloon attachment fixture may be inserted through the working channel of the endoscope.
- the forceps, snare or fixture is used to grasp the guide wire and the guide wire is pulled up through the working channel of the endoscope and out of the patient's mouth.
- a dilation device with its attached inflation lumen is secured to the end of the guide wire and is pulled through the working channel of the endoscope using the guide wire and into the stomach.
- the dilation device may have a dilation balloon having a distally located dilation section having pre-determined volume and diameter upon full inflation and a proximal retention balloon component having a diameter upon full inflation that is greater than the diameter of the dilation section.
- the dilation device has a diameter that fits within the working channel of the endoscope. Typically, the diameter is in the range of about 2 millimeters or less.
- the needle is removed from the stomach, while retaining the guide wire in the needle tract.
- the dilation device is pulled up into and partially through the needle tract so that it reaches the abdominal tissue and the skin on the exterior of the patient as illustrated in FIG. 2 .
- the dilation balloon 106 of the dilation device 100 is then inflated by gradually introducing controlled amounts of fluid (e.g., liquid or gas) to increase pressure in the balloon so the dilation section 108 smoothly and gradually expands the needle tract into a stoma tract.
- the proximal retention balloon component 112 of the dilation balloon 106 is also inflated as the dilation section 108 is inflated.
- the proximal retention balloon component 112 becomes larger than the dilation section 108 and expands to full inflation, it stabilizes the stomach wall “SW” by bringing it up against the wall of the abdomen “AW” as illustrated in FIG. 3B .
- the fully inflated diameters of the dilation balloon may be selected from a range to match the diameter of the catheter tube device (e.g., the PEG device) that will be inserted.
- the dilation balloon 106 can have variable diameters such that the dilation section 108 may have at least one diameter(s) and the retention section 112 (the proximal retention balloon component) may have at least one diameter that is greater than the dilation section 108 .
- a peel-away sheath is placed over the distal-most portion of the dilation device (i.e., from the outside of the patient).
- the dilation balloon of the dilation device is deflated by only a small amount (e.g. partially deflated) to allow the peel-away sheath to pass over the distal end of the dilation device and through the stoma tract into the stomach.
- a catheter tube (e.g., a PEG device) is then threaded over the guide wire and the distal end of PEG device is inserted through the peel away sheath.
- the distal end of the PEG device is now in a position to hold the gastric lumen against the abdominal wall so the dilation balloon may be fully deflated and withdrawn through the peel-away sheath.
- the syringe inflation connector must be cut off of the inflation lumen in order to withdraw the dilation device through the abdominal wall.
- the peel-away sheath is then separated and removed from the stoma tract. Any other placement tools are removed, and the retainer on the distal, in-dwelling end of the PEG device holds the PEG device in place.
- the PEG device may be inserted over the deflated dilation without the use of the peel away sheath. This places the PED device in a position to hold the gastric lumen against the abdominal wall so the dilation balloon may be fully deflated and withdrawn through the PEG device.
- the dilation device once it has its balloon completely deflated and while it is still attached to the guide wire, may be removed through the working channel of the endoscope by withdrawing the guide wire through the working channel of the endoscope.
Abstract
Description
- This disclosure relates to catheters such as feeding tubes and their placement in the body of a patient.
- Numerous situations exist in which a body cavity needs to be catheterized to achieve a desired medical goal. One relatively common situation is to provide nutritional solutions or medicines directly into the stomach or intestines. A stoma is formed in the stomach or intestinal wall and a catheter is placed through the stoma. This surgical opening and/or the procedure to create the opening is commonly referred to as “gastrostomy”. Feeding solutions can be injected through the catheter to provide nutrients directly to the stomach or intestines (known as enteral feeding). A variety of different catheters intended for enteral feeding have been developed over the years, including some having a “low profile” relative to the portion of the catheter which sits on a patient's skin, as well as those having the more traditional or non-low profile configuration. These percutaneous transconduit catheters (sometimes referred to as “percutaneous transconduit tubes”) are frequently referred to as “gastrostomy catheters”, “percutaneous gastrostomy catheters”, “PEG catheters” or “enteral feeding catheters”. U.S. Pat. No. 6,019,746 for a “Low Profile Balloon Feeding Device” issued to Picha et al. on Feb. 1, 2000, provides an example of one device.
- These catheters are frequently placed in a procedure called percutaneous endoscopic gastrostomy (frequently referred to as PEG). Traditionally, a PEG tube is placed using endoscopic guidance or x-ray guidance. In a conventional PEG procedure that places a PEG tube into a patient's stomach, an endoscope is used to observe that the patient's esophagus is unobstructed and to inspect and inflate the stomach to see that the area selected for the gastrostomy can be distended.
- If the location is suitable, this spot is selected. Prior to placement of any feeding tube, it has been found that it is useful to anchor the anterior wall of the gastric lumen (e.g., the stomach) to the abdominal wall as a step prior to creating the stoma tract through the two. Insufflation of the gastric lumen has also been found to be successful in maintaining the lumen in close proximity of the abdominal wall in some procedures. This procedure is also applicable to jejunostomy or gastro-jejunostomy as well as the gastrostomy procedure referred to above. Similar procedures may also be applicable or desirable for other catheter tubes such as peritoneal drainage tubes.
- After the wall of the lumen is anchored, a needle is inserted into the patient in the area in the appropriate location. Additionally, a small incision may be made in the skin. An endoscopist will then typically watch through the endoscope as a needle pushes through the patient's skin, then through the abdominal wall, and enters the gastric lumen in the selected area to form a needle tract. A guide wire is passed through the needle into the gastric lumen (e.g., the stomach). The endoscopist will use an endoscopic snare to grasp the guide wire firmly. The snare, passed through the working channel of the endoscope, firmly grabs the guide wire. Both the endoscope and snare are then withdrawn together through the patient's mouth, pulling the guide wire with them. The end of the guide wire that extends out from the patient's mouth is subsequently attached to a PEG tube and the other end of the guide wire remains outside the patient's skin in the abdominal region.
- The PEG tube is guided into the patient's mouth (while the endoscope is completely removed from the patient) and pulled into the patient's gastric lumen as the guide wire is pulled from the end that remains outside the patient's skin. Once the PEG tube is in the gastric lumen, it is pulled partially through the gastric and abdominal walls until a bumper of the PEG tube is snug against the gastric mucosa. However, in order for the PEG tube to be pulled partially through the gastric and abdominal walls and skin, the original needle tract must be dilated. This dilation is carried out with conventional dilation devices that employ a tapered dilator at the distal end of the PEG tube so that it dilates the opening as it is pulled through the gastric mucosa. During such dilation, the endoscope is again passed into the patient and subsequently used to visually observe that the bumper of the PEG tube is snug against the gastric mucosa.
- In other conventional PEG tube placement procedures, endoscopy is not used at all. Instead, x-ray techniques are used to help select a particularly suitable location in the patient's body (e.g., the stomach) for the introduction of the PEG tube. X-ray is used for guiding the PEG tube placement and for inspecting the PEG tube's final position.
