Abstract:
A low profile adaptor is disclosed to reduce the length of a gastrostomy tube that has been inserted by means of conventional endoscopic procedures or with a replacement feeding tube inserted into the patient&#39;s stomach. The gastrostomy tube is cut to the appropriate length by the physician. The adaptor comprises a stem which is inserted into the open end of the gastrostomy tube. The valve assembly contains a seal that functions as a one-way valve to prevent reflux of gastric contents but permits the introduction of feeding solution into the feeding tube. A lock and key mechanism is incorporated into the hub of the gastrostomy tube to prevent disconnection of the feeding tube. A cover is placed over the opening of the adapter to prevent contamination of the lumen of the gastrostomy tube.

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
       [0001]    This application is a continuation of U.S. patent application Ser. No. 11/629,724, filed Dec. 15, 2006, now U.S. Pat. No. 8,858,533, which is a U.S. national stage application under 35 U.S.C. §371 of International Application No. PCT/US05/023297, filed Jun. 29, 2005, which claims the benefit of U.S. Provisional Application No. 60/583,703, filed Jun. 29, 2004, the disclosures of each of which is incorporated, in its entirety, by this reference. 
     
    
     BACKGROUND 
       [0002]    Gastrostomy is the creation of a temporary or permanent opening between the stomach and the outer skin in the upper abdominal wall. Gastrostomy tubes are indicated for use when a patient cannot be fed by conventional means and long-term gastric access is needed. Nutrition is either fed, through such a gastrostomy tube, to the patient in a single dose (bolus feeding) or over time using a pump (continuous feeding). Also, the patient may require medication that can be administered directly into the patient&#39;s stomach using the gastrostomy tube. This is particularly advantageous in patients, especially children, who often dislike the taste of certain medications. 
       BRIEF SUMMARY 
       [0003]    One aspect of the instant disclosure relates to a system for providing fluid communication with a gastrostomy tube. Particularly, a connector is disclosed that may include a stem upon which an end region of a gastrostomy tube is positionable. As may be appreciated, the stem may define a bore for communicating with a lumen defined by the gastrostomy tube. Further, a locking region extending from the connector and proximate to at least a portion of the stem may be configured to be radially inwardly biased to compress at least a portion of the end region of the gastrostomy tube positionable upon the stem. 
         [0004]    In a further aspect of the instant disclosure, another embodiment of a system for providing fluid communication with a gastrostomy tube is disclosed. More specifically, such a system may include a stem upon which an end region of a gastrostomy tube is positionable. Also, the system may include a compression structure comprising a plurality of tines adjacent to at least a portion of the stem may be configured to be radially inwardly biased to compress at least a portion of the end region of the gastrostomy tube positionable upon the stem. 
         [0005]    In a further embodiment encompassed by the instant disclosure, a system for providing fluid communication with a gastrostomy tube may include a connector comprising a body including a stem upon which an end region of a gastrostomy tube is positionable, wherein the body further includes at least one recess configured to allow access to at least a portion of the stem. In addition, at least one clip may be configured to be positioned within the recess, the at least one clip comprising at least two movable legs, the at least two movable legs configured to compress at least a portion of the end region of the gastrostomy tube positionable upon the stem. 
         [0006]    In another aspect of the instant disclosure, a system for providing fluid communication with a gastrostomy tube including a stem upon which an end region of a gastrostomy tube is positionable is disclosed. In addition, the system may include a plurality of physically separate components configured, when assembled to one another, to compress at least a portion of the end region of the gastrostomy tube positionable upon the stem. 
         [0007]    Another aspect of the instant disclosure relates to a gastrostomy tube and feeding tube assembly. Particularly, a feeding tube assembly may be capable of selective coupling to an adaptor in fluid communication with an gastrostomy tube and may be rotatable, when coupled to the adaptor, about a longitudinal axis of the adaptor. 
         [0008]    The instant disclosure also relates to a method of coupling a stem to a gastrostomy tube. Specifically, a stem may be positioned within an end region of a gastrostomy tube. Also, a plurality of separate components may be positioned proximate to the end region of the gastrostomy tube and assembled to cause radial inward compression of at least a portion of the end region of the gastrostomy tube. 
         [0009]    A further method of coupling a stem to a gastrostomy tube relates to positioning a stem within an end region of a gastrostomy tube, positioning a plurality of tines generally about the circumference of the end region of the gastrostomy tube, and radially inwardly biasing the plurality of tines. 
         [0010]    Features from any of the above mentioned embodiments may be used in combination with one another, without limitation. In addition, other features and advantages of the instant disclosure will become apparent to those of ordinary skill in the art through consideration of the ensuing description, the accompanying drawings, and the appended claims. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0011]    Further features of the subject matter of the instant disclosure, its nature, and various advantages will be more apparent from the following detailed description and the accompanying drawings, which illustrate various exemplary embodiments, are representations, and are not necessarily drawn to scale, wherein: 
           [0012]      FIG. 1  shows a schematic view of an implanted gastrostomy tube; 
           [0013]      FIG. 2  shows a schematic view of a shortened gastrostomy tube including an adaptor coupled thereto; 
           [0014]      FIG. 3  shows a schematic view of the shortened gastrostomy tube including an adaptor shown in  FIG. 2 , further including a feeding tube assembly; 
           [0015]      FIG. 4  shows a cross-sectional view of a gastrostomy tube adaptor; 
           [0016]      FIG. 5  shows a partial, schematic, side cross-sectional view of one embodiment of a gastrostomy tube connector; 
           [0017]      FIG. 6  shows a partial, schematic, side cross-sectional view of another embodiment of a gastrostomy tube connector; 
           [0018]      FIG. 7  shows a partial, schematic, side cross-sectional view of a further embodiment of a gastrostomy tube connector; 
           [0019]      FIG. 8  shows a perspective view of an embodiment of a gastrostomy tube adaptor; 
           [0020]      FIG. 9  shows a perspective view of another embodiment of a gastrostomy tube adaptor; 
           [0021]      FIG. 10  shows a perspective view of a one-way valve; 
           [0022]      FIG. 11  shows a perspective view of another embodiment of a one-way valve; 
           [0023]      FIG. 12  shows a perspective view of yet a further embodiment of a one-way valve; 
           [0024]      FIG. 13  shows a perspective view of a gastrostomy tube adaptor including compression clips; 
           [0025]      FIG. 14  shows a perspective view of compression clips positioned about a gastrostomy tube; 
           [0026]      FIG. 15  shows a schematic, side cross-sectional view of the adaptor shown in  FIG. 13 ; 
           [0027]      FIG. 16  shows a perspective view of a feeding tube assembly configured to mechanically couple to a gastrostomy tube apparatus; 
           [0028]      FIG. 17  shows a perspective view of a base element including a stem and a gastrostomy tube positioned upon the stem; 
           [0029]      FIG. 18  shows a perspective view of a clamping apparatus; 
           [0030]      FIG. 19  shows a schematic, top-elevation view of the clamping apparatus shown in  FIG. 18 ; 
           [0031]      FIG. 20  shows a schematic, top-elevation view of the clamping apparatus shown in  FIG. 18 , when assembled; 
           [0032]      FIG. 21  shows a perspective view of a gastrostomy tube assembly including a clamping apparatus as shown in  FIGS. 18 through 20 ; 
           [0033]      FIG. 22  shows a perspective view of another embodiment of a clamping apparatus; 
           [0034]      FIG. 23  shows a perspective view of the clamping apparatus shown in  FIG. 22  assembled to a base element; 
           [0035]      FIG. 24  shows a schematic, side cross-sectional view of the assembly shown in  FIG. 23 ; 
           [0036]      FIG. 25  shows an exploded assembly view of another embodiment of a gastrostomy tube adaptor assembly; 
           [0037]      FIG. 26  shows a partial, schematic, side cross-sectional view of the assembly shown in  FIG. 25 ; 
           [0038]      FIG. 27  shows an exploded assembly view of a further embodiment of a gastrostomy tube adaptor assembly; 
           [0039]      FIG. 28  shows a partial, schematic, side cross-sectional view of the assembly shown in  FIG. 27 ; 
           [0040]      FIG. 29  shows a schematic, side cross-sectional view of one embodiment of a feeding tube assembly; 
           [0041]      FIG. 30  shows a schematic, side cross-sectional view of another embodiment of a feeding tube assembly including a movable locking element; 
           [0042]      FIGS. 31 and 32  show different top-elevation views of the feeding tube assembly shown in  FIG. 30 ; 
           [0043]      FIG. 33  shows a perspective view of yet an additional embodiment of a feeding tube assembly; 
           [0044]      FIG. 34  shows a schematic, side cross-sectional view of the feeding tube assembly shown in  FIG. 33 ; 
           [0045]      FIG. 35  shows a schematic view of a gastrostomy tube adaptor including a base element and a pliant ring; 
           [0046]      FIG. 36  shows a schematic view of the gastrostomy tube adaptor shown in  FIG. 35 , in unassembled state; and 
           [0047]      FIG. 37  shows a schematic, side cross-sectional view of a further embodiment of a gastrostomy tube adaptor. 
       
