Editing Naso-jejunal tubes (section)

== Freka ==

* Polyurethane tubes (silicone version 8, 13, 16Fr)
* ENFit connectors
* Radio-opaque stripe
* Sizes 8-15Fr

=== '''Single-lumen gastric''' ===

**
** '''Freka linear'''
***
*** Available 8-15Fr
*** ~$40
***
** '''Freka Y-connector'''
***
*** Available 8-15Fr

=== '''Single-lumen jejunal''' ===

** '''Freka Endolumina'''
***
***
*** Single-lumen tube
*** Can be paced through the working channel of a standard gastroscope (just need >=2.8mm channel)
*** Flexible tube length
*** Radio-opaque
*** 8Fr, 270cm, external diameter 2.6mm
*** ~$140

=== '''Multi-lumen''' ===

** '''Freka Trelumina'''
***
***
*** B - intestinal lumen for jejunal feeding - 9Fr, 150cm
*** C - gastric ventilation lumen, for pressure regulation during suction with valve - 16Fr, 95cm. This part has an external diameter of 5.3mm.
*** D - gastric decompression lumen - funnel connector
*** Can't be cut shorter
*** Can be used for gastric decompression via active aspiration, gravity or active wall suction.
*** ~$260
*** Push method:
**** Insert the tube to stomach
**** Follow down with gastroscope
**** Grasp the tip and carry it to duodenum
**** Push tip forward to ligament of Treitz
**** Once in final position, remove the mandrin (wire)
**** Pull scope back to stomach, but keep the position of the tip constant with forceps
**** Retract forceps to endoscope, and remove both
**** Fix to nose
**** Post-scope XR
*** Seldinger method
**** >3.5m guidewire (Jagwire 450cm 0.035-inch straight-tip guidewire is a good choice)
**** Advance gastroscope as far as possible into duodenum
**** Insert wire through working channel, as far as ligament of Treitz
**** Withdraw scope while pushing wire gently in other direction
**** Re-route the wire from mouth to nose - insert the blue re-routing catheter which comes in the packet through the nose, then pull it out through the mouth with Magill forceps, then feed the wire through it until it comes out the nose. To avoid dislocation during this procedure, fix the oesophageal end of the wire in mouth with Magill forceps.
**** Flush Freka with water and remove mandrin from the Freka Trelumina
**** Feed the Freka over the wire, while the wire is fixed at nostril
** '''Freka EasyIn'''
***
*** A - gastric decompression - 16Fr
*** B - ENFit for intestinal feeding - 8Fr
*** External diameter 2.6mm - can be placed through a gastroscope with a working channel at least 2.8mm.
*** Can be shortened
*** Radio-opaque throughout
*** Can be used for gastric decompression by active aspiration or gravity drainage, but not by active suction, due to the absence of a gastric ventilation port.
*** ~$260

[[Category:Nutrition]]