- In yet another procedure, known as gastropexy, a needle is used to pierce a patient's abdominal wall to place one or more fasteners in a patient's gastric lumen. A fastener, such as a “T-bar” fastener, carried at or near the tip of the needle is desirably deployed by the needle so that it can be positioned against an inner wall of the gastric lumen. A tensioning suture is connected to the fastener and, at an opposite end of the suture on the outer surface of the patient's body, the suture is desirably also connected to a suture holder, which permits adjustment of the tension on the suture. In this manner, when the suture is tensioned a patient's gastric lumen wall is more closely positioned to the outer surface of the patient's body, and the gastric lumen is stabilized in a position. Usually, at least three and desirably four fasteners are placed in a triangular, square, or diamond-shaped configuration through a patient's skin and into the gastric lumen.
- While there are some problems associated with these conventional procedures including an increased risk of esophageal trauma associated with multiple passes of an endoscope into and out of a patient or placement of the PEG in an improper location, one significant problem is related to the additional complications of anchoring the wall of the gastric lumen to the abdomen. It would be desirable to avoid the complications of the additional steps of such a procedure and/or the additional trauma caused by mechanically anchoring (even temporarily) the wall of the gastric lumen to the abdomen. While avoiding these complications may be desirable, suitable devices or procedures are lacking.
- Accordingly, there is a need for a device, system and method for placing a non-vascular catheter tube such as a PEG tube in a patient that reduces these risks and trauma and is easy to perform.
- In response to the difficulties and problems discussed herein, this disclosure describes a dilation device and dilation system. The dilation device is an inflatable device that is used for placing catheter tubes in a non-vascular lumen, desirably under direct visualization using an endoscope.
- According to this disclosure, a conventional endoscope is advanced into the stomach to insufflate and allow palpation to locate an appropriate site. Once the appropriate site is located, a needle is inserted into the stomach through the abdomen from outside the body to form a needle tract. A guide wire is then introduced into the stomach through the needle, and a system is provided for: positioning a dilation device in the needle tract; maintaining the dilation device in the desired position; dilation of the needle tract, and removal of the dilation device.
- The dilation device includes an inflatable balloon including a dilation region forming a first portion of the device and a retention region forming a second portion of the device, an inflation lumen to inflate and deflate the inflatable balloon, a tubular support, and a continuous pathway through the device that accommodates a guide wire. The inflatable balloon may be compliant, semi-compliant, or non-compliant.
- The inflatable balloon (also referred to as a “dilation balloon”) is located towards the distal end of the device. The dilation balloon includes a distal section and an opposing proximal section. The dilation balloon has a length with a pre-determined diameter upon full inflation to fit a specific sized catheter tube device. Alternatively, the dilation balloon may be dilated to various effective diameters using respectively different inflation pressures to fit various catheter tubes. The proximal section of the dilation balloon (that portion of the dilation balloon that is positioned in the non-vascular lumen) may be designed to have substantially the same diameter features of the distal section or it may have a section with a larger diameter than any diameters of the distal section. The balloon section with the largest diameter is referred to as the “retention section” or the proximal retention balloon component”. Once this section is inflated, it functions to provide retention of the dilation device within the non-vascular lumen (e.g., the stomach). The proximal retention balloon component may be compliant, semi-compliant, or non-compliant. The inflatable balloon (i.e., the dilation balloon) has two opposing open ends. These open ends are attached to the tubular support.
- The tubular support of the dilation device supports the dilation balloon. The dilation device also has at least one inflation lumen to inflate and deflate the dilation balloon component. It is contemplated that any of the inflation lumens included in the dilation device can serve as the tubular support for the dilation balloon. In other words, the tubular support may define the relevant inflation lumens.
- The dilation device may have a continuous single pathway through its entirety to accommodate a guide wire. This pathway may include the inflation lumen for the dilation balloon and the tubular support; or it may be a separate lumen that is contained within the walls of an inflation lumen, the tubular support; or combinations thereof.
- According to this disclosure, the dilation device may be utilized in “inside-out” or “outside-in” dilation procedures. Inside-out dilation procedures involve attachment of the dilation device to the guide wire outside of the patient's mouth or inside the non-vascular lumen (e.g., the stomach or other space). A non-limiting example of attachment outside the patient's mouth may involve the following steps: insertion of an endoscope that extends from outside the mouth to inside the stomach; conventional placement of a guide wire through the skin, abdominal wall and stomach wall utilizing a needle; insertion of a standard endoscopic forceps or an endoscopic snare through the working channel of the endoscope; using the forceps or snare to grasp the guide wire portion that is in the stomach and then pulling the guide wire through the working channel of the endoscope and out of the patient's mouth (unlike current practice where the entire endoscope is removed from the patient); securely attaching the end of the dilation device that is closest to the dilation balloon (not the retention balloon portion of the dilation device) to the end of the guide wire that extends from the patient's mouth; pulling the guide wire and attached dilation device back through the working channel of the endoscope so that the dilation balloon exits the working channel into the stomach via the guide wire portion that remains outside the skin. An non-limiting example of attachment of the dilation device to the guide wire inside the patient's stomach may involve the following features and/or steps: the dilation device contains a fixture (magnet, hook, loop, snare, etc.) at the end that is closest to the dilation balloon (the side that enters the mouth first); the dilation device is pushed through the working channel of the endoscope so that the fixture exits the working channel; the fixture is attached under visualization of the endoscope by connecting the fixture to the guide wire (that was inserted through the needle); pulling the guide wire portion that remains outside the skin so that the dilation device pulls through the working channel and into the stomach. Regardless of the steps used to place the dilation device in the stomach, after placement in the stomach it is pulled into and partially through the needle tract so that at least a portion of the deflated dilation balloon extends through the abdominal tissue and the skin and the retention balloon resides in the stomach.
- Outside-in dilation procedures differ from inside-out procedures in that they do not pass the dilation device through the working channel of the endoscope in order to position the dilation device in the stomach, nor is there any need to attach the dilation device to a guide wire that extends from the patient's stomach through the mouth. Outside-in procedures may involve the following steps: insertion of an endoscope that extends through the mouth to inside of the stomach; conventional initial placement of a guide wire through the skin, abdominal wall, and stomach wall through an inserted needle and then removal of the needle with the guide wire in place; mounting the dilation device over the end of the guide wire that is outside of the patient's skin; partial insertion of the dilation device into the needle tract so that the retention balloon enters the stomach before any portion of the dilation balloon.
- In positioning the dilation device, the dilation balloon must be in a deflated state so that the dilation device easily slides through the working channel of the endoscope and/or it penetrates the needle tract without excessive force. The dilation device in this deflated state desirably wraps and folds around the tubular support as much as possible to minimize the effective cross-sectional area of the dilation device during insertion through the endoscope and/or needle tract. Such folding and wrapping is achieved by intentionally folding the balloon walls in pre-planned arrangements, via the use of a pleater and/or folder manufacturing apparatus, or by random overlapping and folding afforded by the flexible nature and thinness of the balloon walls.
