guidewire final presentation apr 12
TRANSCRIPT
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