USRE48453E1 - Feeding tube aperture - Google Patents

Abstract

A feeding tube aperture supported and aligned with a feeding tube opening in an abdominal wall of a patient, including a base having a first end surface transverse to an axis of the base and a feeding tube, a second opposed end surface, a central feeding tube passage extending between the first and second end surfaces, a plurality of vent passages around the feeding tube passage and extending between the first and second end surfaces, a hollow, cylindrical feeding tube support extension centered on and extending outwardly from the feeding tube passage to support and align the feeding tube aperture, and a plurality of spaced apart resilient spacers extending outwards from the second end surface. The plurality of spaced apart resilient spacers resiliently space the second end surface from the abdominal wall and form a plurality of air passages to allow a flow of air around the abdominal wall and the feeding tube opening.

Description

CROSS REFERENCES TO RELATED APPLICATIONS

The present Application is related to and claims benefit of U.S. patent application Ser. No. 13/253,945 for a Feeding Tube Aperture filed Oct. 5, 2011 by Henry Kiefer.

FIELD OF THE INVENTION

The present invention relates to the gavage administration of liquid foods and medications directly to the stomach of a patient through a feeding tube extending from the interior of the patient's stomach and through, for example, the patient's abdominal wall, to an exterior source of liquid food or medication or both and, in particular to a feeding tube aperture positioned generally at exterior of the patient's abdominal wall to support the feeding tube.

BACKGROUND OF THE INVENTION

Many medical processes, such as treatment for cancer in a patient's thoracic region, require the long term implantation of a gavage feeding tube, hereafter generally referred to as a “feeding tube,” that is anchored in the patient's stomach and extends through the patient's abdominal wall and skin to an exterior source of liquid food or medications. The implantation of such feeding tubes, however, often results in further medical problems for a number of reasons, such as movement of the stomach itself or relative movement between the patient and the exterior source of liquid food or medication, which often result in displacement of the feeding tube and frequently results in laceration, puncturing, distortion or irritation of the feeding tube opening through the abdominal wall. It is therefore generally necessary to provide some means of feeding tube support at the feeding tube opening to prevent or limit motion between the feeding tube and the abdominal wall and skin of the patient in this region.

Feeding tube support devices of the prior art have proven generally unsatisfactory for general use for a number of reasons. For example, the devices described in U.S. Pat. No. 5,792,119 to Marx for a TUBULAR IMPLANT TO BE USED FOR PERCUTANEOUSLY FEED A PATIENT, U.S. Pat. No. 4,344,435 to Aubin for a METHOD AND SURGICALLY IMPLANTABLE APPARATUS FOR PROVIDING FLUID COMMUNICATION WITH THE INTERIOR OF THE BODY, U.S. Patent Application Publication No. US2011/0288534 to Aguirre et al. For a DEVICE FOR EXTERNAL PERCUTANEOUS CONNECTIONS, and U.S. Pat. No. 4,393,873 to Nawash et al. For a GASTROSTOMY AND OTHER PERCUTANEOUS TUBES are generally too complex in structure, or require complex implantation methods and apparatus, and therefore too expensive for general use.

In addition, such devices are often and typically detrimental to the patient. For example, the feeding tube support devices of the prior art generally entrap body fluids seeping from the patient's body in the region around the opening through which the feeding tube penetrates the patient's skin while preventing or limiting the flow of air to and cleaning access to the region around the feeding tube opening. These limitations generally result in irritation to and very possibly necrosis of the patent's skin in the region around the feeding tube, and possibly even within the feeding tube passage through the patient's abdominal wall. In addition, the feeding tube support devices of the prior art are typically rigid structures of significant size and frequently cause discomfort to the patient by digging into the skin of the patient as the patient moves about.

Certain other feeding tube devices of the prior art, such as that described in U.S. Pat. No. 4,397,647 to Gordon for a CATHETER STABLIZATION FITTING HAVING A SNAP-OVER COVER, may provide some support to a feeding tube but are attached to the patient at some distance from the feeding tube opening through the patient's abdominal wall and mere prevent or limit disturbance to the feeding tube due to movement between the patient and the exterior source of liquid food or medication and do not and cannot provide the necessary support in the region of the feeding tube opening through the patient's abdominal wall.

