Gastro-Jejunal Feeding Tube Guide Wire for InfantsDr. Riad Rahhal, Director, Pediatric Gastroenterology Fellowship ProgramUniversity of Iowa Children's HospitalDepartment of Pediatrics

Arunan Arivalagan, Ahmad El-Hattab, Sean Ephraim, Ryan HoemanBiomedical Engineering, University of Iowa, Iowa City, IA

Toby Donjakowski, Medical Device Specialist

Gastro-jejunal procedure

What is it?

Placement of feeding tube into the patient’s jejunum

Addresses infants that cannot swallow

Gastro-jejunal procedure

Accommodations for infants:

Alternative to nasogastric/ nasoentric procedure

Surgical procedure steps

1. Endoscope placement

Surgical procedure steps

1. Endoscope placement

2. Guidewire placement

Surgical procedure steps

1. Endoscope placement

2. Guidewire placement

3. Endoscope removal

Surgical procedure steps

1. Endoscope placement

2. Guidewire placement

3. Endoscope removal4. Placement of

feeding tube and removal of guidewire

Final result

Kimberly-Clark feeding tube

Savary-Gilliard guidewire

Problems

Upon guidewire removal:

Uncoiling of tip

Problems

Upon guidewire removal:

Uncoiling of tip

Damage to feeding tube valve

Objectives

main objective:

design a guidewire for use with GJ feeding tube insertion

Objectives

Maintain Flexibility Sterilizability Biocompatibility

Implement Better interaction with feeding tube Reusability Low cost

Our solution

Small, constant diameter▪ Unlike Savary-

Gilliard guidewire

Our solution

Small, constant diameter

Reinforcing brace▪ Demonstration vide

o

Advantages

Constant diameter▪ Minimal valve/coil issues

Reinforcing brace▪ More tensile strength

Biocompatible▪ Nitinol, stainless steel

Reusable

prevent uncoilin

g

Manufacturing modification

ORIGINAL MODIFIED

Manufacturing modification

Manufacturing modification

Our Prototype

Specifications Stainless steel tail

and coil Nitinol brace Uniform diameter

ourprototype

Savary-Gilliard

Comparison

OUR PROTOTYPE

Body diameter 0.040 inches

Coil diameter 0.041 inches

Coil reinforcement Nitinol brace

SAVARY-GILLIARD

Body diameter 0.031 inches

Coil diameter 0.070 inches

No coil reinforcement

nearlyconstant

Force Testing

Force vs. position▪ Testing video

Test Results and Discussion

1 2 30.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00Static Frictional Force

Savary

Protoype

Coil Position

Fo

rce (

N)

Looking Ahead

More testing Biocompatibility Paper work

Confidentiality agreements patenting FDA approval