KR20210008256A - A nasogastric tube having a improved safetiness - Google Patents

Abstract

The present invention relates to a feeding tube having an improved safety by inserting the feeding tube while grasping the position of the tip of the feeding tube and the surrounding environment by mounting an endoscope, and having an improved safety, a plurality of lumens 110 A tube body 100 having; And a connector 200 formed at a rear end of the tube body 100; Including, the tube body 100, at least, therein, a first lumen 110 for feeding, and a fifth lumen 150 for an endoscope optical fiber 520, the connector 200, At least, it includes a feeding connecting portion 210 used to administer nutrients or drugs to a patient, and an endoscope connecting portion 250 through which the optical fiber 520 of the endoscope device 500 enters and exits, and the endoscope connecting portion It is characterized in that the endoscope is configured to be detachable from the fifth lumen 150 of the tube body through the part 250.

Description

Feeding tube with improved safety {A NASOGASTRIC TUBE HAVING A IMPROVED SAFETINESS}

The present invention relates to a feeding tube having improved safety, and more particularly, inserting the feeding tube while grasping the position of the tip of the feeding tube and the surrounding environment by mounting an endoscope, but allowing simple and efficient steering and preventing even reverse flow. In order to further improve the safety in the process of insertion and use, it relates to a feeding tube having improved safety.

In general, patients who require prolonged nutrition and drug infusion, patients who are unable to take oral feeding, patients who are unable to perform adequate nutrient absorption through the stomach, patients with bowel movement problems, gastrointestinal obstruction or severe gastroesophageal reflux problems, or prior For patients with a history of esophageal cancer or gastric resection, the device for direct injection of nutrition and drugs is called “Nasogasrtric Tube” (NG Tube), and this nutrition method is called “Nongastric Tube Nutrition Method”.

In other words, nutritional support for inpatients is a very important part for patient recovery, and malnutrition deteriorates the function of various organs such as the gastrointestinal tract, kidneys, and heart, affects the metabolism of drugs and wound recovery, and reduces immunity to cause infection. It is known that, as shown in FIG. 1, when unconscious patients such as infants, severely ill patients, and dementia are unable to swallow food, as shown in FIG. Inserting 1) into the esophagus and using a feeding syringe (2) to provide food directly to the stomach through the feeding tube (1) or to administer prescribed drugs.

Figure 1 (a) shows a state in which a general feeding tube (1) is injected into the stomach through the esophagus, and Figure 1 (b) shows a state of use of a feeding tube that supplies food, etc. using a syringe (2). Is shown.

However, the conventional feeding tube is a method of blindly inserting the tube without seeing it, and this method has a problem that may damage the tissue while inserting the tube.In particular, in the case of patients with esophageal varices, varicose veins due to the tube In addition, when there is a surgical joint or other pathological findings in the esophagus and stomach, it can cause bleeding in the stomach, which can lead to death. May cause complications.

Moreover, there is a possibility that the tube may enter the wrong path other than the normal path. In particular, if it enters the airway through the vocal cords, the patient's airway may be severely stimulated, causing problems such as coughing and airway contraction. In the case of the patient with the intestine, several problems have been caused by the existing feeding tube, such as the tube can create a gap between the tracheal tubes, which can cause abnormal ventilation.

Figure 2 is a diagram showing a side effect case of the use of a general feeding tube, Figure 2 (a), the feeding tube damages or stimulates the epiglottis, which closes the airways when food goes down and opens the airways when breathing 2(b) is a case where the feeding tube penetrates the base of the skull and reaches the brain, and FIG. 2(c) is a case where the feeding tube enters the bronchi, whereby pneumothorax occurs or the tube is It is a case in which a cough is caused by irritation of the airways, and Fig.2(d) shows that a feeding tube irritates the surroundings or injects a relatively large amount of food due to lack of information about the inside of the stomach such as the amount of gas remaining. And aspiration pneumonia caused by reflux to the airways, and there were various other problems.

On the other hand, as for the gastrointestinal feeding tube proposed to solve the problem of the above gastrointestinal feeding tube, US Patent Publication No. 2008/0004598 (feeding tube insertion system and method) has been proposed.

3 is an overall schematic diagram of the feeding tube insertion system 100 in which the feeding tube 110, the guide member 120 and the insertion member 130 are simultaneously coupled according to the first prior art, and FIG. 4 is It is a view showing a state in which the feeding tube insertion system of the first prior art is inserted into the esophagus.

The guide member 120 is partially surrounded or penetrated by a portion of the feeding tube 110 during insertion of the feeding tube 110 so that the feeding tube 110 follows a path set by the guide member 120.