Other feeding tube support devices of the prior art, such as that described in U.S. Pat. No. 4,666,433 to Parks for a GASTROSTOMY FEEDING DEVICE, have the virtue of simplicity and thus of reasonable cost, but also have the limitations and disadvantages of the above discussed devices of the prior art. For example, the Parks '433 device includes a disk-like element that bears against the skin of the patient in the region around the feeding tube opening, this providing at least some degree of discomfort to the patient as discussed above. While Parks '433 purports to provide openings through the disk-like element that bears against the skin of the patient around feeding tube opening for to provide air circulation, it is apparent that the described openings are too small to provide any useful degree of air circulation and are in any case blocked by the skin of the patient. The Parks '433 embodiment having radial ridges on the bottom of the disk-like element to space the disk-like element from the skin of the patient still only allows very limited air circulation as the ridges themselves limit air circulation; in addition, the hard, sharp edged ridges will themselves be yet another source of irritation to the skin around the feeding tube opening.

It is therefore apparent that the prior art does not offer a feeding tube support device that offers medical patients comfortable, easy-to-use support for feeding tubes or a feeding tube support device that will not puncture, rip or otherwise irritate the skin around a feeding tube opening or the internal tissue lining of a feeding tube passage or that can reliably prevent necrosis and possible infection.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention will be described by way of exemplary embodiments, but not limitations, illustrated in the accompanying drawings in which like references denote similar elements, and in which:

FIG. 1A shows an end view of a feeding tube aperture;

FIG. 1B shows a side view of a feeding tube aperture;

FIG. 1C shows a sectional side view of a feeding tube support extension;

FIG. 1D shows a sectional end view of a resilient spacer; and

FIG. 2 is an isometric view of a feeding tube aperture.

SUMMARY OF THE INVENTION

A feeding tube aperture positionable at an external abdominal wall of a patient and along a feeding tube extending through the abdominal wall of the patient to support and align the feeding tube with a feeding tube opening through the abdominal wall of the patient.

In a present embodiment the feeding tube aperture includes a base having a circumferential surface symmetric about an axis, a first end surface transverse to the axis, a second end surface transverse to the axis and facing in an axially opposite direction from the first end surface, a centrally located feeding tube passage extending along the axis and through the base from the first end surface to the second end surface and having an interior diameter accommodating the feeding tube in a slidable frictional engagement between the feeding tube and an interior surface of feeding tube passage, a hollow, cylindrical feeding tube support extension extending outwardly from the first end surface and axially centered on the axis with an interior diameter accommodating the feeding tube in a slidable frictional engagement between the feeding tube and an interior surface of the feeding tube support extension, a plurality of large axial vent passages occupying a region between the centrally located feeding tube passage and the circumferential surface and extending through the base from the first end surface to the second end surface with the axial vent passages being disposed symmetrically around the centrally located feeding tube passage, and a plurality of resilient spacers extending outwards from the second end surface and spaced circumferentially apart around a circumference of the second end surface.

When the feeding tube aperture is mounted onto a feeding tube with the second end surface oriented toward and directly adjacent the abdominal wall with the resilient spacers in contact with the abdominal wall the feeding tube aperture is resiliently spaced apart from the abdominal wall by the resilient spacers, and the resilient spacers form an air space between the second end surface and the abdominal wall and a plurality of circumferential vent passages between the air space and the resilient spacers, so that the axial vent passages through the base, the air space between the second end surface and the abdominal wall and the circumferential vent passages allow a flow of air around the abdominal wall and the feeding tube opening in the abdominal wall.

In further embodiments of the feeding tube aperture, the feeding tube aperture may include a circumferential flange located on the circumference of the second end surface and extending outwards from second end surface, and each of the resilient spacers is comprised of a generally cylindrical hollow tube of resilient foam with a longitudinal opening extending lengthwise from end to end along a wall of the resilient spacer wherein each resilient spacer is attached to the feeding tube aperture by mounting the resilient spacer at a selected location on the circumference of the circumferential flange with one side of the longitudinal opening of the longitudinal opening bearing against the base in the region of the circumferential surface of the base an adjacent surface of the circumferential flange and a second side of the longitudinal opening bearing against an inner edge of circumferential flange and second end surface.

