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Guidewire Final Presentation Apr 12

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Guidewire Final Presentation Apr 12

  1. 1. Gastro-Jejunal Feeding Tube Guide Wire for Infants<br />Dr. RiadRahhal, Director, Pediatric Gastroenterology Fellowship Program<br />University of Iowa Children's Hospital<br />Department of Pediatrics<br />ArunanArivalagan, Ahmad El-Hattab, Sean Ephraim, Ryan Hoeman<br />Biomedical Engineering, University of Iowa, Iowa City, IA<br />Toby Donjakowski, Medical Device Specialist<br />
  2. 2. Gastro-jejunal procedure<br />What is it?<br />Placement of feeding tube into the patient’s jejunum<br />Addresses infants that cannot swallow<br />
  3. 3. Gastro-jejunal procedure<br />Accommodations for infants:<br />Alternative to nasogastric/ nasoentric procedure<br />
  4. 4. Surgical procedure steps<br />Endoscope placement<br />
  5. 5. Surgical procedure steps<br />Endoscope placement<br />Guidewire placement<br />
  6. 6. Surgical procedure steps<br />Endoscope placement<br />Guidewire placement<br />Endoscope removal<br />
  7. 7. Surgical procedure steps<br />Endoscope placement<br />Guidewire placement<br />Endoscope removal<br />Placement of feeding tube and removal of guidewire<br />
  8. 8. Final result<br />
  9. 9. Kimberly-Clark feeding tube<br />
  10. 10. Savary-Gilliard guidewire<br />
  11. 11. Problems<br />Upon guidewire removal:<br />Uncoiling of tip<br />
  12. 12. Problems<br />Upon guidewire removal:<br />Uncoiling of tip<br />Damage to feeding tube valve<br />
  13. 13. Objectives<br />main objective:<br />design a guidewirefor use with GJ feeding tube insertion<br />
  14. 14. Objectives<br />Maintain<br />Flexibility<br />Sterilizability<br />Biocompatibility<br />Implement<br />Better interaction with feeding tube<br />Reusability<br />Low cost<br />
  15. 15. Our solution<br />Small, constant diameter<br />Unlike Savary-Gilliard guidewire<br />
  16. 16. Our solution<br />Small, constant diameter<br />Reinforcing brace<br />Demonstration video<br />
  17. 17. Advantages <br />Constant diameter<br />Minimal valve/coil issues<br />Reinforcing brace<br />More tensile strength<br />Biocompatible<br />Nitinol, stainless steel<br />Reusable<br />prevent uncoiling<br />
  18. 18. Manufacturing modification<br />ORIGINAL<br />Modified<br />
  19. 19. Manufacturing modification<br />
  20. 20. Manufacturing modification<br />
  21. 21. Our Prototype<br />Specifications<br />Stainless steel tail and coil<br />Nitinol brace<br />Uniform diameter<br />our<br />prototype<br />Savary-Gilliard<br />
  22. 22. Comparison<br />Our prototype<br />Body diameter<br />0.040 inches<br />Coil diameter<br />0.041 inches<br />Coil reinforcement<br />Nitinol brace<br />Savary-gilliard<br />Body diameter<br />0.031 inches<br />Coil diameter<br />0.070 inches<br />No coil reinforcement<br />nearly<br />constant<br />
  23. 23. Force Testing<br />Force vs. position<br />Testing video<br />
  24. 24. Test Results and Discussion<br />
  25. 25. Looking Ahead<br />More testing<br />Biocompatibility<br />Paper work<br />Confidentiality agreements<br />patenting<br />FDA approval<br />

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