Marcos G Molina, MD, Gabriella Shull, Trenton Woodcock, Gabriel Jacobs, Charlie Phillips, Andrew Khair, PhD, Arthur Erdman, PhD, Diksha Srishyla, Marcos R Molina, MD, Robert Acton, MD, Mojca Konia, MD, PhD. University of Minnesota
A feared post-surgical complication of gastric surgery is the disruption of the staple line secondary to over distention of the stomach. To prevent this “never event” from happening a blindly-placed nasogastric tube (NGT) is usually left in place to allow drainage of excess gastric juices and/or air contents. The normal predicted path of healing allows for its prompt removal within days of surgery without usual complications. However, depending on the clinical picture, a second NGT may be deemed necessary; raising the risk of subsequent harm. Therefore, we propose the use of direct visual guidance for the secure deployment of the NGT in the post-operatively period after gastric surgery.
Our nasogastric tube prototype design consists of a single lumen (16-F) tube with a Y-port at the distal end, which allows the passage of a standard 2-millimeter neonatal bronchoscope. The distal tip of the NGT consist of a flexible component that allows the NGT to be easily directed by the bronchoscope. The lumen of the NGT is initially isolated from the external environment keeping the bronchoscope sterile during placement. For this purpose, a translucent lens-like detachable membrane has been designed. After reaching its target this membrane can be easily suctioned out when connected to wall suction and therefore opening the lumen of the tube to the exterior. At the moment, we do not have any preliminary data other than the device prototype but testing will take place using porcine anatomical models in the following months.
The future direction of this project is to completely re-engineer the NGT into a more reliable, safer and cost effective diagnostic and therapeutic tool. We envisioned that the proposed NGT design and direct visual deployment mechanism could be widely used in a broader set of clinical indications and serve as an alternative to the current classical NGT insertion method. In this manner, by using a direct visual confirmation modality we will aim to reduce the healthcare-related costs of confirmatory X-rays and the patient exposure to unnecessary radiation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 84320
Program Number: ETP739
Presentation Session: Emerging Technology Poster
Presentation Type: Poster