Method for implanting a percutaneous endoscopic gastrostomy/jejunostomy tube in a patient and access needle for use in said method

Abstract

Method for implanting a percutaneous endoscopic jejunostomy tube in a patient and access needle for use in the method. In one embodiment, the method comprises the steps of (a) providing an access needle wherein the distal end of the stylet extends distally for an appreciable distance beyond the distal end of the cannula; (b) inserting the stylet, but not the cannula, into the jejunum; (c) grabbing the stylet with an endoscopically-positioned snare; (d) anchoring the jejunum against the abdominal wall of the patient using the snared stylet; (e) loosening the snare slightly while advancing the cannula into the jejunum and into the loosened snare; (f) tightening the snare around the cannula; (g) removing the stylet from the cannula; (h) inserting a guide wire or suture through the cannula and into the jejunum; and (i) proceeding in the conventional fashion to implant a PEJ tube into the patient using the guide wire or suture.

What is claimed is:  
     
         1 . A method for implanting a percutaneous endoscopic jejunostomy tube in a patient, said method comprising the steps of: 
 (a) providing an access needle, the access needle comprising a stylet and a cannula, the stylet being removably insertable into the cannula, wherein the distal end of the stylet extends distally for an appreciable distance beyond the distal end of the cannula;    (b) inserting the stylet, but not the cannula, into the jejunum;    (c) grabbing the stylet with an endoscopically-positioned snare;    (d) anchoring the jejunum against the abdominal wall of the patient using the snared stylet;    (e) loosening the snare slightly while advancing the cannula into the jejunum and into the loosened snare;    (f) tightening the snare around the cannula;    (g) removing the stylet from the cannula;    (h) inserting a guide wire or suture through the cannula and into the jejunum; and    (i) using the guide wire or suture to implant a PEJ tube into the patient.    
     
     
         2 . The method as claimed in  claim 1  wherein the distal end of the stylet extends distally beyond the distal end of the cannula by about 1.5 inch.  
     
     
         3 . The method as claimed in  claim 1  wherein the distal end of the cannula has a marking to facilitate distinguishing the cannula from the stylet.  
     
     
         4 . The method as claimed in  claim 1  wherein the access needle further includes a cannula hub fixed to the proximal end of the cannula and a stylet hub fixed to the proximal end of the stylet, said cannula hub being removably securable to said stylet hub to prevent unwanted longitudinal movement of said stylet relative to said cannula.  
     
     
         5 . The method as claimed in  claim 4  wherein said cannula hub and said stylet hub are threadingly engageable with one another.  
     
     
         6 . An access needle, said access needle comprising: 
 (a) a cannula, said cannula having a proximal end and a distal end;    (b) a cannula hub, said cannula hub being fixed to said proximal end of said cannula;    (c) a stylet, said stylet having a proximal end and a distal end and being removably insertable into said cannula; and    (d) a stylet hub, said stylet hub being fixed to said proximal end of said stylet, said stylet hub being removably securable to said cannula hub to prevent unwanted longitudinal movement of said stylet relative to said cannula;    (e) wherein the distal end of said stylet extends distally for an appreciable distance beyond the distal end of said cannula when said stylet hub is secured to said cannula hub.    
     
     
         7 . The access needle as claimed in  claim 6  wherein the distal end of said stylet extends distally about 1.5 inch beyond said cannula.  
     
     
         8 . The access needle as claimed in  claim 6  wherein said cannula has a length that is approximately two-thirds the length of said stylet.  
     
     
         9 . The access needle as claimed in  claim 6  wherein the distal end of said cannula has a marking to facilitate distinguishing said cannula from said stylet.  
     
     
         10 . The access needle as claimed in  claim 9  wherein said marking is a chemically-etched band located at the distal end of said cannula.  
     
     
         11 . The access needle as claimed in  claim 6  wherein said stylet is solid.  
     
     
         12 . The access needle as claimed in  claim 6  wherein each of said cannula hub and said stylet hub is provided with gripping elements.  
     
     
         13 . The access needle as claimed in  claim 6  wherein said cannula hub and said stylet hub are threadingly engageable with one another.