The insertion member 130 is made of a straight, elongated body portion 172 and an insertion portion 174 that is curved in engagement with the end of the guide member 120, and these are inserted into the nasal cavity or oral pharynx of the patient.

The insertion member 130 includes a handle 176 that allows the insertion member 130 to be easily gripped and controlled by a user. The handle is formed as two loops attached to the main body 172 and extending downward from the main body 172. The loop forms a handle opening 178, and the opening accommodates, for example, a user's index and middle fingers so that the insertion member 130 is gripped.

The extension 180 extending from the body portion to the rear of the handle 176 improves stability during handling of the insertion member 130. The body 172 of the insertion member 130 has a sufficient thickness and strength, and may be made of any suitable material to support the appropriate weight of the insertion portion 174 and a portion of the guide member 120 attached thereto during insertion. I can.

The insert 174 typically has one or more flexures to conform to the anatomy of the patient's nasal cavity and oropharynx. The insertion portion 174 provides sufficient stiffness to support the soft weight 158 of the guide member 120, but has sufficient flexibility to deform as necessary while inserting the insertion portion 174 into the patient's nasal cavity. It is composed of a flexible biocompatible material that provides, provides a desired amount of stiffness and flexibility, and allows the insertion member to easily pass through the nasal cavity of the insertion portion 174.

In this situation, the swallowable weight 158 will be released from the insertion member 130, and the user may advance the guide member 120 into the oral cavity by applying a longitudinal pressure depending on the rigidity of the guide member to aid in placement. will be.

Once the swallowable weight 158 of the guide member 120 is disposed on the end of the insertion member 130, in order to keep the swallowable weight 158 in place, the user Tension must be applied.

3 and 4, when the swallowable weight 158 is disposed on the tip 186 of the insertion part 174, the tip 186 is preferably controlled by light tension on the guide member 120. Fixed in position.

By releasing the tension on the guide member 120 by loosening the engagement, the swallowable weight 158 is allowed to be released from the tip 186, allowing the swallowable weight 158 to fall.

The guide member 120 may be a thin cord or line having a leading portion 154 having sufficient flexibility to be easily inserted and swallowed by the patient and a leading portion 154 swallowed by the patient, and when the tube is inserted It has sufficient rigidity to guide the feeding tube 110.

A swallowable weight 158 is attached to the head portion 154, and the connection portion 156 connects the tail portion 152 and the head portion 154. In order to prevent the tail from being swallowed by the patient, a stopper 160 near the end 150 of the guide member 120 may be provided on the opposite side of the swallowable weight 158.

The insertion member 130 is used to help the insertion of the leading portion 154 of the guide member 120 only partially into the nasal cavity of the patient, and a longitudinal pressure may be applied to the guide member 120 to proceed further.

The distal end 116 of the feeding tube 110 further includes a guide member holding structure 136 configured to slide along the guide member 120. The guide member holding structure preferably includes a generally tubular protrusion or intrusion attached parallel to the base end 114 having a tubular opening 140 for receiving the guide member 120. Once the guide member is inserted, the guide member holding structure 136 allows the feeding tube 110 to move slidably and telescopically along the guide member 120. Accordingly, the guide member 110 may act to establish a path for the feeding tube 110 to follow as the feeding tube 110 is inserted into the stomach of the patient through the nasal cavity, pharynx, and esophagus of the patient. The leading end 138 and the rear end 248 of the guide member holding structure 136 are preferably chamfered.

While the guide member holding structure 136 has been described as a tubular element attached to the distal end 116 as shown in FIG. 3, other structures are also slidable along the guide member 120 and/or a guide configured for telescopic movement. It can be used to form the member retention structure 136. For example, the guide member retention structure 136 may be formed as one or more loops or retention tabs attached to the distal end 116.

That is, in the first prior art, the guide member 120 and the insertion member 130 are inserted together, but the ends in the sharply curved channel are inserted using the tension of the insertion part 174 of the insertion member and the gravity of the weight 158 It is designed to have improved stability than a general feeding tube by removing the insertion member 130 and inserting the tube 110 along the guide wire when the curved section passes.

However, in the case of the first prior art, the structure is too complex, and it is still a blind method like a general feeding tube, and since it must be steered purely by the tension of the insertion part and the gravity of the weight, the nasal cavity, pharynx, esophagus and stomach of the complex structure There is a limit to the smooth insertion.

On the other hand, as a kind of additional gastrointestinal feeding tube, U.S. Patent Publication No. 2010/0274225 is disclosed, and the second prior art relates to a feeding tube having a function of detecting stomach contents, and the residual amount in the stomach (Gastric It relates to a feeding tube having a Residual Volume, GRV) detection sensor.