- According to an aspect of this disclosure, the dilation device contains only one balloon. The dilation balloon of the dilation device is inflated by gradually introducing controlled amounts of fluid (e.g., liquid or gas) to increase pressure in this balloon. As previously described, the dilation balloon may have a length of a single diameter or it may have varying diameters. The portion of the balloon that has a length of a single diameter is placed in the needle tract and inflates radially to provide atraumatic dilation (as compared to serial dilation) of the entire needle tract to create the stoma tract. The proximal retention balloon component portion of the device inflates inside the stomach and not in the needle tract. It is used to stabilize the device and to help prevent the device from pulling out of the stoma tract during the procedure.
- A better understanding of the above and many other features and advantages of the liquid dispensing device with flow indicator may be obtained from a consideration of the detailed description of this disclosure below, particularly if such consideration is made in conjunction with the appended drawings.
-
FIG. 1 is a side cross-sectional view illustrating an exemplary dilation device that has a tubular support upon which is mounted the inflatable dilation balloon. -
FIG. 2 is a side cross-sectional view illustrating the position of an exemplary dilation device pulled through the gastric lumen wall and abdominal wall prior to inflation of the device. -
FIGS. 3A and 3B are side cross-sectional views of an exemplary dilation device showing an inflated dilation balloon and inflated retention stabilizing the lumen wall against the abdominal wall. InFIG. 3A the inflatable dilation balloon is in position with the retention portion within the lumen but the lumen is not snugly against the inside of the abdominal wall. InFIG. 3B the gastric lumen has been pulled snugly against the inside of the abdominal wall. - Reference will now be made to the drawings in which the various elements of the present disclosure will be given numeral designations and in which the disclosure will be discussed so as to enable one skilled in the art to make and use the disclosure. It is to be understood that the following description is only exemplary of the principles of the present disclosure, and should not be viewed as narrowing the pending claims. Those skilled in the art will appreciate that aspects of the various embodiments discussed may be interchanged and modified without departing from the scope and spirit of the disclosure.
- Since the stomach is a common example of a non-vascular lumen, for the purpose of describing this disclosure, the use of the term “gastric lumen” or “stomach” is representative of all other non-vascular lumens or spaces (e.g., duodenum, jejunum, ileum, peritoneal cavity, etc.), unless otherwise specified.
- Turning now to the drawings, there is shown at
FIG. 1 in side, cross-sectional view, an exemplarystoma dilation device 100 that includes atubular support 102 defining at least onecontinuous pathway 104 through the device. The continuous pathway is configured to accommodate a guide wire. - The
tubular support 102 has a length, width and a longitudinal axis “LA”. Thetubular support 102 should be flexible but not too flexible as to readily collapse or kink when pressure is applied radially or axially. The width of the tubular support should be sufficiently small that it may fit in the working channel of an endoscope. For example, the tubular support may have a width of from about 0.2 to about 2 millimeters. More desirably, the tubular support may have a width of from about 0.5 to about 1.75 millimeters. The tubular support may be made of a variety of suitable materials. Exemplary materials include thermoplastic polyurethanes such as TECOFLEX® medical-grade aliphatic polyether polyurethanes available from Lubrizol Advanced Materials, Inc., Thermedics™ Polymer Products, Wilmington, Mass. - The
device 100 includes aninflatable dilation balloon 106 located on thetubular support 102 having at least oneinflatable dilation section 108 at adistal portion 110 of the device and at least one inflatableretention balloon component 112 located on a proximal portion of the device 114 (i.e., the proximal retention balloon component 112). Thedilation balloon 106 has at least one dilationballoon inflation lumen 116 to inflate and deflate the dilation balloon. Desirably, theinflation lumen 116 is integrated in thetubular support 102. In this regard, thetubular support 102 may define multiple lumens. That is, the tubular support may define acontinuous pathway 104, at least one dilationballoon inflation lumen 116 to inflate and deflate thedilation balloon 106. It is contemplated that the inflation lumens may be separated from the tubular support and be in the form of pilot tubes or the like. - According to this disclosure, the proximal
retention balloon component 112 is configured to have an effective cross-section upon full, unrestrained inflation that is greater than the largest cross-sectional diameter of thedilation section 108 upon inflation as is generally illustrated inFIG. 1 . Thedilation section 108 of the balloon has a length and a circular cross-section with a pre-determined diameter upon full inflation to fit a specific sized catheter tube device. Alternatively, thedilation section 108 may be dilated to various effective diameters using respectively different inflation pressures to fit various catheter tubes. As a non-limiting example, the effective inflated diameter of thedilation section 108 may range from about 3 to about 10 millimeters. As another non-limiting example, the effective inflated diameter of thedilation section 108 may range from about 2 to about 8 millimeters. An inflated dilation balloon with a length and with a non-circular cross section along the length, e.g. elliptical or oval, is also contemplated. - The
proximal portion 114 of the dilation balloon 106 (that portion of the dilation balloon that is positioned in the non-vascular lumen) incorporates the retention section 112 (also referred to as the “proximal retention balloon component”) having a substantially larger cross section or diameter than any diameters of thedilation section 108. Generally speaking, the proximal retention balloon component may have a cross section or diameter that is about 1.5 times to about 3 times the diameter of thedilation section 108. Once this proximalretention balloon component 112 is inflated, it functions to stabilize the wall of the lumen and/or provide retention of the dilation device within the non-vascular lumen (e.g., the stomach). - The proximal
retention balloon component 112 may have a circular or non-circular cross section as long as it is able to function as described above. The retention balloon may have or lack a cross section with one axis of symmetry. The proximalretention balloon component 112 may, for example, have a square, rectangular, triangular, elliptical, oval or other geometric. Alternatively and/or additionally the proximalretention balloon component 112 may incorporate lobes, fingers or projections that contribute to its cross-section so it is greater than the diameter of thedilation section 108. Thedilation balloon 106 desirably includes two opposing open ends. The open ends may be attached to the tubular support. Thedilation balloon 106 may haveopen ends - The dilation balloon may be formed of materials such that the balloons are compliant, semi-compliant, or non-compliant. That is, the balloon may be relatively elastic (e.g., compliant) so that it stretches as well as expands upon inflation. The balloon may also be somewhat elastic (e.g., semi-compliant) so that it expands but has limited stretch upon inflation. The balloon may be inelastic (e.g., non-compliant) so that it expands without significant stretch upon inflation. Desirably, the balloons may be formed of polyurethane material identified as Pellethane® 2363-90A, available from Lubrizol Advanced Materials, Inc., Thermedics™ Polymer Products.
- This disclosure also covers a system for dilating a stoma and inserting a non-vascular catheter tube, the system includes a stoma dilation device as described above. The system also includes a non-vascular catheter tube configured to fit over the fully or partially inflated dilation balloon (i.e., the dilation section 108) through the dilated stoma tract and into the portion of the non-vascular lumen stabilized by the retention section (i.e., the proximal retention balloon component). According to the system, the stoma dilation device is configured to be deflated and at least a portion of the device withdrawn through the non-vascular catheter tube.
