guidewire final presentation apr 12
TRANSCRIPT
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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
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Gastro-jejunal procedure
What is it?
Placement of feeding tube into the patient’s jejunum
Addresses infants that cannot swallow
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Gastro-jejunal procedure
Accommodations for infants:
Alternative to nasogastric/ nasoentric procedure
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Surgical procedure steps
1. Endoscope placement
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Surgical procedure steps
1. Endoscope placement
2. Guidewire placement
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Surgical procedure steps
1. Endoscope placement
2. Guidewire placement
3. Endoscope removal
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Surgical procedure steps
1. Endoscope placement
2. Guidewire placement
3. Endoscope removal4. Placement of
feeding tube and removal of guidewire
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Final result
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Kimberly-Clark feeding tube
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Savary-Gilliard guidewire
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Problems
Upon guidewire removal:
Uncoiling of tip
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Problems
Upon guidewire removal:
Uncoiling of tip
Damage to feeding tube valve
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Objectives
main objective:
design a guidewire for use with GJ feeding tube insertion
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Objectives
Maintain Flexibility Sterilizability Biocompatibility
Implement Better interaction with feeding tube Reusability Low cost
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Our solution
Small, constant diameter▪ Unlike Savary-
Gilliard guidewire
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Our solution
Small, constant diameter
Reinforcing brace▪ Demonstration vide
o
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Advantages
Constant diameter▪ Minimal valve/coil issues
Reinforcing brace▪ More tensile strength
Biocompatible▪ Nitinol, stainless steel
Reusable
prevent uncoilin
g
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Manufacturing modification
ORIGINAL MODIFIED
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Manufacturing modification
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Manufacturing modification
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Our Prototype
Specifications Stainless steel tail
and coil Nitinol brace Uniform diameter
ourprototype
Savary-Gilliard
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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
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Force Testing
Force vs. position▪ Testing video
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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)
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Looking Ahead
More testing Biocompatibility Paper work
Confidentiality agreements patenting FDA approval
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