In other words, GRV (Gastric Residual Volume) is the amount of residual gastrointestinal contents that remain in the stomach after a certain period of time has elapsed from intestinal feeding, and when the GRV level is high, hygiene conditions may deteriorate or complications may occur, such as vomiting or inflammation. A feeding tube with a GRV detection sensor is proposed to inform healthcare providers that feeding should be reduced or stopped before this occurs.

5 shows an exemplary feeding tube 100 with an integrated GRV detection sensor 102 inserted into the patient 106. The volume display device 104 may also be connected to the feeding tube 100. The feeding tube 100 may include a funnel-shaped device 108 that is fixedly attached or connectable to the feeding tube end so as to deliver nutrients such as food to the stomach 110 of the patient through the feeding tube 100. have. The sensor 102 may be connected to the volume display device 104 via a wire or other conductive element 112 in the feeding tube 100, or via a wireless connection.

The stomach 110 has a structure to provide a seal including the lower esophageal sphincter 114, and the pyloric sphincter 116 between the stomach and duodenum 118 upon metastasis to the esophagus. These structures help keep the contents in the stomach. Regardless of the patient's location, the fundus 120 is the part of the stomach where most of the stomach contents accumulate, so it is important that the GRV detection sensor 102 can be placed around or inside the base. Accurate placement of the sensor within the stomach contents can lead to more accurate readings.

Therefore, according to the second prior art, since the GRV detection sensor 102 measures the amount of gastrointestinal contents present in the stomach, it is possible to adjust the amount of feeding based on this, as well as take appropriate measures by detecting the backflow phenomenon. You will be able to.

However, the second prior art also has a limitation in sensing because the GRV detection sensor is a pressure sensor or a fluid detection circuit composed of a photodiode and a phototransistor, and in particular, in the process of inserting a feeding tube, the conventional general There is a limit that it is no different because it is a blind feeding tube.

On the other hand, U.S. Patent Laid-Open Publication No. 2014/0188080 (feeding tube) prevents reflux of food and prevents damage (nose erosion, esophageal perforation, tissue damage to the esophagus, etc.) To reduce this, a vacuum control device connects the esophagus to the tube to prevent backflow of food along the esophagus to the trachea, and enables the local selective vacuum application within the esophagus so that the position of the esophagus connected to the tube can change over time. By doing so, an improved nasogastric tube (NGT) is proposed to reduce tissue damage such as the esophagus.

6 is a view showing the feeding tube device and the state of use according to the third prior art, Figure 6 (a) is a simplified schematic diagram of the feeding tube constructed and operated according to the third prior art, Figure 6 (b) is a simplified cross-sectional view of the NGT according to the third prior art, a cross-sectional view taken along line II-II of Figure 6 (a), Figure 6 (c) is the third prior art Simplified schematic diagram of a feeding tube used to suck and seal the inner wall of the esophagus for NGT according to.

The third prior art will be described in more detail with reference to Fig. 6(a), the main lumen 12 can be used to supply and administer drugs and other oral preparations, and can also be used to inhale fluid from the stomach. At this time, the main lumen 12 may be a dual lumen of a supply lumen and a suction lumen. The main lumen 12 has a source of material for supply or administration, and optionally one or more suitable base connectors 14 for connection to a pressure source (eg an inhaler).

As shown in Fig. 6B, there are four vacuum lumens 16 spaced around the main lumen 12. The main lumen 12 and vacuum lumen 16 are arranged in concentrically arranged conduits. The vacuum lumen 16 is coupled with the vacuum source 18 through a pressure regulator 20 and valve 22 forming a vacuum regulating device.

The main lumen 12 and the vacuum lumen 16 may be configured as one unit, and the vacuum lumen 16 is a separate unit that slides over the main lumen 12 after inserting the main lumen 12 into the patient body. Alternatively, the vacuum lumen 16 may be first introduced to the patient and the main lumen 12 may slide between the vacuum lumens 16.

As shown in Fig. 6(a), each vacuum lumen 16 includes a vacuum seal 24 comprising one or more suction ports 26. As shown in FIGS. 6A and 6C, when the vacuum generated by the vacuum source 18 is applied, the inner wall of the esophagus is pulled by the suction port 26.

A pressure regulator 20 can be used to match the vacuum level created by the vacuum source 18 to the vacuum level required for vacuum sealing. For example, the pressure regulator 20 may be used to reduce or otherwise regulate the negative pressure generated by the vacuum source 18.