In still further embodiments, the interior surface of the feeding tube support extension may further include at least one of at least one crimped region and at least one raised nub to engage the feeding tube to resist inadvertent movement between the feeding tube and the feeding tube aperture.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

A feeding tube aperture of the present invention will be described in the following with reference toFIGS. 1A, 1B, 1C and 1D andFIG. 2 whereinFIGS. 1A and 1B are respectively diagrammatic illustrations of an end view and a sectional side view of afeeding tube aperture100 of the present invention.FIG. 1C is a side cross section view of a part of a feeding tube support extension,FIG. 1D is an end cross section view of a resilient spacer andFIG. 2 is an isometric diagrammatic view of afeeding tube aperture100 of the present invention.

As illustrated therein, afeeding tube aperture100 is generally disk shaped and includes abase110 having acircumferential surface110A symmetric about anaxis100A, a firstend surface116E 110E transverse toaxis100A with a circumferentialcurved surface110C extending between and joiningcircumferential surface110A andfirst end surface110B, asecond end surface110D transverse toaxis100A and facing in an axially opposite direction fromfirst end surface110B, and may include acircumferential flange120 located on thecircumference120A ofsecond end surface110D.

Feeding tube aperture100 includes a centrally locatedfeeding tube passage130 extending alongaxis100A and throughbase110 fromfirst end surface110E tosecond end surface110D. The interior diameter offeeding tube passage130 has a diameter to accommodate afeeding tube130A in a slidable friction engagement between afeeding tube130A and the interior surface offeeding tube passage130. In use,feeding tube aperture100 will be oriented withfirst end surface110A facing away from anabdominal wall130C of a patient andsecond end surface110B facing toward theabdominal wall130C with afeeding tube130A extending from a feeding tube opening130B in theabdominal wall130C of a patient and passing throughfeeding tube passage130 so that thefeeding tube130A and will be secured byfeeding tube aperture100 in a generally perpendicular orientation to theabdominal wall130C of the patient.

Feeding tube aperture100 further includes a plurality of relatively largeaxial vent passages132 occupying the region between centralfeeding tube passage130 andcircumferential surface110A ofbase110 and extending throughbase110 fromfirst end surface110B tosecond end surface110D withaxial vent passages132 generally being disposed symmetrically aroundfeeding tube passage130. It will also be noted thataxial vent passages132 together occupy a relatively large portion of the areas offirst end surface110B andsecond end surface110D, as illustrated inFIGS. 1A, 1B and 2 and as will be discussed further below.

In a presently preferred embodiment, afeeding tube aperture100 further includes a hollow, cylindrical feedingtube support extension140 that is secured to and extends outwardly fromfirst end surface110B with feedingtube support extension140 being axially centered onaxis100A andfeeding tube passage130. Feedingtube support extension140 has an interior diameter accommodating afeeding tube130A to allow afeeding tube130A to pass through feedingtube support extension140 in a slidable friction engagement between afeeding tube130A and the interior surface offeeding tube passage130. For these purposes, and as illustrated in FIG.10 1C, feedingtube support extension140 may include crimpedregions145 or a plurality of internal raisednubs146 disposed on theinterior surface144 of feedingtube support extension140 to prevent theplastic tube anchor140 from inadvertently sliding or supping along thefeeding tube130A. Lastly, feedingtube support extension140 may, for example, be a separate element that is secured tobase110, for example by glue or a mechanical joint, or may be cast or molded as an integral part ofbase110 andcircumferential flange120.

Afeeding tube aperture100 further includes a plurality of resilient foam “booties,” hereafter referred to asresilient spacers150, mounted to and spaced circumferentially apart from each other around thecircumference120A of second end surface11 OD withresilient spacers150 extending outwards from the second end surface11 OD. It will be noted that the number ofresilient spacers150 may vary, depending on the specific embodiment of afeeding tube aperture100, but there will typically be at least three resilient spacers and may be four, as illustrated inFIG. 1B, or five, as illustrated inFIG. 2. It must also be noted that for purposes of clarity showing other elements of afeeding tube aperture100, only two opposed mountedresilient spacers150 are illustrated inFIG. 1A; it will be understood, however, that as stated and as shown inFIGS. 1B and 2, afeeding tube aperture100 will include 3 or moreresilient spacers150, such as four or five or more.

