Method and apparatus for emplacement of a gastrostomy catheter

An apparatus for providing access through an opening in a surface, comprising:

• an elongate tube having a proximal end, a distal end, and a main body, with an access passage through the tube;
• anchoring means attached to said distal end for anchoring said elongate tube at said opening, said anchoring means having a first configuration wherein an outer diameter of said anchoring means is substantially equal to an outer diameter of said tube, and having a second configuration wherein said anchoring means outer diameter is greater than said tube outer diameter;
• means for retaining said anchoring means in said second configuration;
• means for manipulating said anchoring means into each of said first and second configurations, for insertion of said anchoring means and a portion of the tube through the opening while said anchoring means is in said first configuration, and for manipulating said anchoring means into said second configuration;
• wherein said anchoring means includes a first end, a second end, and a middle portion, said middle portion including a plurality of legs, each leg having a first section and a second section, and wherein each said first section is attached in a hinged fashion to said first end, and each said second section is attached in a hinged fashion to said second end, and each said first section is attached in a hinged fashion to at least one said second section, such that when said first and second ends are pulled away from one another, said anchoring means takes on said first configuration such that each said first section is substantially collinear with one said second section, and such that when said first and second ends are pushed towards one another, said anchoring means takes on said second configuration such that each said first section is substantially parallel and adjacent to at least one said second section;
• and wherein each of said first sections has a first length and each of said second sections has a second length which is shorter than said first length.

An apparatus for providing access through an opening in a surface, comprising:

• an elongate tube having a proximal end, a distal end, and a main body, with an access passage through the tube;
• anchoring means attached to said distal end for anchoring said elongate tube at said opening, said anchoring means having a first configuration wherein an outer diameter of said anchoring means is substantially equal to an outer diameter of said tube, and having a second configuration wherein said anchoring means outer diameter is greater than said tube outer diameter;
• means for retaining said anchoring means in said second configuration;
• and
• means for manipulating said anchoring means into each of said first and second configurations, for insertion of said anchoring means and a portion of the tube through the opening while said anchoring means is in said first configuration, and for manipulating said anchoring means into said second configuration;
• wherein said anchoring means includes a first end, a second end, and a middle portion, said middle portion including a plurality of legs, each leg having a first section and a second section, wherein each said first section is attached in a hinged fashion to said first end, and each said second section is attached in a hinged fashion to said second end, and each said first section is attached in a hinged fashion to at least one said second section, such that when said first and second ends are pulled away from one another, said anchoring means takes on said first configuration such that each said first section is substantially collinear with one said second section, and such that when said first and second ends are pushed towards one another, said anchoring means takes on said second configuration such that each said first section is substantially parallel and adjacent to at least one said second section;
• wherein each second end includes a bore in communication with said tube;
• wherein said manipulating means includes an insertion tool and means disposed within said second end bore for coacting with said insertion tool for pushing said anchoring means into said first configuration and for pulling said anchoring means into said second configuration;
• and wherein said insertion tool includes a bore for receiving a wire disposed in the opening in the surface.

A method for emplacement of a catheter into a patient, said catheter including a distal end having an expandable and collapsible anchor, including the steps of:

• (1) interlocking an insertion tool with the anchor without applying longitudinal force to the anchor;
• (2) passing the interlocked insertion tool and anchor into the patient such that the anchor enters the patient in its collapsed configuration;
• (3) manipulating the insertion tool such that the anchor is expanded;
• and
• (4) removing the insertion tool without applying longitudinal force to the anchor, leaving the anchor within the patient.

A method of emplacement of a catheter into a patient, said catheter including a distal end having an expandable and collapsible anchor, including the steps of:

• (1) inserting a needle into the patient, the needle having a lumen therethrough, thereby forming an opening;
• (2) inserting a guide wire through the lumen of the needle;
• (3) removing the needle;
• (4) interlocking an insertion tool with the anchor;
• (5) passing the interlocked insertion tool and anchor into the patient such that the anchor enters the patient in its collapsed configuration;
• (6) manipulating the insertion tool such that the anchor is expanded;
• and
• (7) removing the insertion tool, leaving the anchor within the patient;
• wherein the insertion tool is provided with a bore therethrough, and wherein step 5 includes the step of passing the bore over the guide wire for guiding it into the opening.

An anchor, comprising:

• a first section;
• a second section;
• a middle section having a first end attached in a hinged fashion to said first section and a second end attached in a hinged fashion to said second section, said middle section having at least two configurations, namely an expanded configuration wherein the anchor has an enlarged diameter and a first collapsed configuration wherein the anchor has a reduced diameter;
• means for grasping said second section and moving it in a first direction relative to said first section, such that said middle section takes on its expanded configuration, said grasping means also being for moving said second section in a second direction relative to said first section, such that said middle section takes on said first collapsed configuration;
• and
• means, attached to said anchor, for maintaining said middle section in said expanded configuration, said maintaining means including means for increasing resistance to repositioning to said first collapsed configuration when a radial force is applied to said middle section.