The valve 22 can be used to move the vacuum between different vacuum lumens 16 so that the suction level is not constant over time in the vacuum seal 24, so as to provide variability in how the esophageal wall is sucked. I can.

The NGT 10 may be provided with a different number of vacuum seals 24 and suction ports 26, and the vacuum to the seal 24 may be adjusted to produce peristaltic motion or other vibrating motion of the esophagus. .

Thus, according to the third prior art, since at least one auxiliary suction port 33 is provided adjacent to the vacuum seal 24, and the vacuum seal 24 seals the esophagus, the vacuum suction port 33 A can be used to aspirate and remove any oral secretions such as saliva, while one or more vacuum lumens 16 may be used to expel liquids arriving from the patient's stomach. That is, when reverse flow occurs, one or more of the vacuum lumens 16 may draw at least a portion thereof toward the valve 22 through the suction port 26. Consequently, the vacuum source 18 will reduce the risk of VAP or other bacterial infection by preventing or minimizing aspiration of reflux food and liquid into the lungs.

However, the third prior art focuses on preventing backflow of food after the feeding tube is safely disposed, and there is no improvement for problems that may occur in the process of inserting the feeding tube for the first time. Since it is used to prevent reverse flow, etc., there is a limit in safety and cannot be over the limit that comes from the blind-type insertion technology.

US Patent Publication No. 2008/0004598 (Feeding tube insertion system and method) US Patent Publication No. 2010/0274225 (feeding tube with gastric content detection function) US Patent Publication No. 2014/0188080 (feeding tube)

The present invention is to solve the above problems, and its object is to provide an improved safety by inserting the feeding tube while checking the position of the tip of the feeding tube and the surrounding environment by mounting an endoscope. It relates to a feeding tube having.

In addition, the present invention relates to a feeding tube having improved safety, which enables simple and efficient steering, and also prevents reverse flow.

The above objects and other additional objects will be clearly recognized by those skilled in the art without departing from the spirit of the present invention by the appended claims.

A feeding tube having an improved safety according to an aspect of the present invention for achieving the above object includes: a tube body 100 having a plurality of lumens 110; And a connector 200 formed at a rear end of the tube body 100; Including, the tube body 100, at least, therein, a first lumen 110 for feeding, and a fifth lumen 150 for an endoscope optical fiber 520, the connector 200, At least, it includes a feeding connecting portion 210 used to administer nutrients or drugs to a patient, and an endoscope connecting portion 250 through which the optical fiber 520 of the endoscope device 500 enters and exits, and the endoscope connecting portion It is characterized in that the endoscope is configured to be detachable from the fifth lumen 150 of the tube body through the part 250.

Preferably, a balloon device 300 including a fixed balloon 310 positioned at a front end of the tube body 100 and a hub 320 positioned at a rear end of the tube body 100; The tube body 100 further includes a third lumen 130 for a balloon device therein.

More preferably, a steering device 400 mounted into the tube body through the connector 200; The tube body 100 further includes a fourth lumen 120 for the steering device wire 420 therein, and the connector 200 also includes a wire 420 for the steering device 400. ) Is inserted and further has a connecting part 240 for a steering device that supports the handle 410 of the steering device.

More preferably, the front end of the feeding tube is composed of a soft part 102, and the middle of the feeding tube is a hard part 101 in which a twist-preventing cable 101a made of sus wire is wound around a coating layer to prevent twisting. ), while preventing twisting in the middle of the feeding tube, the steering at the tip of the tube is smooth, so that it is easy to insert while preventing tissue damage.

In addition, preferably, the feeding connecting portion 210 and the steering device connecting portion 240 are configured as a first connector located at the rear end, and the endoscope connecting portion 250 is separately formed as a second connector in the middle. It is characterized by constituting.

Most preferably, as a feeding tube used by inserting the optical fiber 520 of the endoscope device 500 into the fifth lumen 150 of the tube body through the endoscope connecting portion 250, the endoscope device 500 ) Is characterized by being reusable.

According to the feeding tube having improved safety according to the present invention, a microscopic endoscope is mounted in a single lumen, and the feeding tube is inserted while grasping the position of the tip of the feeding tube and the surrounding environment, so that the safety is further improved.

Moreover, according to the feeding tube of the present invention, a very thin guide wire is inserted into the auxiliary lumen in a single lumen to enable simple and efficient steering.

In addition, the feeding tube of the present invention also applies hydraulic pressure to the auxiliary lumen in a single lumen to inflate the balloon at the tip end to prevent even backflow, so that the safety is further improved.

First of all, the microscopic endoscope used in the present invention is recyclable, and by providing a connector having such various functions, various functions can be achieved by a single lumen, and thus various advantageous advantages are obtained.

