Image: The PUMA-G external and balloon magnets (Photo courtesy of CoapTech)
A novel percutaneous ultrasound gastrostomy (PUG) system allows physicians to place feeding tubes at the point of care, using solely ultrasound imaging.
The CoapTech (Baltimore, MD, USA) PUMA-G System is based on two units; a small magnet placed inside a balloon catheter that is inserted into the stomach over a guidewire, and a strong external magnet that attracts the smaller magnet in the balloon to the insertion area. An ultrasound probe is used to examine the tissues between the skin surface and the stomach so as to realign the balloon catheter until a suitable insertion area is determined that does not impinge on internal organs, major blood vessels, or other critical anatomy.
Once the optimal site has been identified, the enteral gastrostomy feeding tube can be safely placed over the guidewire, using standard dilators to expand the tract. Benefits of the system include an enhanced safety profile, as there is no endoscope, no ionizing radiation, and no risk of organ damage due to blind sticks; and cost-effectiveness, as the PUMA-G delivers a 30-50% reduction in hospital costs, major savings from shorter lengths of stay, and revenue enhancement through optimization of suite productivity.
“The inspiration for this product came after seeing countless patients needing a simple G-tube insertion or replacement who needlessly wound up staying multiple days in the hospital waiting for a specialist and an operating room to be available,” said Steven Tropello, MD, founder and chief medical officer of CoapTech. “Clinicians trained in POC ultrasound will be able to utilize the PUMA-G System to safely and swiftly place a G-tube at the bedside, which should keep patients progressing on their journey towards recovery and home.”
Gastrostomy is the creation of an artificial external opening into the stomach for nutritional support or gastric decompression using a feeding tube. Typically this includes an incision in the patient's epigastrium through a surgical approach, a percutaneous approach by interventional radiology, or a percutaneous endoscopic gastrostomy (PEG).