Contrast Imaging

If there is concern with the patency of the distal tract, contrast imaging is recommended. If there is no distal anastomosis, it may not be needed. Contrast imaging ensures the distal intestine is patient for chyme reinfusion.

Tube Size

A generic ENFit feeding tube with a gauge of 6 Fr is recommended with The Insides® Neo. The connector must be ENFit to be able to work with The Insides® Neo. If the patient’s chyme is thicker, an 8 Fr generic ENFit feeding tube may be necessary.

Nutrition

The Insides® Neo is started when a patient is stabilised on either nasogastric, orogastric and/or parenteral nutrition, supplemented with breast milk, for their nutritional needs. As the patient progresses on The Insides® Neo and breast milk is increased, the nasogastric, orogastric and/or parenteral nutrition requirements can reduce.

Sepsis

All infective sources must be resolved before starting The Insides® Neo

Prolapsed or Herniated stomas

After careful clinical evaluation, patients may be able to use/continue to use The Insides® Neo if a generic ENFit feeding tube can safely be inserted and secured in the distal limb of the stoma.

Contraindications to reinfusing chyme into the distal limb

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• Trophic Feeds‍
  • If a patient can only tolerate trophic feeds (1ml every 4 hours to keep the distal intestine ‘open’), this is a contraindication until further clinical assessment is undertaken.

• Imperforate Anus‍
  • The Insides® Neo can only be used to perform chyme reinfusion once successful dilation of the neo anus is achieved.‍

• ‍Hirschsprung’s‍
  • The Insides® Neo cannot be used to perform chyme reinfusion with patients who have Hirschsprung’s disease.

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