On the other hand, additional features and advantages of the present invention will be more clarified through the following description.

1 is a view showing a state of use of a general feeding tube.
2 is a diagram showing a case of side effects in use of a general feeding tube.
3 is a side view of a feed tube insertion system of the first prior art.
Figure 4 is a view showing a state in which the feeding tube insertion system of the first prior art is inserted into the esophagus.
5 is a view of a state in which the feeding tube according to the second prior art is inserted through the esophagus of the patient to the stomach.
6 is a view showing a feeding tube and a state of use according to the third prior art.
7 is an overall schematic view of a feeding tube with improved safety according to the first embodiment of the present invention.
Figure 8 is a plan view of a state in which the endoscope is removed from the feeding tube of Figure 7;
9 is a state diagram of a use of an endoscope used in the feeding tube of FIG. 7.
10 is a plan view of a state in which an endoscope and a steering mechanism are removed from the feeding tube of FIG. 7;
Figure 11a is a plan view of only the basic tube in a state in which all additional devices are removed from the feeding tube of Figure 7;
Figure 11b is a cross-sectional view of the tube body in the feeding tube of the present invention.
12 is a schematic diagram of a cable for preventing twisting of the feeding tube of FIG. 7;
13 is a graph showing the correlation between the force of the wire for direction adjustment of the feeding tube of Figure 7 and the movement of the tube tip.
14A is a view showing an example of inflating a balloon through a balloon in the feeding tube of FIG. 7.
14B is a view showing an example of a balloon inflated at a position of a patient's stomach.
15 is a view for explaining the effect of the feeding tube having improved safety according to the first embodiment of the present invention.
Figure 16 is a real photograph of a state in which the direction adjustment mechanism is inserted into the feeding tube having improved safety according to the second embodiment of the present invention.
Figure 17 is a real photograph of the endoscope used in the feeding tube of Figure 16.
Figure 18a is an example of the feed tube connector of Figure 16.
Figure 18b is another example of the feed tube connector of Figure 16.
19 is a cross-sectional view of the feeding tube of FIG. 16;
20 is an enlarged photograph of a boundary portion of a soft portion and a hard portion of the feeding tube of FIG. 16;
Figure 21 is an enlarged photograph of the balloon portion of the feeding tube of Figure 16.

Hereinafter, a feeding tube having improved safety according to a preferred embodiment of the present invention will be described in detail with reference to the accompanying drawings.

In this specification, the embodiments and embodiments described below should be considered as illustrative and not restrictive, and the present invention is not limited to the details given herein, but substitutions and equivalent other implementations within the scope and equivalents of the appended claims. It can be changed to yes.

(Example 1)

First, a feeding tube having an improved safety according to a first embodiment of the present invention will be described with reference to FIGS. 7 to 15.

7 is an overall schematic view of the feeding tube having improved safety according to the first embodiment of the present invention, FIG. 8 is a plan view of the feeding tube of FIG. 7 with the endoscope removed, and FIG. 9 is the feeding tube of FIG. 7 Fig. 10 is a plan view of the endoscope and the steering mechanism removed from the feeding tube of Fig. 7, and Fig. 11A is only the basic tube in a state in which all additional devices are removed from the feeding tube of Fig. 7 11B is a cross-sectional view of a tube body in the feeding tube of the present invention, and FIG. 12 is a schematic diagram of a twist-resistant cable of the feeding tube of FIG. 7.

13 is a graph showing a correlation between the force of the guide wire for adjusting the direction of the feeding tube of FIG. 7 and the movement of the tip of the tube, and FIG. 14A is a view showing an example of balloon inflation through the balloon in the feeding tube of FIG. 7, FIG. 14B is a view showing an example of a balloon inflated at the patient's gastric door position, and FIG. 15 is a view for explaining the overall effect of the feeding tube having improved safety according to the first embodiment of the present invention.

In the feeding tube having improved safety according to the first embodiment of the present invention, it is possible to check the path of the esophagus during insertion using an endoscope and the state of the stomach after insertion, and the tip of the feeding tube with a steering device while checking the path with the endoscope. It is a gastrointestinal feeding tube that is easy and safe to insert by adjusting the direction of the gastrointestinal tract, and is capable of being twisted and positioned in the stomach by an additional balloon device and a twist-resistant cable.

In other words, the conventional enteral tubes have an increased risk of being bent or knotted in the stomach, and in this case, there may be problems such as poor administration of drugs and nutrients, and poor suction of the stomach contents. In the case of directly checking the path using an endoscope, it can be used very safely and efficiently because it can solve these problems that can be brought about by the existing blind tube insertion.

