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Pediatrics Gastrointestinal Device

<< 2014 Projects

 Pediatric Gastrostomy Button with Leakage Reducing Secondary Balloon


Need: A way to prevent tube leakage in pediatric buttons to maximize patient comfort and device longevity.

 

Abstract

Eighty percent of pediatric patients with delayed development have some form of feeding disorder, bringing forth severe consequences such as growth retardation and even death. To combat this problem, gastrostomy buttons (silicone feeding devices) are implanted in the abdominal wall. The gastrostomy button brings nutritional formula and medication directly into the stomach of patients with neurological, metabolic, swallowing, and general feeding disorders. Gastrostomy buttons can be replaced at home rather than in a clinical setting, and have an incremental range of diameters (12-24 Fr) and lengths (0.8-6.5cm). Most utilize a flexible silicone balloon that receives distilled water via the balloon port, anchoring the button in place.

Our team concentrated on tube leakage, a major complication with negative consequences such as skin irritation, infection, and discomfort from frequent replacement. These complications result in additional expenses associated with replacement and infection medication. Because of the limited sizing increments, gastric fluid can travel up the stoma to the skin when the tubing girth does not properly fit the stoma. Similarly, broken or round-shaped balloons can also lead to leaking of gastric contents.

After brainstorming three primary concepts, we chose to prototype our expandable tube girth concept, as we felt it addressed leakage while also increasing device longevity and patient comfort. This prototype features a secondary balloon around the portion of the tube in contact with the stoma. The secondary balloon inflates with water through an additional port to block fluid from leaking through the stoma. The secondary balloon port, located 120° from the original port and the balloon cap, allows for a triangular external bolster design that reduces exclusive pressure from the original valve. The flat balloon adapted from the AMT Mini One button contours against the abdominal wall to increase stoma blockage. Our design diminishes leakage, increases comfort, and increases device longevity.

(Left to right)  Linda Xia, Hansmeet Singh, Meredith Nix, and Brandon Huang with graduate student mentor, Sungjin Park. The group investigated how to improve a pediatric ‘gastronomy button’ or feeding device which interfaces with the abdominal wall for patients who have delayed gastric development. They incorporated balloons into their design to decrease leakage and increase device longevity as it adapts to patients' growth.

Click here to see the group's poster.