- In an exemplary and non-limiting description of a placement of the device, an endoscope may be advanced into a non-vascular lumen (e.g., the stomach) to insufflate and allow palpation to locate a catheter tube location site (e.g., a PEG location site). Once the site is located, a needle may be inserted into the stomach through the abdomen and a guide wire may be introduced into the stomach through the needle.
- Standard endoscopic forceps, an endoscopic snare, or a balloon attachment fixture may be inserted through the working channel of the endoscope. The forceps, snare or fixture is used to grasp the guide wire and the guide wire is pulled up through the working channel of the endoscope and out of the patient's mouth.
- A dilation device with its attached inflation lumen is secured to the end of the guide wire and is pulled through the working channel of the endoscope using the guide wire and into the stomach. The dilation device may have a dilation balloon having a distally located dilation section having pre-determined volume and diameter upon full inflation and a proximal retention balloon component having a diameter upon full inflation that is greater than the diameter of the dilation section. When these balloons are in a folded or tightly wrapped state, the dilation device has a diameter that fits within the working channel of the endoscope. Typically, the diameter is in the range of about 2 millimeters or less.
- The needle is removed from the stomach, while retaining the guide wire in the needle tract. The dilation device is pulled up into and partially through the needle tract so that it reaches the abdominal tissue and the skin on the exterior of the patient as illustrated in
FIG. 2 . - Referring now to
FIGS. 3A and 3B , thedilation balloon 106 of thedilation device 100 is then inflated by gradually introducing controlled amounts of fluid (e.g., liquid or gas) to increase pressure in the balloon so thedilation section 108 smoothly and gradually expands the needle tract into a stoma tract. The proximalretention balloon component 112 of thedilation balloon 106 is also inflated as thedilation section 108 is inflated. When the proximalretention balloon component 112 becomes larger than thedilation section 108 and expands to full inflation, it stabilizes the stomach wall “SW” by bringing it up against the wall of the abdomen “AW” as illustrated inFIG. 3B . According to an aspect of this disclosure, the fully inflated diameters of the dilation balloon may be selected from a range to match the diameter of the catheter tube device (e.g., the PEG device) that will be inserted. As shown inFIG. 1 andFIGS. 3A and 3B , thedilation balloon 106 can have variable diameters such that thedilation section 108 may have at least one diameter(s) and the retention section 112 (the proximal retention balloon component) may have at least one diameter that is greater than thedilation section 108. - After the dilation device has its affixed balloon fully inflated, a peel-away sheath is placed over the distal-most portion of the dilation device (i.e., from the outside of the patient). The dilation balloon of the dilation device is deflated by only a small amount (e.g. partially deflated) to allow the peel-away sheath to pass over the distal end of the dilation device and through the stoma tract into the stomach.
- A catheter tube (e.g., a PEG device) is then threaded over the guide wire and the distal end of PEG device is inserted through the peel away sheath. The distal end of the PEG device is now in a position to hold the gastric lumen against the abdominal wall so the dilation balloon may be fully deflated and withdrawn through the peel-away sheath. Note that the syringe inflation connector must be cut off of the inflation lumen in order to withdraw the dilation device through the abdominal wall. The peel-away sheath is then separated and removed from the stoma tract. Any other placement tools are removed, and the retainer on the distal, in-dwelling end of the PEG device holds the PEG device in place.
- Alternatively, the PEG device may be inserted over the deflated dilation without the use of the peel away sheath. This places the PED device in a position to hold the gastric lumen against the abdominal wall so the dilation balloon may be fully deflated and withdrawn through the PEG device.
- In yet another alternative, the dilation device, once it has its balloon completely deflated and while it is still attached to the guide wire, may be removed through the working channel of the endoscope by withdrawing the guide wire through the working channel of the endoscope. This requires the PEG to be installed in the manner described above, e.g., partial deflation of the dilation balloon and installation of the PEG through the peel-away sheath prior to dilation device removal.
- While this disclosure has been described in connection with certain preferred embodiments it is to be understood that the subject matter encompassed by way of this disclosure is not to be limited to those specific embodiments. On the contrary, it is intended for the subject matter of this disclosure to include all alternatives, modifications and equivalents as can be included within the spirit and scope of the following claims.
Claims (11)
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Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20160135843A1 (en) * | 2014-11-17 | 2016-05-19 | 3VO Medical, Inc. | Intrauterine balloon apparatus, system, and method for augmenting uterine birthing forces during parturition |
US20170035660A1 (en) * | 2012-12-21 | 2017-02-09 | Avent, Inc. | Dilation Device for Placing Catheter Tubes |
CN107348976A (en) * | 2017-05-19 | 2017-11-17 | 薛运章 | A kind of mesenterium support meanss and method for supporting |
Families Citing this family (60)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2012033936A2 (en) | 2010-09-08 | 2012-03-15 | Tyco Healthcare Group Lp | Catheter with imaging assembly |
US20120078039A1 (en) | 2010-09-27 | 2012-03-29 | Kok-Ming Tai | Dilation Device for Placing Catheter Tubes |