Moreover, preventing twisting and bending by fixing the position of the tube by using a balloon device such as a balloon is an important factor in ensuring the function of the tube.

First, schematically explaining the feeding tube of the present invention, as shown in Figs. 7 to 12, a soft tube body 100 having a plurality of lumens 110; A connector 200 formed at a rear end of the tube body 100; A balloon device 300 including a fixed balloon 310 positioned at a front end of the tube body 100 and a hub 320 positioned at a rear end of the tube body 100; A steering device 400 mounted into the tube body through the connector 200; And an endoscope 500 that is detachably inserted into the tube body through the connector 200. The tube body 100 has a plurality of lumens (channels) therein, a first lumen 110 for feeding with a relatively large inner diameter in the center, and a steering with a relatively small inner diameter around the center Consisting of a fourth lumen 120 for the device wire 420, a fifth lumen 150 for an endoscope optical fiber 520 of a medium-sized inner diameter and a third lumen 130 for a balloon (see FIG. 11B). ), the connector 200, a feeding connecting portion 210 used to administer nutrients or drugs to a patient by a syringe, and a wire 420 for the steering device 400 are inserted, and the handle of the steering device ( It includes a connecting part 240 for a steering device supporting the 410 and a connecting part 250 for an endoscope through which the optical fiber 520 of the endoscope device 500 enters and exits.

As shown in FIGS. 7 and 8, the connecting part 210 for feeding and the connecting part 240 for the steering device are configured as a first connector at the rear end, and the connecting part for endoscope 250 is in the middle. It may be configured separately as a connector. In the case of such a configuration, when feeding with the feeding tube of the present invention, in general while the patient is lying down, feeding is performed in a high position to prevent reflux, and the endoscopic device is positioned in a rather low position. This is because it is advantageous for monitoring.

To describe each part in more detail, first, the state in which the endoscope (500 in Fig. 9) is removed from the feeding tube of this embodiment is shown in Fig. 8, and the endoscope 500 of Fig. 9 is used in an existing hospital. It is made of an endoscope having an optical fiber 520 of a much narrower diameter than the endoscope, but the light source and monitor connection of the endoscope device 510 for the endoscope device 500 is to be compatible with existing equipment used in hospitals. It can be used usefully and efficiently without additional cost.

The distal end 521 of the endoscope optical fiber 520 is located at the bare tip 151 of the endoscope lumen 150 of the feeding tube of this embodiment, and a discharge port 111 of the feeding lumen 110 is provided nearby, The balloon 310 of the balloon device is wrapped around the discharge port 131 of the balloon lumen 130 at a suitable location nearby.

The hub 320 of the balloon device 300 is also provided at the same position as the second connector, and a valve device 321 is provided at the end of the hub of the balloon device, so that a pressurizing device 2'such as a separate syringe: After pressurizing the balloon 310 with 14a), even if the pressurizing device is removed, it is preferable that the pressure is not removed due to a valve device such as a check valve (see FIG. 10).

Reference numeral 111 denotes a lumen outlet for feeding, 131 denotes a lumen outlet for a balloon device, 151 denotes an endoscope lumen outlet, and the tip of the lumen for a steering device is the tube along with a guide wire 420 It is fixedly attached to a fixed point (not shown) at the tip of the body.

In addition, as shown in FIGS. 11A and 11B, the length of the tube body 100 of the feeding tube of the present invention is required to be about 1000 to 1500 mm, and the outer diameter of the tube body 100 is preferably about 5.0 mm, In this case, the inner diameter of the first lumen 110 for feeding is 2.4 mm, the inner diameter of the fourth lumen 140 for the guide wire of the steering device 400 is 0.4 mm, and the fifth lumen for the endoscope optical fiber 520 ( 150) and the third lumen 130 for the balloon device 300 each have an inner diameter of 1.0 mm or less (preferably 0.8 mm), and accordingly, the outer diameter of the endoscope optical fiber 520 is 0.9 mm or less (preferably Is 0.7 mm or less). That is, the outer diameters of the endoscope optical fiber 520 and the guide wire 420 of the steering device need to be slightly smaller (for example, 0.1 mm) than the inner diameters of the fifth and fourth lumens 150 and 140, respectively. have.

The endoscope 500 inserted into the feeding tube of the present invention, unlike the tube, is not used once, but is sterilized so that it can be used continuously, and the angle of view of the optical fiber 520 is ±35° and the viewing angle is 90°. desirable.