When feedingtube aperture100 is in use, as illustrated inFIGS. 1A, 1B and 2, the feedingtube aperture100 is slidingly mounted onto afeeding tube130A and directly adjacent to the patient'sabdominal wall130C with feedingtube aperture100 oriented withfirst end surface110B and feedingtube support extension140 facing away fromabdominal wall130C of a patient andsecond end surface110D facing towardabdominal wall130C with afeeding tube130A extending from a feedingtube opening130B in theabdominal wall130C.Resilient spacers150 will then bear againstabdominal wall130C so thatsecond end surface110D will thereby be resiliently spaced apart fromabdominal wall130C.

Becauseresilient spacers150 are located around thecircumference120A ofsecond end surface110D,resilient spacers150 are thereby radially spaced apart from the feedingtube opening130B in theabdominal wall130C of a patient. Feedingtube aperture100 therefore does not exert pressure directly on feedingtube opening130B or the area immediately surrounding feedingtube opening130B and such pressure as is exerted againstabdominal wall130C by feedingtube aperture100 is resiliently cushioned and distributed over a signification area of the surroundingabdominal wall130C byresilient spacers150.

As further illustrated inFIGS. 1A, 1B and 3,resilient spacers150 occupy only a portion of thecircumference120A ofsecond end surface110D, being illustrated in the figures as approximately half or less of thecircumference120A ofsecond end surface110C. The circumferential spacing ofresilient spacers150 around thecircumference120A ofsecond end surface110D, together withsecond end surface110D of feedingtube aperture100 being spaced apart fromabdominal wall130C and feedingtube opening130B byresilient spacers150, thereby provides a relativelylarge air space110E AS betweensecond end surface110D andabdominal wall130C and a plurality of relatively largecircumferential vent passages110F betweenair space110E AS and the exterior surroundings of thefeeding tube aperture100.Axial vent passages132 throughbase110,air space110E AS betweensecond end surface110D andcircumferential vent passages110F thereby provide significantly increased air flow to and around the area betweenabdominal wall130C and feeding tube opening130B and feedingtube aperture100, thereby significantly reducing the risk of irritation, infection and necrosis of the tissues at or around feedingtube opening130B.

In a present embodiment of afeeding tube aperture100, and as illustrated inFIGS. 1A, 1B, 1D and 2, eachresilient spacer150 comprises a generally cylindrical hollow tube of resilient foam with a longitudinal opening150A extending lengthwise from end to end along thewall150B of theresilient spacer150.Resilient spacers150 are attached to feedingtube aperture100 by mounting eachresilient spacer150 at a selected location oncircumferential flange120 withcircumferential flange120 entering into longitudinal opening150A. As indicated, a first side150E of longitudinal opening150A will thereby bear againstbase110 in the region ofcircumferential surface110A and the adjoining area ofcircumferential flange120 and asecond side150C side of longitudinal opening150A will bear againstsecond end surface110D ofbase110. The resilience of the foam material comprisingresilient spacers150 will retainresilient spacers150 on feedingtube aperture100 andcircumferential flange120, butresilient spacers150 may be further secured to feeding tube aperture by, for example, an adhesive or glue. It will also be noted that the resilient of the foam material comprisingresilient spacers150 will tend to allowresilient spacers150 to conform to the curvature ofcircumferential flange120, butresilient spacers150 may be molded with a curvature matching that ofcircumferential flange120 orcircumference120A ofsecond end surface110D.

It will be further understood thatresilient spacers150 may assume other forms, such as blocks or legs of resilient foam secured tosecond end surface110D or to second end surface110G andcircumferential flange120, such as by adhesives or glue, so long as suchresilient spacers150 occupy only a portion of thecircumference120A ofsecond end surface110D and resiliently spacesecond end surface110D and feedingtube aperture100 apart fromabdominal wall130C to provide relatively large air spaces and air passages betweensecond end surface110D andabdominal wall130C with feeding tube opening130B to thereby provide significantly increased air flow to and around the area betweenabdominal wall130C and feeding tube opening130B and feedingtube aperture100. Further in this regard, it will be recognized that in the present shown exemplary embodiment of afeeding tube aperture100 of the present invention the primary function ofcircumferential flange120 is to provide a means for attaching the illustratedresilient spacers150 to thefeeding tube aperture100, and that certain alternative implementations ofresilient spacers150 may not require acircumferential flange120.