WO2013026565A1 (en) * | 2011-08-20 | 2013-02-28 | Advanced Medical Balloons | Trans-anal inflow catheter and method for intermittently triggering a reflex-coordinated defecation |
US20140066966A1 (en) * | 2012-08-30 | 2014-03-06 | Children's National Medical Center | Endopyloric tool and method to treat hypertropic pyloric stenosis |
USD716841S1 (en) | 2012-09-07 | 2014-11-04 | Covidien Lp | Display screen with annotate file icon |
US9198835B2 (en) | 2012-09-07 | 2015-12-01 | Covidien Lp | Catheter with imaging assembly with placement aid and related methods therefor |
USD717340S1 (en) | 2012-09-07 | 2014-11-11 | Covidien Lp | Display screen with enteral feeding icon |
US9517184B2 (en) | 2012-09-07 | 2016-12-13 | Covidien Lp | Feeding tube with insufflation device and related methods therefor |
USD735343S1 (en) | 2012-09-07 | 2015-07-28 | Covidien Lp | Console |
US9108024B2 (en) | 2012-09-28 | 2015-08-18 | Avent, Inc. | Retention component for placement of enteral feeding tubes |
US9522253B2 (en) * | 2013-03-13 | 2016-12-20 | Vascular Solutions, Inc. | Drainage or feeding catheter assembly |
WO2014145799A1 (en) | 2013-03-15 | 2014-09-18 | Ez Off Weightloss, Llc | System and method for gastric restriction and malabsorption |
US9833350B2 (en) | 2013-03-15 | 2017-12-05 | Ez-Off Weightloss, Llc | Anchorable size-varying gastric balloons for weight loss |
CN103263280A (en) * | 2013-06-04 | 2013-08-28 | 赵远思 | Intestine stoma fixing device |
US10258372B2 (en) | 2013-08-05 | 2019-04-16 | Endo-Tagss, Llc | Transabdominal gastric surgery system and method |
US10219799B2 (en) | 2013-08-05 | 2019-03-05 | Endo-Tagss, Llc | Transabdominal gastric device and method |
CN103405297A (en) * | 2013-08-27 | 2013-11-27 | 林建江 | Complete flow turning type intestinal fistulization tube |
US9839774B2 (en) * | 2013-11-18 | 2017-12-12 | Halkey-Roberts Corporation | Medical luer connector |
CA2932285C (en) | 2013-12-17 | 2019-10-08 | Standard Bariatrics, Inc. | Resection line guide for a medical procedure and method of using same |
CA2944329C (en) | 2014-03-29 | 2019-08-20 | Standard Bariatrics, Inc. | End effectors, surgical stapling devices, and methods of using same |
AU2015241193B2 (en) | 2014-03-29 | 2020-01-02 | Standard Bariatrics, Inc. | End effectors surgical stapling devices, and methods of using same |
US10470911B2 (en) | 2014-09-05 | 2019-11-12 | Standard Bariatrics, Inc. | Sleeve gastrectomy calibration tube and method of using same |
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WO2016097824A1 (en) * | 2014-12-18 | 2016-06-23 | Evoluzione S.R.L. | Medical device for performing ileostomies and/or jejunostomies |
WO2016164682A1 (en) | 2015-04-09 | 2016-10-13 | Boston Scientific Scimed, Inc. | Trap balloon catheter with trap balloon retainer |
EP3280481B1 (en) * | 2015-04-09 | 2023-01-25 | Boston Scientific Scimed Inc. | Trap balloon catheter with trap balloon retainer |
US9808282B2 (en) * | 2015-06-04 | 2017-11-07 | Medos International Sarl | Surgical cannula system and method of use |
US10285837B1 (en) | 2015-09-16 | 2019-05-14 | Standard Bariatrics, Inc. | Systems and methods for measuring volume of potential sleeve in a sleeve gastrectomy |
KR101725235B1 (en) * | 2015-12-01 | 2017-04-11 | 충남대학교산학협력단 | Surgical Trocar |
CN106182730B (en) * | 2016-07-28 | 2018-10-16 | 七星电气股份有限公司 | A kind of expansion mold for cool condensing electric cable accessories |
AU2016419833B2 (en) * | 2016-08-17 | 2021-12-16 | Avent, Inc. | Enteral feeding satiation device |
EP3522826B1 (en) | 2016-10-04 | 2022-05-11 | EZ-OFF Weight loss, LLC | Sleeve-anchorable gastric balloon for weight loss |
WO2018071065A1 (en) | 2016-10-14 | 2018-04-19 | Noar Mark D | Balloon structure with anchoring portions for anchoring in a bodily passage |
WO2018150219A1 (en) * | 2017-02-16 | 2018-08-23 | N.V. Nutricia | Gastrostomy device with an improved retaining element |
CN110678159A (en) * | 2017-02-16 | 2020-01-10 | 纽崔西亚公司 | Gastrostomy device with pressure monitoring |
JP6995869B2 (en) * | 2017-02-23 | 2022-01-17 | ボストン サイエンティフィック サイムド,インコーポレイテッド | Mounting equipment used with medical equipment |
CN107174315B (en) * | 2017-05-04 | 2019-10-11 | 温州市人民医院 | Peritoneo-puncture needle fixes device |
US11338112B2 (en) | 2017-07-03 | 2022-05-24 | Cathaid, Inc. | Devices for monitoring movement of a secured catheter during a procedure |
WO2019036490A1 (en) | 2017-08-14 | 2019-02-21 | Standard Bariatrics, Inc. | End effectors, surgical stapling devices, and methods of using same |
RU2691924C1 (en) * | 2017-12-25 | 2019-06-18 | Арчил Зурабович Цулая | Method for gastrostomy using polypropylene mesh |
KR101984878B1 (en) | 2018-01-10 | 2019-05-31 | 강석진 | Dry edible Materials pulverization machine |
WO2019232537A1 (en) | 2018-06-01 | 2019-12-05 | Endo RX, LLC | Dilation device and method of use |
US11412260B2 (en) * | 2018-10-29 | 2022-08-09 | Google Llc | Geometric transforms for image compression |
BR112021010343A2 (en) * | 2018-11-30 | 2021-08-24 | Quick Tube Medical, Llc | Method and apparatus for treating tension pneumothorax using a quick-deploying chest port |
CN109700525A (en) * | 2018-12-28 | 2019-05-03 | 先健科技(深圳)有限公司 | Stoma instrument |
US11666696B2 (en) | 2019-03-25 | 2023-06-06 | Ellen McGrath | Enterostomy drainage methods and devices |
USD896365S1 (en) * | 2019-06-24 | 2020-09-15 | Mark Sipe | Medical port disc |
KR102049701B1 (en) * | 2019-08-22 | 2020-01-08 | 이지희 | A liquid medicine injection machine Of Balloon type |
CN211884905U (en) | 2019-08-22 | 2020-11-10 | 贝克顿·迪金森公司 | Balloon dilatation catheter and balloon thereof |
CN110801312A (en) * | 2019-10-21 | 2020-02-18 | 复旦大学附属中山医院 | Intervene valve release stop device |
CN114641265A (en) | 2019-11-04 | 2022-06-17 | 标准肥胖病研究公司 | Systems and methods for performing surgery using Laplace's Laplacian tension retraction during surgery |
CN111375121B (en) * | 2020-03-18 | 2022-05-17 | 南京鼓楼医院 | Nerve block sleeve assembly |
JP2021154089A (en) * | 2020-03-30 | 2021-10-07 | テルモ株式会社 | Transfistula tube device |
CN112245772B (en) * | 2020-10-19 | 2022-05-06 | 四川大学华西医院 | Monitoring regulation and control device of adjustable two sacs three chambeies intraductal air pressure |