In addition, since such a feeding tube is very thin, there is a possibility that twisting may occur in the stomach. As shown in FIG. 12, the main body 100 of the feeding tube of the present invention is, for example, a flexible polyimide cable. It is preferable to use a twist-resistant cable wound with sus wire of 0.1mm thickness.

In addition, the feeding tube of this embodiment should be designed to withstand a load of more than a certain level, and according to the ISO10555-1 standard, both ends of the tube should withstand a load of 15N or more, and the axes of the feeding tube are adjusted so that they are horizontal to each other. After that, when the pressure of, for example, 300kpa to 320kpa is maintained for 30 seconds in the axial direction due to the relative action of the syringe piston and the outer cylinder, it is made by checking whether there is leakage of liquid in the tube.

Particularly, when entering the balloon tube, it minimizes damage to the gastrointestinal mucosa, and it is a double-structured tube to prevent twisting, and a balloon device can be used to fix the position of the tube, and in some cases, a feeding lumen is used. Alternatively, it is more desirable to use an extra channel to allow foreign substances in the stomach to be discharged to the outside.

X-ray impermeable material is used at the end of the product to identify the location of the product, and it is easy to mount the tube under the pylorus. Depending on the patient's condition, visual observation using an endoscope and X-ray use are simultaneously possible. It is good to do it.

The evaluation of the suitability for use of the balloon device is an essential item in medical device development due to the revision of ISO 60601-1-3, and the diameter of the fixed balloon should be 25mm and the width of 15mm after 15cc injection.

In addition, for the proper view of the endoscope, a 2cm outside diameter of the esophagus (based on an adult male) is secured, the angle of view of the endoscope is adjusted, and the entire outer wall of the esophagus on the monitor is visible.

For effective entry into the tube and the endoscope, the tube must be inserted without jamming or friction when entering the human body, so that the tube is smoothly entered through the finishing treatment (coating, angle of the tip end).

In addition, when mounting the tube in the human body, the tube should not be twisted after checking the X-ray, and the suction of foreign substances in the esophagus, stomach wall, and stomach should be smoothly carried out, and the syringe containing enteral nutrients in the stomach inside the human body The nutrient must be discharged from the end of the tube to check whether the nutrient reaches the stomach by injecting it into the tube through a (syringe) or the like. In addition, the balloon should be expanded through a contrast agent, and there should be no problem in the human body, and the location on the X-ray should be checked. Even when the tube is removed after use, there is no part that can damage the human tissue, and It is configured to fall out.

Subsequently, with reference to Figs. 13 to 15, the effect of the feeding tube of the present invention will be described.

First, the correlation between each force and angle with respect to the degree of bending of the wire and wire/feeding tube is as shown in Fig. 13(a), and the correlation between each displacement and angle with respect to the degree of bending is shown in Fig. As shown in (b), when the handle 410 of the steering device 400 at the rear end of the feeding tube is pulled or pushed, the tube body 100 at the tip end through the guide wire 420 is moved to one side and the other side. It is possible to bend, so that the tip of the feeding tube is directed in a desired direction while viewing the path through the endoscope, so that the feeding tube can be inserted into the desired location without damaging the esophagus of the patient.

Next, in the balloon device 300 of the feeding tube according to the present invention, as shown in FIG. 14A, the balloon hub 320 is fastened to the connecting portion 230 for the balloon device, and the syringe is connected to the valve 321 at the tip of the hub. When air is blown into the balloon hub 410 with the tip of the feeding tube inserted into the stomach while being fastened, the discharge port 131 through the lumen (third lumen) 130 for the balloon device of the tube body 100 As shown in FIG. 14B, since the fixed balloon 310 swells up to block the gastric door, it is possible to prevent separation of the feeding tube due to carelessness of the patient or operation error, and furthermore, excessive food or gas in the stomach It is possible to prevent backflow due to an increase in pressure or operation error.

The various advantages of the present invention are shown in FIG. 15, and according to the feeding tube of the present invention, since the desired insertion direction of the tube body can be effectively changed with the steering device while viewing the inside through the endoscope during tube insertion, a special technique Or, it can be operated at home even for ordinary people without specialized knowledge, and it can be inserted without damaging the patient's tissue at all. In addition, during the procedure, since the twist-resistant cable is used while also looking inside the body and is fixed by a balloon device, it prevents the tube from twisting, prevents accidental separation of the tube body, and prevents reverse flow. It is a technology that has several advantages compared to the prior art, such as can be done.

(Example 2)

Next, a feeding tube having improved safety according to a second embodiment of the present invention will be described with reference to FIGS. 16 to 21.

