BACKGROUND: With present techniques, transpyloric feeding tube placement is unreliable. This study evaluated a new nasoduodenal tube placed through a gastroscope. METHODS: A therapeutic gastroscope was advanced into the distal duodenum, and through the 3.7-mm channel this feeding tube was advanced under direct vision into the small bowel. The tube/guidewire combination was then advanced with the concomitant equidistant retraction of the scope until the wire could be grasped at the lips and exchanged to the nose using a nasal transfer tube. The guidewire was removed, and a "Y" connector was then attached to the end of the tube. RESULTS: Successful tube placement in all 21 patients (14M/7F) required an endoscopy time of 31 +/- 3.3 min and the tubes were utilized for 9.24 +/- 0.94 days. Tube tips were confirmed in the distal duodenum (10) or proximal jejunum (11) by radiographic contrast injection. CONCLUSION: This new through-the-scope tube can be placed in the distal duodenum quickly, safely, and consistently.
BACKGROUND: With present techniques, transpyloric feeding tube placement is unreliable. This study evaluated a new nasoduodenal tube placed through a gastroscope. METHODS: A therapeutic gastroscope was advanced into the distal duodenum, and through the 3.7-mm channel this feeding tube was advanced under direct vision into the small bowel. The tube/guidewire combination was then advanced with the concomitant equidistant retraction of the scope until the wire could be grasped at the lips and exchanged to the nose using a nasal transfer tube. The guidewire was removed, and a "Y" connector was then attached to the end of the tube. RESULTS: Successful tube placement in all 21 patients (14M/7F) required an endoscopy time of 31 +/- 3.3 min and the tubes were utilized for 9.24 +/- 0.94 days. Tube tips were confirmed in the distal duodenum (10) or proximal jejunum (11) by radiographic contrast injection. CONCLUSION: This new through-the-scope tube can be placed in the distal duodenum quickly, safely, and consistently.