Lastly with regard to use of afeeding tube aperture100 of the present invention, it has been described above that the interior diameters and configurations of feedingtube passage130 and feedingtube support extension140 are selected to engage afeeding tube130A in a sliding frictional engagement so that thefeeding tube aperture100 will not slide inadvertently with respect to thefeeding tube130A. At the same time, the interior diameters and configurations of feedingtube passage130 and feedingtube support extension140 are selected to allow thefeeding tube aperture100 to be intentionally slide along the feedingtube130A to allow thefeeding tube aperture100 to be moved away fromabdominal wall130C and feeding tube opening130B to allow cleaning of thefeeding tube aperture100,abdominal wall130C and feedingtube opening130B, and any medical treatment that may be necessary or desirable.

In a present embodiment of afeeding tube aperture100, the axial length of feedingtube aperture100, that is ofbase110 andcircumferential flange120, is on the order of 0.75 inches and the diameter ofcircumferential flange120 is on the order of 2.00 inches and feedingtube aperture100 includes four symmetrically disposed circularaxial vent passages132 having diameters on the order of 0.5 inches while the diameter of feedingtube passage130 and thus the interior diameter of feedingtube support extension140 are selected to provide a frictional sliding fit with afeeding tube130A, typically about 0.25 inches. It will be understood, however, that these dimensions may differ from those illustrated in the exemplary present embodiment of afeeding tube aperture100, depending upon the specific application and use and the diameter of thefeeding tubes130A with which thefeeding tube aperture100 is to be used.

Lastly, in the present exemplary embodiment of afeeding tube aperture100 and feedingtube support extension140 thefeeding tube aperture100 and feedingtube support extension140 will typically be cast or molded from a plastic material and feedingtube aperture100 and feedingtube support extension140 may comprise separate pieces joined mechanically or by an adhesive or glue or may be cast or molded as a single, integral body. The material comprisingfeeding tube aperture100 and feedingtube support extension140 will preferably accommodate various sterilization processes and will preferably have smooth surfaces to reduce accumulated deposits of body fluids, liquid food or medication, to facilitate cleaning of thefeeding tube aperture100, feeding tube opening130B and theabdominal wall130C around feedingtube aperture130, and to reduce potential irritation to the patient.

While the present invention has been related in terms of the foregoing embodiments, those skilled in the art will recognize that the invention is not limited to the embodiments described. The present invention can be practiced with modification and alteration within the spirit and scope of the appended claims. Thus, the description is to be regarded as illustrative instead of restrictive on the present invention.

Claims (4)

What is claimed is:

1. A feeding tube aperture positionable at an external abdominal wall of a patient and along a feeding tube extending through the abdominal wall of the patient to support and align the feeding tube with a feeding tube opening through the abdominal wall of the patient, comprising:

a base having

a circumferential surface symmetric about an axis,

a first end surface transverse to the axis,

a second end surface transverse to the axis and facing in an axially opposite direction from the first end surface,

a centrally located feeding tube passage extending along the axis and through the base from the first end surface to the second end surface and having an interior diameter accommodating the feeding tube in a slidable frictional engagement between the feeding tube and an interior surface of the feeding tube passage,

a plurality of large axial vent passages occupying a region between the centrally located feeding tube passage and the circumferential surface and extending through the base from the first end surface to the second end surface with the plurality of large axial vent passages being disposed symmetrically around the centrally located feeding tube passage,

a hollow, cylindrical feeding tube support extension extending outwardly from the first end surface and axially centered on the axis with an interior diameter accommodating the feeding tube in a slidable frictional engagement between the feeding tube and an interior surface of the feeding tube support extension, and