An anchor, comprising:

• a first section;
• a second section;
• a middle section having a first end attached in a hinged fashion to said first section and a second end attached in a hinged fashion to said second section, wherein said middle section includes at least one first segment attached by a first hinge to said first section, at least one said second segment attached by a second hinge to said second section;
• and means for attaching said first segment in a hinged fashion to said second segment;
• said middle section having at least two configurations, namely an expanded configuration of enlarged diameter and a first collapsed configuration of reduced diameter, wherein said middle section in said first collapsed configuration has a diameter substantially equal to a diameter of said first section, and in said expanded configuration has a diameter larger than said diameter of said first section;
• means for grasping said second section and moving it in a first direction relative to said first section, such that said middle section takes on its expanded configuration, said grasping means also being for moving said second section in a second direction relative to said first section, such that said middle section takes on said first collapsed configuration;
• and
• means for maintaining said middle section in said expanded configuration, wherein said maintaining means comprises means for preventing relative motion of said first and second segments, wherein said preventing means includes an elastic membrane positioned over said middle section and attached to at least one of said first and second sections, said membrane being in a stretched state when said middle section is in said expanded configuration, for exerting an axially inward force on said middle section.

An anchor, comprising:

• a first section;
• a second section;
• a middle section having a first end attached in a hinged fashion to said first section and a second end attached in a hinged fashion to said second section, wherein said middle section includes at least one first segment attached by a first hinge to said first section, at least one said second segment attached by a second hinge to said second section;
• and means for attaching said first segment in a hinged fashion to said second segment;
• said middle section having at least two configurations, namely an expanded configuration of enlarged diameter and a first collapsed configuration of reduced diameter, wherein said middle section in said first collapsed configuration has a diameter substantially equal to a diameter of said first section, and in said expanded configuration has a diameter larger than said diameter of said first section;
• means for grasping said second section and moving it in a first direction relative to said first section, such that said middle section takes on its expanded configuration, said grasping means also being for moving said second section in a second direction relative to said first section, such that said middle section takes on said first collapsed configuration;
• and
• means for maintaining said middle section in said expanded configuration, wherein said maintaining means comprises means for preventing relative motion of said first and second segments, wherein said preventing means includes means for interlocking said first and second segments to one another when said middle section is in said expanded configuration.

An anchor, comprising:

• a first section;
• a second section;
• a middle section having a first end attached in a hinged fashion to said first section and a second end attached in a hinged fashion to said second section, wherein said middle section includes at least one first segment attached by a first hinge to said first section, at least one said second segment attached by a second hinge to said second section;
• and means for attaching said first segment in a hinged fashion to said second segment;
• said middle section having at least two configurations, namely an expanded configuration of enlarged diameter and a first collapsed configuration of reduced diameter, wherein said middle section in said first collapsed configuration has a diameter substantially equal to a diameter of said first section, and in said expanded configuration has a diameter larger than said diameter of said first section;
• means for grasping said second section and moving it in a first direction relative to said first section, such that said middle section takes on its expanded configuration, said grasping means also being for moving said second section in a second direction relative to said first section, such that said middle section takes on said first collapsed configuration;
• and
• means for maintaining said middle section in said expanded configuration, wherein said maintaining means comprises means for preventing relative motion of said first and second segments, wherein said preventing means includes means for interlocking said first and second sections to one another when said middle section is in said expanded configuration.

An apparatus for inserting a tube through an opening, the tube including a proximal end and a distal end, including:

• anchoring means attached to said distal end of the tube for anchoring the tube at said opening, said anchoring means having a first resting configuration wherein an outer diameter of said anchoring means is no greater than approximately a diameter of said tube, and having a second resting configuration wherein said outer diameter of said anchoring means is greater than said diameter of said tube;
• means for manipulating said anchoring means into each of said first and second configurations, for insertion of said anchoring means through the opening while said anchoring means is in said first configuration, and for maintaining the tube in place relative to the opening while said anchoring means is in said second configuration;
• and
• means, attached to said anchoring means, for maintaining said anchoring means in said second resting configuration, said maintaining means including means for increasing resistance to repositioning to said first resting configuration when a radial force is applied to said anchoring means.

A method of emplacement of a tube into an opening, the tube including a lumen and a distal end and an anchor attached to the distal end, where the anchor has a bore in communication with the lumen, including the steps of:

• (1) interlocking an insertion tool with the anchor without applying longitudinal force to the anchor;
• (2) passing the anchor through the opening by means of the insertion tool, with the anchor in a first configuration wherein an outer diameter of the anchor is no greater than approximately an outer diameter of the tube;
• (3) manipulating the anchor from within the bore, by means of the insertion tool, such that the anchor is moved into an expanded configuration wherein the outer diameter of the anchor is greater than the outer diameter of the tube, such that the tube seats within the opening with the anchor on one side of the opening;
• and
• (4) unlocking the insertion tool from the anchor, without applying longitudinal force to the anchor, and removing the insertion tool.