WO2022204078A1 (en) | 2021-03-23 | 2022-09-29 | Standard Bariatrics, Inc. | Systems and methods for preventing tissue migration in surgical staplers |
CN113576578B (en) * | 2021-07-29 | 2022-09-13 | 宿州微腾企业管理咨询服务有限公司 | Intracardiac branch of academic or vocational study hemostasis constriction device |
KR102597188B1 (en) | 2021-08-20 | 2023-11-02 | 주식회사 파인메딕스 | Gastrostomy Tube Kit |
CN114099912B (en) * | 2021-11-18 | 2024-03-22 | 南京脉创医疗科技有限公司 | Intracranial balloon dilation catheter |
TWI773597B (en) * | 2021-11-25 | 2022-08-01 | 長庚學校財團法人長庚科技大學 | Guided operation and detection device for gastrostomy care |
CN114082086B (en) * | 2021-12-23 | 2024-03-29 | 赛诺神畅医疗科技有限公司 | Balloon guiding catheter |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6293924B1 (en) * | 1996-12-12 | 2001-09-25 | Advanced Cardiovascular Systems, Inc. | Balloon assembly with separately inflatable sections |
US7137993B2 (en) * | 2001-12-03 | 2006-11-21 | Xtent, Inc. | Apparatus and methods for delivery of multiple distributed stents |
US20070255209A1 (en) * | 2006-04-21 | 2007-11-01 | C.R. Bard, Inc. | Feeding device and bolster apparatus and method for making the same |
US20080167606A1 (en) * | 2006-09-25 | 2008-07-10 | Valentx, Inc. | Toposcopic access and delivery devices |
US20090281379A1 (en) * | 2008-05-12 | 2009-11-12 | Xlumena, Inc. | System and method for transluminal access |
Family Cites Families (120)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3397699A (en) | 1966-05-05 | 1968-08-20 | Gerald C. Kohl | Retaining catheter having resiliently biased wing flanges |
US3633579A (en) | 1967-05-24 | 1972-01-11 | Sherwood Medical Ind Inc | Catheter placement device and method |
US3915171A (en) | 1974-06-06 | 1975-10-28 | Dennis William Shermeta | Gastrostomy tube |
US4393873A (en) | 1980-03-10 | 1983-07-19 | Nawash Michael S | Gastrostomy and other percutaneous transport tubes |
US4315513A (en) | 1980-03-10 | 1982-02-16 | Nawash Michael S | Gastrostomy and other percutaneous transport tubes |
US4531943A (en) | 1983-08-08 | 1985-07-30 | Angiomedics Corporation | Catheter with soft deformable tip |
US4627838A (en) | 1983-12-09 | 1986-12-09 | Bard Limited | Stylet actuated winged catheter |
US4758219A (en) | 1985-05-17 | 1988-07-19 | Microvasive, Inc. | Enteral feeding device |
US4763654A (en) * | 1986-09-10 | 1988-08-16 | Jang G David | Tandem independently inflatable/deflatable multiple diameter balloon angioplasty catheter systems and method of use |
US4850953A (en) | 1987-07-27 | 1989-07-25 | Habley Medical Technology Corporation | Gastrostomy valve |
US4861334A (en) | 1988-06-24 | 1989-08-29 | Nawaz Arain | Self-retaining gastrostomy tube |
US4944732A (en) | 1988-08-15 | 1990-07-31 | Sandoz Nutrition Corporation | Gastrostomy feeding port |
JPH0249547U (en) * | 1988-09-30 | 1990-04-06 | ||
US4972845A (en) | 1989-01-05 | 1990-11-27 | Abbott Laboratories | Stoma measuring device |
US5073166A (en) | 1989-02-15 | 1991-12-17 | Medical Innovations Corporation | Method and apparatus for emplacement of a gastrostomy catheter |
US5374254A (en) | 1990-11-29 | 1994-12-20 | Buma; Shelley J. | Catheters with adjustable external locking bolsters |
US5092850A (en) | 1990-11-29 | 1992-03-03 | Buma Shelley J | Catheter with adjustable external locking bolster |
US5112310A (en) | 1991-02-06 | 1992-05-12 | Grobe James L | Apparatus and methods for percutaneous endoscopic gastrostomy |
ES2126604T3 (en) | 1991-11-06 | 1999-04-01 | Inbae Yoon | STABILIZER OF SURGICAL INSTRUMENTS. |
US5356391A (en) | 1992-06-22 | 1994-10-18 | Medical Innovations Corp. | Flexible retainer flange for gastrostomy tube and the method of installing it |
US5484420A (en) | 1992-07-09 | 1996-01-16 | Wilson-Cook Medical Inc. | Retention bolsters for percutaneous catheters |
US5248302A (en) | 1992-08-05 | 1993-09-28 | Biosearch Medical Products Inc. | Percutaneous obturatable internal anchoring device |
US5702365A (en) * | 1992-09-08 | 1997-12-30 | King; Toby St. John | Daul-lumen catheter |
DK0683684T3 (en) * | 1993-01-07 | 2001-11-05 | Medical Innovations Corp | Catheter system for gastrostomy |
US5413565A (en) | 1993-01-15 | 1995-05-09 | Sandoz Nutrition Ltd. | Gastrostomy feeding port with elastic adjustable tip |
US5336203A (en) | 1993-05-28 | 1994-08-09 | Abbott Laboratories | Low profile gastrostomy device with dome |
US5505698A (en) * | 1993-10-29 | 1996-04-09 | Medtronic, Inc. | Cardioplegia catheter with elongated cuff |
US5429598A (en) | 1994-04-19 | 1995-07-04 | Applied Medical Resources Corporation | Surgical access device and procedure |
US6036673A (en) * | 1996-01-11 | 2000-03-14 | C. R. Bard, Inc. | Bolster for corporeal access tube assembly |
ES2241035T3 (en) * | 1996-01-11 | 2005-10-16 | C.R. Bard Inc. | TUBE ASSEMBLY TO ACCESS THE BODY. |
US5860952A (en) | 1996-01-11 | 1999-01-19 | C. R. Bard, Inc. | Corporeal access tube assembly and method |
US6019746A (en) | 1996-05-17 | 2000-02-01 | Applied Medical Technology, Inc. | Low profile balloon feeding device |
DE19634116C2 (en) | 1996-08-23 | 1998-08-20 | Fresenius Ag | Catheter for percutaneous enteral nutrition |
US6494848B1 (en) | 1996-12-19 | 2002-12-17 | St. Jude Medical Puerto Rico B.V. | Measuring device for use with a hemostatic puncture closure device |
NL1005068C2 (en) | 1997-01-23 | 1998-07-27 | Ct Rrn Academisch Ziekenhuis U | Catheter system and a catheter forming part thereof. |
SE507786C2 (en) * | 1997-02-04 | 1998-07-13 | Stig Bengmark | Probe for providing fluid communication with the small intestine |
US5928260A (en) | 1997-07-10 | 1999-07-27 | Scimed Life Systems, Inc. | Removable occlusion system for aneurysm neck |
US6077250A (en) | 1997-10-01 | 2000-06-20 | Boston Scientific Corporation | Apparatus and method for percutaneously placing gastrostomy tubes |
US6186985B1 (en) | 1997-10-03 | 2001-02-13 | Boston Scientific Corporation | Gastro-intestinal tube with dissolvable support bolster |
US6464686B1 (en) * | 1998-01-21 | 2002-10-15 | Abbott Laboratories | Polyurethane feeding tube and associated adaptors |
US6364858B1 (en) | 1998-03-31 | 2002-04-02 | Applied Medical Research, Inc. | Collapsible internal bolster for gastrostomy device |