a plurality of resilient spacers attached to a circumference of the second end surface and extending outward from the second end surface, the plurality of resilient spacers being spaced circumferentially apart around the circumference of the second end surface with a longitudinal axis of each of the plurality of resilient spacers extending generally along the circumference of the second end surface, so that

when the feeding tube aperture is mounted onto the feeding tube with the second end surface oriented toward and directly adjacent the abdominal wall with the plurality of resilient spacers in contact with the abdominal wall,

the feeding tube aperture is resiliently spaced from the abdominal wall by the plurality of resilient spacers, and

the plurality of resilient spacers form a common air space located between the second end surface and the abdominal wall, the air space extending from the centrally located feeding tube passage to the circumference of the second end surface and communicating with each of the plurality of large axial vent passages and with each of a plurality of circumferential vent passages formed between adjacent pairs of the plurality of resilient spacers, so that the plurality of large axial vent passages through the base, the air space between the second end surface and the abdominal wall and the plurality of circumferential vent passages allow a flow of air around the abdominal wall and the feeding tube opening in the abdominal wall during use.

2. The feeding tube aperture ofclaim 1, further comprising:

a circumferential flange located on the circumference of the second end surface and extending outwards from the second end surface, wherein

each of the plurality of resilient spacers comprises a generally cylindrical hollow tube of resilient foam with a longitudinal opening in a wall of the generally cylindrical hollow tube extending lengthwise along the longitudinal axis of each of the plurality of resilient spacers, and

each of the plurality of resilient spacers is attached to the feeding tube aperture by mounting each of the resilient spacers at a selected location on a circumference of the circumferential flange with a first side of the longitudinal opening bearing against the base in a region of the circumferential surface of the base and an adjoining surface of the circumferential flange and a second side of the longitudinal opening bearing against the second end surface of the base.

3. The feeding tube aperture ofclaim 1, further comprising:

a circumferential flange located on the circumference of the second end surface and extending outwards from the second end surface, wherein

each of the plurality of resilient spacers comprises a generally cylindrical hollow tube of resilient foam having a longitudinal opening formed in a wall of the generally cylindrical hollow tube, and

each of the plurality of resilient spacers is attached to the feeding tube aperture via engagement of the longitudinal opening with the circumference of the second end surface.

4. A medical tube aperture positionable at skin of a patient and along a medical tube extending through the skin of the patient to support and align the medical tube with a medical tube opening through the skin of the patient, comprising: a base having a circumferential surface symmetric about an axis, a first end surface transverse to the axis, a second end surface transverse to the axis and facing in an axially opposite direction from the first end surface, a centrally located medical tube passage extending along the axis and through the base from the first end surface to the second end surface and having an interior diameter accommodating the medical tube in a slidable frictional engagement between the medical tube and an interior surface of the medical tube passage, a plurality of large axial vent passages occupying a region between the centrally located medical tube passage and the circumferential surface and extending through the base from the first end surface to the second end surface with the plurality of large axial vent passages being disposed symmetrically around the centrally located medical tube passage, a hollow, cylindrical medical tube support extension extending outwardly from the first end surface and axially centered on the axis with an interior diameter accommodating the medical tube in a slidable frictional engagement between the medical tube and an interior surface of the medical tube support extension, and a plurality of resilient spacers attached to a circumference of the second end surface and extending outward from the second end surface, the plurality of resilient spacers being spaced circumferentially apart around the circumference of the second end surface with a longitudinal axis of each of the plurality of resilient spacers extending generally along the circumference of the second end surface, so that when the medical tube aperture is mounted onto the medical tube with the second end surface oriented toward and directly adjacent the skin with the plurality of resilient spacers in contact with the skin, the medical tube aperture is resiliently spaced from the skin by the plurality of resilient spacers, and the plurality of resilient spacers form a common air space located between the second end surface and the skin, the air space extending from the centrally located medical tube passage to the circumference of the second end surface and communicating with each of the plurality of large axial vent passages and with each of a plurality of circumferential vent passages formed between adjacent pairs of the plurality of resilient spacers, so that the plurality of large axial vent passages through the base, the air space between the second end surface and the skin and the plurality of circumferential vent passages allow a flow of air around the skin and the medical tube opening in the skin during use.

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