FIG. 16 is a real photograph of a feeding tube having an improved safety according to a second embodiment of the present invention with a direction adjustment mechanism inserted, and FIG. 17 is a real photograph of an endoscope used in the feeding tube of FIG. 18A is a real photograph of an example of the feed tube connector of FIG. 16, FIG. 18B is a real photograph of another example of the feed tube connector of FIG. 16, FIG. 19 is a cross-sectional view of the feed tube of FIG. 16, and FIG. 20 is It is an enlarged picture of the boundary part of the soft part and the hard part of a feeding tube, and FIG. 21 is an enlarged picture of the balloon part of the feeding tube of FIG.

In the case of the second embodiment, it is almost similar to the case of the first embodiment, but this embodiment is described with real photos of an actual finished product, but the first connector 201 is There is a spare connecting portion 260 for the same other purpose (see Fig. 16), and the endoscope 500' is improved in accordance with the present invention (see Fig. 17). In addition, the connector 200 is also different from the first connector 201 having a feeding connecting portion 210, a steering device connecting portion 240, and a spare connecting portion 260, and an endoscope connecting portion 250 The second connector 202 having) and into which the steering device 300 is inserted is the same as in the first embodiment.

18A and 18B, the color or transparency of the first connector 201 and the second connector 202 may be changed in various ways depending on the situation.

As shown in FIG. 19, the feeding tube body 100 is also similar to the case of the first embodiment, but as shown in the actual picture, the four-channel tube body having the same size as the embodiment of the present invention is It can be seen that it is technically possible.

Additionally, as shown in FIG. 20, in the case of the present embodiment, the middle of the feeding tube is a hard part 101 in which a sus wire is wound around a covering layer to prevent twisting, and the tip of the tube is composed of a soft part 102 , While preventing twisting in the middle of the feeding tube, it is possible to facilitate the insertion while preventing tissue damage due to smooth steering at the tip of the tube.

Finally, FIG. 21 is an actual enlarged picture of the main body 100 and the fixed balloon 310 of the feeding tube.

In the above, the present invention has been described according to an embodiment of the present invention, but changes and modifications within the scope not departing from the technical spirit of the present invention by those of ordinary skill in the art belong to the present invention. Of course.

100: tube body 110: lumen for feeding (first lumen)
111: feeding lumen outlet 130: balloon device lumen (third lumen)
131: lumen discharge port for balloon device 140: lumen for steering device (4th lumen)
150: endoscope lumen (5th lumen) 151: endoscope lumen exit
200: connector 201: first connector
202: second connector 210: connecting portion for feeding
240: connecting portion for the steering device 250: connecting portion for the endoscope
300: balloon device 310: fixed balloon
320: hub 321: valve
400: steering device 410: steering wheel
420: guide wire
500: endoscope device 510: endoscope device
520: endoscope optical fiber 521: endoscope optical fiber tip

Claims (5)

As a gastrointestinal feeding tube (1),
A tube body 100 having a plurality of lumens 110; And
A connector 200 formed at a rear end of the tube body 100;
Including,
The tube body 100 has at least a first lumen 110 for feeding and a fifth lumen 150 for an endoscope optical fiber 520 therein,
The connector 200 includes, at least, a feeding connecting portion 210 used to administer nutrients or drugs to a patient, and an endoscope connecting portion 250 through which the optical fiber 520 of the endoscope device 500 enters and exits. And
Feeding tube with improved safety, characterized in that the endoscope is configured to be detachable to the fifth lumen 150 of the tube body through the endoscope connecting portion 250. The method of claim 1,
A balloon device 300 including a fixed balloon 310 positioned at a front end of the tube body 100 and a hub 320 positioned at a rear end of the tube body 100;
It further includes,
The tube body 100, a feeding tube with improved safety, characterized in that it further has a third lumen 130 for a balloon device therein. The method according to claim 1 or 2,
The front end of the feeding tube is composed of a soft part 102, and the middle of the feeding tube is composed of a hard part 101 in which a twist-preventing cable 101a is wound around a coating layer to prevent twisting. Feeding tube with improved safety, characterized in that the steering is smooth at the tip of the tube while preventing twisting, preventing tissue damage and making it easy to insert. The method of claim 3,
Improved safety, characterized in that the feeding connecting part 210 is composed of a first connector 201 located at the rear end, and the endoscope connecting part 250 is configured separately with a second connector 202 in the middle Having a feeding tube. The method according to claim 1 or 2,
As a feeding tube used by inserting the optical fiber 520 of the endoscope device 500 into the fifth lumen 150 of the tube body through the endoscope connecting portion 250,
The endoscopic device 500 is a feeding tube with improved safety, characterized in that reusable.

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