US6039714A (en) | 1998-05-12 | 2000-03-21 | Novartis Nutrition Ag | Collapsible retention bolster for gastrostomy and other ostomy tubes |
US6527748B1 (en) | 1998-08-17 | 2003-03-04 | Yutaka Suzuki | Method of gastrostomy, and an infection preventive cover, kit or catheter kit, and a gastrostomy catheter kit |
DE69940835D1 (en) * | 1998-08-17 | 2009-06-10 | Yutaka Suzuki | Gastrostomy procedure and infection protection cap for a catheter device |
US6030406A (en) | 1998-10-05 | 2000-02-29 | Origin Medsystems, Inc. | Method and apparatus for tissue dissection |
US6030361A (en) | 1999-01-25 | 2000-02-29 | Miyashiro; Augusto M. | Gastrostomy apparatus |
US6231547B1 (en) | 1999-02-18 | 2001-05-15 | Abbott Laboratories | External retaining device for a catheter and catheter assembly and method using same |
US6322538B1 (en) | 1999-02-18 | 2001-11-27 | Scimed Life Systems, Inc. | Gastro-intestinal tube placement device |
US20050085771A1 (en) * | 1999-04-16 | 2005-04-21 | Lyon Thomas R. | Clear view cannula |
US6231549B1 (en) | 1999-08-17 | 2001-05-15 | Sherwood Services, Ag | Shim device for enteral feeding system |
US6881420B2 (en) | 2000-06-23 | 2005-04-19 | Teva Pharmaceutical Industries Ltd. | Compositions and dosage forms for gastric delivery of irinotecan and methods of treatment that use it to inhibit cancer cell proliferation |
ITBO20000511A1 (en) | 2000-09-05 | 2002-03-05 | Gianmario Monza | APPARATUS AND METHOD FOR THE CONSTRUCTION OF GASTROSTOMY |
US6692458B2 (en) * | 2000-12-19 | 2004-02-17 | Edwards Lifesciences Corporation | Intra-pericardial drug delivery device with multiple balloons and method for angiogenesis |
US6743207B2 (en) * | 2001-04-19 | 2004-06-01 | Scimed Life Systems, Inc. | Apparatus and method for the insertion of a medical device |
EP1408831A4 (en) | 2001-06-19 | 2007-01-31 | Univ Pennsylvania | Optical guidance system for invasive catheter placement |
DE10139644B4 (en) | 2001-08-11 | 2004-04-01 | Fresenius Kabi Deutschland Gmbh | Mounting part for an adapter of a PEG probe and adapter for a PEG probe with such a mounting part |
US7736336B2 (en) | 2001-09-13 | 2010-06-15 | Allegiance Corporation | Paracentesis device having multiple detachable components |
US6896665B2 (en) | 2001-12-10 | 2005-05-24 | Applied Medical Research | Gastrostomy device package and method of assembly |
US20030163114A1 (en) | 2002-02-26 | 2003-08-28 | Gershowitz Arthur D. | Retrograde cannula having manually retractable sealing member |
JP4351458B2 (en) | 2002-03-18 | 2009-10-28 | オリンパス株式会社 | Endoscope insertion system |
US6666853B2 (en) | 2002-03-27 | 2003-12-23 | Scimed Life Systems, Inc. | Low profile adaptor for use with a medical catheter |
US7083595B2 (en) | 2002-05-01 | 2006-08-01 | Scimed Lipe Systems, Inc. | Medical catheter assembly and method of using the same |
JP2004099584A (en) | 2002-05-02 | 2004-04-02 | Keio Gijuku | Antitumor agent using hsv |
US6764453B2 (en) | 2002-05-08 | 2004-07-20 | Sherwood Services Ag | Stoma measuring device |
US6878130B2 (en) * | 2002-05-28 | 2005-04-12 | Sherwood Services Ag | External inflation indicator for a low profile gastrostomy tube |
US20030225392A1 (en) | 2002-05-31 | 2003-12-04 | Kimberly-Clark Worldwide, Inc. | Low profile transpyloric jejunostomy system and method to enable |
WO2004012805A2 (en) | 2002-08-05 | 2004-02-12 | Miravant Medical Technologies | Light delivery catheter |
US6942641B2 (en) | 2003-05-30 | 2005-09-13 | J. Michael Seddon | Catheter |
EP1638635A1 (en) | 2003-06-20 | 2006-03-29 | Ranier Limited | A medical device |
EP1641512A1 (en) * | 2003-06-20 | 2006-04-05 | Coloplast A/S | A medical device comprising a braided portion |
US7220252B2 (en) * | 2003-07-18 | 2007-05-22 | Polyzen, Inc. | Inflatable dual balloon catheter |
US20070203445A1 (en) * | 2004-02-26 | 2007-08-30 | V-Kardia Pty Ltd | Isolating cardiac circulation |
US7462175B2 (en) * | 2004-04-21 | 2008-12-09 | Acclarent, Inc. | Devices, systems and methods for treating disorders of the ear, nose and throat |
JP4588356B2 (en) * | 2004-04-30 | 2010-12-01 | 日本シャーウッド株式会社 | Gastrostomy tube extender |
JP4623548B2 (en) * | 2004-04-30 | 2011-02-02 | 日本シャーウッド株式会社 | Gastrostomy tube extender |
US7654980B2 (en) | 2004-05-14 | 2010-02-02 | Boston Scientific Scimed, Inc. | Method for percutaneously implanting a medical catheter and medical catheter implanting assembly |
US20060030818A1 (en) | 2004-08-09 | 2006-02-09 | Mcvey Robert D | System and method for securing a medical access device |
US7582072B2 (en) | 2004-09-09 | 2009-09-01 | Kimberly-Clark Worldwide, Inc. | Artificial stoma and method of use |
US20080039715A1 (en) | 2004-11-04 | 2008-02-14 | Wilson David F | Three-dimensional optical guidance for catheter placement |
JP4721329B2 (en) | 2005-04-21 | 2011-07-13 | 日本シャーウッド株式会社 | Indwelling device |
US20060270989A1 (en) | 2005-05-27 | 2006-11-30 | Mcmichael Donald J | Gastric fastening system |
US7691089B2 (en) * | 2005-06-21 | 2010-04-06 | Tyco Healthcare Group Lp | Adjustable trocar washer |
GB2428198A (en) | 2005-07-11 | 2007-01-24 | Stavros Michael Stivaros | A self-retaining surgical tube |
US8954134B2 (en) | 2005-09-13 | 2015-02-10 | Children's Medical Center Corporation | Light-guided transluminal catheter |
US8709018B2 (en) | 2005-09-16 | 2014-04-29 | Applied Medical Technology, Inc. | Non-balloon low profile feed device with insertion/removal tool |
JP2007167082A (en) * | 2005-12-19 | 2007-07-05 | Michiaki Kudo | Guide instrument of in-vivo insertion tube via gastric fistula and instrument kit for changing percutaneous gastrostoma-tube to jejunum tube via gastric fistula |
US7740609B2 (en) * | 2006-03-03 | 2010-06-22 | Boston Scientific Scimed, Inc. | Balloon catheter |
US7771396B2 (en) | 2006-03-22 | 2010-08-10 | Ethicon Endo-Surgery, Inc. | Intubation device for enteral feeding |
US20070255222A1 (en) | 2006-03-27 | 2007-11-01 | Changqing Li | Catheter assembly including internal bolster |
US20070239171A1 (en) | 2006-03-30 | 2007-10-11 | Ethicon Endo-Surgery, Inc. | Medical snaring device |
US20070233005A1 (en) * | 2006-04-03 | 2007-10-04 | Mcmichael Donald J | Surgical fastening tool |
