MIC Transgastric-Jejunal Feeding Tube is also intended for individuals who require both gastric decompression and jejunal feeding. Available in a variety of sizes to accommodate different patient demands.

Indications For Use

MIC Gastric-Jejunal feeding tube is recommended for patients who struggle with stomach absorption, have intestinal motility issues, gastric outlet obstruction, severe gastroesophageal reflux, are at risk of aspiration, or have had a previous esophagectomy.

Contraindications

Contraindications for placement of a Gastric-Jejunal feeding tube include, but are not limited to, ascites, colonic interposition, portal hypertension, peritonitis, and morbid obesity.

MIC Transgastric-Jejunal Feeding Tube Kit Contents:

• 1 – Secur-Lok Ring
• 1 – Coated Guidewire
• 1 – Instructions for Use
• 1 – Water Soluble Lubricant
• 1 – Patient Care Guidelines
• 1 – 35 ml Catheter Tip Syringe
• 1 – Gastric-Jejunal Feeding Tube
• 1 – Luer Slip Syringe – Prefilled w/ 10 ml Water

Complications

The following complications may be associated with any Gastric-Jejunal feeding tube:

• Infection
• Perforation
• Intussusception
• Skin Breakdown
• Pressure Necrosis
• Hypergranulation Tissue
• Intraperitoneal Leakage
• Stomach or Duodenal Ulcers

Placement

MIC Gastric-Jejunal feeding tube may be placed percutaneously under fluoroscopic or endoscopic guidance or as a replacement to an existing device using an established stoma tract.

Caution: A gastropexy must be performed to affix the stomach to the anterior abdominal wall, the feeding tube insertion site identified, and the stoma tract dilated before initial tube insertion to ensure patient safety and comfort. The length of the tube should be sufficient to be placed 10–15 cm beyond the Ligament of Treitz.

Caution: Do not use the retention balloon of the feeding tube as a gastropexy device. The balloon may burst and fail to attach to the stomach to the anterior abdominal wall.

Instructions for Use

MIC GJ Gastric-Jejunal Feeding Tube is a single-unit feeding/drainage device. It enters the stomach through a gastric stoma. A balloon inside the stomach seals the internal stoma to prevent stomach contents from leaking around the stoma. The external SECUR-LOK* ring holds the tube and the balloon in place. The feeding/jejunal port is labeled JEJUNAL. It delivers nutrients to the small intestine. This port features a “universal connector” to adapt to standard feeding sets. The side port is labeled GASTRIC. Use it to drain the stomach. It connects to suction or gravity drainage. A third port labeled BAL is used to inflate and deflate the balloon.

Jejunal Feeding

Warning: Never connect the jejunal port to suction. Do not measure residuals from the jejunal port.

• Assemble the equipment: Formula, Feeding set, Catheter-tip irrigating syringe, Enteral feeding pump, Water for flushing the tube.
• Wash your hands with soap and water. Rinse and dry them thoroughly.
• Before starting the feeding, it is important to verify that your tube is in the correct position. Look at the centimeter numbers on the tube. Compare them to the numbers recorded in the information section. If they are different, adjust the tube and the ring. Refer to the tube care section for more details.
• Shake the formula and wipe the container tops before opening. If you do not use all the formula, cover the open container, record the date and time, and store it in the refrigerator. Throw away formula more than 24 hours old. Do not mix the new formula with the old formula. There is always a chance it will spoil.
• Pour the formula into the feeding bag.
• Inject 30 mL of water into the jejunal port. Use the 35 ml irrigating syringe from your kit.
• Run the formula through the feed set tubing to reduce the amount of air entering the stomach. Attach the tubing to the enteral feeding pump. Follow the manufacturer’s directions to set the pump.
• Insert the feed set into the jejunal port of the MIC* tube. Push the set into the port and twist 1/4 turn. This secures the set to the “universal connector” inside the MIC* tube’s feeding port.
• If the feed set tubing has a clamp, open it.
• Start the feeding pump.
• Flush the jejunal and gastric ports EVERY SIX HOURS WITH AT LEAST 30 ml WATER. DO NOT USE FORCE.
• If you see a formula in the gastric drainage, stop the feeding and notify the specialist.

Gastric Decompression

Some specialists recommend decompressing the stomach (letting the air or fluid out) before or after feeding. FOLLOW YOUR SPECIALIST’S INSTRUCTIONS. Open the gastric (side) port and connect it to gravity drainage or low intermittent suction. This allows stomach contents and/or gas to escape. Flush the gastric port EVERY SIX HOURS with at least 30 ml of water. Do not use continuous or high intermittent suction. High pressure could collapse the tube or injure the stomach tissue and cause bleeding.

DO’S

• DO Use a feeding pump to give formula.
• DO Keep the gastric and jejunal ports clean.
• DO Wash the tube and SECUR-LOK ring often.
• DO Adjust the SECUR-LOK 3 mm from the skin.
• DO Use commercially prepared formula for jejunal feeding.
• DO Dispose of unused formula after 24 hours from opening
• DO Irrigate both ports every six hours with a MINIMUM of 30 ml of water.

DON’TS

• DON’T let the formula sit in the tube.
• DON’T Use any diet not prescribed by your Health Care Provider.
• DON’T fill the balloon with air, medications, or food.
• DON’T push the ring tightly onto the abdomen.
• DON’T Clamp the tube with instruments that may damage the tube.
• DON’T Use oil-based lubricants.
• DON’T Use gravity or bolus feedings through the jejunal port.
• DON’T use suction on the jejunal port or check for residual.
• DON’T Rotate the tube in a circle.
• DON’T tape the ring to the skin.
• DON’T let the formula sit in the tube.
• DON’T attempt to clear an obstruction with a wire or anything else; you could puncture the tube.

Note: Verify package integrity. Do not use if the package is damaged or the sterile barrier compromised.

Note: The risk for perforation may be higher in patients weighing <10kg.