CA2656626A1 (en) | 2006-07-05 | 2008-01-10 | Aspiration Medical Technology, Llc | Shunt apparatus for treating obesity by extracting food |
FR2904531B1 (en) | 2006-08-02 | 2009-06-12 | Eleph Ent Technology | PERCUTANEOUS GASTROSTOMY PROBE |
US7547303B2 (en) | 2006-08-03 | 2009-06-16 | Boston Scientific Scimed, Inc. | Catheter assembly including foldable internal bolster |
US7648479B2 (en) | 2006-08-03 | 2010-01-19 | Deka Products Limited Partnership | Systems and methods for removing ingested material from a stomach |
US8241250B2 (en) * | 2006-08-31 | 2012-08-14 | Cook Medical Technologies Llc | Rotationally actuated fixation mechanism |
JP2008099917A (en) | 2006-10-19 | 2008-05-01 | Goodman Co Ltd | Catheter indeflator |
US8414611B2 (en) * | 2006-11-03 | 2013-04-09 | Boston Scientific Scimed, Inc. | Main vessel constraining side-branch access balloon |
CN101657180A (en) | 2007-03-14 | 2010-02-24 | 凯瑟琳·A·M·威茨曼 | Methods and systems for locating a feeding tube inside of a patient |
WO2008121311A1 (en) | 2007-03-29 | 2008-10-09 | Boston Scientific Scimed, Inc. | Catheter assembly including coiled internal bolster |
EP2155082B1 (en) | 2007-05-17 | 2012-06-20 | Boston Scientific Scimed, Inc. | Tissue securing and sealing apparatus |
US10166138B2 (en) | 2007-06-12 | 2019-01-01 | Convatec Technologies, Inc. | Ostomy appliance |
US8211136B2 (en) * | 2007-08-31 | 2012-07-03 | Kimberly-Clark Worldwide, Inc. | Stoma dilator |
CA2967491A1 (en) | 2008-06-19 | 2009-12-23 | Convatec Technologies Inc. | A stoma extender for use with an ostomy appliance |
US20090318757A1 (en) | 2008-06-23 | 2009-12-24 | Percuvision, Llc | Flexible visually directed medical intubation instrument and method |
WO2010008793A1 (en) | 2008-06-23 | 2010-01-21 | Percuvision, Llc | Flexible visually directed medical intubation instrument and method |
US9107810B2 (en) | 2008-06-24 | 2015-08-18 | Cook Medical Technologies Llc | Gastric port system |
US20090318873A1 (en) | 2008-06-24 | 2009-12-24 | Cook Incorporated | Medical malecot with magnets |
DE102008037916A1 (en) | 2008-08-14 | 2010-02-18 | Fresenius Kabi Deutschland Gmbh | Device for creating a percutaneous endoscopic gastrostomy |
WO2010033629A1 (en) * | 2008-09-18 | 2010-03-25 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear nose and throat |
US20100087706A1 (en) | 2008-09-30 | 2010-04-08 | Intrapace, Inc. | Lead Access |
US20100081991A1 (en) * | 2008-09-30 | 2010-04-01 | Tyco Healthcare Group Lp | Skin level device for use with gastrostomy tube |
WO2010075032A2 (en) | 2008-12-22 | 2010-07-01 | Cook Incorporated | Low-profile external fitting |
US8252057B2 (en) * | 2009-01-30 | 2012-08-28 | Ethicon Endo-Surgery, Inc. | Surgical access device |
WO2010115102A1 (en) | 2009-04-02 | 2010-10-07 | Radius International Limited Partnership | Low profile and tension monitoring external peg bolster |
US8715244B2 (en) * | 2009-07-07 | 2014-05-06 | C. R. Bard, Inc. | Extensible internal bolster for a medical device |
WO2011053242A1 (en) | 2009-10-29 | 2011-05-05 | Ah San Pang | A spacer and a method of using the same |
US20130144272A1 (en) | 2010-06-14 | 2013-06-06 | Christopher J. Cutie | Stricture treatment and drainage catheter |
US20120078039A1 (en) | 2010-09-27 | 2012-03-29 | Kok-Ming Tai | Dilation Device for Placing Catheter Tubes |
US9108024B2 (en) * | 2012-09-28 | 2015-08-18 | Avent, Inc. | Retention component for placement of enteral feeding tubes |
-
2011
- 2011-09-26 US US13/245,577 patent/US20120078039A1/en not_active Abandoned
- 2011-09-26 US US13/245,562 patent/US9339442B2/en active Active
- 2011-09-26 US US13/245,542 patent/US9211234B2/en active Active
- 2011-09-26 US US13/245,552 patent/US9125800B2/en active Active
- 2011-09-27 JP JP2013529764A patent/JP5830103B2/en active Active
- 2011-09-27 CA CA2811246A patent/CA2811246A1/en not_active Abandoned
- 2011-09-27 AU AU2011309683A patent/AU2011309683B2/en active Active
- 2011-09-27 KR KR1020137006482A patent/KR20130138204A/en active Search and Examination
- 2011-09-27 CN CN201180046595.9A patent/CN103189034B/en active Active
- 2011-09-27 BR BR112013007171-0A patent/BR112013007171A2/en not_active IP Right Cessation
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- 2011-09-27 JP JP2013529765A patent/JP5977747B2/en active Active
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- 2011-09-27 CA CA2811425A patent/CA2811425C/en active Active
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Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6293924B1 (en) * | 1996-12-12 | 2001-09-25 | Advanced Cardiovascular Systems, Inc. | Balloon assembly with separately inflatable sections |
US7137993B2 (en) * | 2001-12-03 | 2006-11-21 | Xtent, Inc. | Apparatus and methods for delivery of multiple distributed stents |
US20070255209A1 (en) * | 2006-04-21 | 2007-11-01 | C.R. Bard, Inc. | Feeding device and bolster apparatus and method for making the same |
US20080167606A1 (en) * | 2006-09-25 | 2008-07-10 | Valentx, Inc. | Toposcopic access and delivery devices |
US20090281379A1 (en) * | 2008-05-12 | 2009-11-12 | Xlumena, Inc. | System and method for transluminal access |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20170035660A1 (en) * | 2012-12-21 | 2017-02-09 | Avent, Inc. | Dilation Device for Placing Catheter Tubes |
US10130559B2 (en) * | 2012-12-21 | 2018-11-20 | Avent, Inc. | Dilation device for placing catheter tubes |
US20160135843A1 (en) * | 2014-11-17 | 2016-05-19 | 3VO Medical, Inc. | Intrauterine balloon apparatus, system, and method for augmenting uterine birthing forces during parturition |
US10206595B2 (en) * | 2014-11-17 | 2019-02-19 | 3VO Medical, Inc. | Intrauterine balloon apparatus, system, and method for augmenting uterine birthing forces during parturition |
US10856754B2 (en) | 2014-11-17 | 2020-12-08 | 3VO Medical, Inc. | Intrauterine balloon apparatus, system, and method for augmenting uterine birthing forces during parturition |
CN107348976A (en) * | 2017-05-19 | 2017-11-17 | 薛运章 | A kind of mesenterium support meanss and method for supporting |
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