    
    
     DETAILED DESCRIPTION 
       [0048]    Systems, apparatuses, and methods for operably coupling to an implanted gastrostomy tube are disclosed. More particularly, an apparatus or system that may be coupled to an implanted gastrostomy tube to provide fluid communication with such gastrostomy tube is encompassed by the instant disclosure. For example, in one embodiment,  FIG. 1  shows a gastrostomy tube  10  that has been implanted within a patient and has a length of between approximately eight to approximately twelve inches of tubing extending from the surface of the patient&#39;s abdomen. A gastrostomy tube having such a length may be helpful in clinical environments where a nurse may need to frequently access the device without disturbing the patient. As shown in  FIG. 1 , the gastrostomy tube  10  may be initially coupled to a patient by an internal bolster  20  and an external bolster  12 , which may facilitate creation of and maintain a stoma tract  22  formed between the abdominal wall  18  and the stomach wall  26 . As mentioned above, a gastrostomy tube  10  having a relatively long length (e.g., in excess of about six inches extending from the patient) may cause difficulties. For instance, a gastrostomy tube  10  exhibiting a relatively long length may invite removal of the gastrostomy tube  10 , particularly if the patient is prone to disturb or dislodge the gastrostomy tube  10  from the stoma, or if the gastrostomy tube  10  becomes caught on something and is inadvertently removed. Therefore, especially if the patient is ambulatory, a shorter gastrostomy tube  10  may be more comfortable and less troublesome. Thus, the instant disclosure contemplates that the gastrostomy tube  10 , as shown in  FIG. 1 , may be shortened and operably coupled to an apparatus or system encompassed by the instant disclosure. Optionally, such coupling may occur after an adhesion or stoma tract  22  forms between an abdominal wall  18  and a stomach wall  26  of a patient. 
         [0049]    Explaining further, conceptually, gastrostomy tube  10  may be shortened (e.g., after a stoma tract forms between an abdominal wall and a stomach of a patient) and an apparatus may be coupled to the shortened gastrostomy tube  10  to provide for fluid communication with the shortened gastrostomy tube.  FIG. 2  shows a schematic representation of a shortened gastrostomy tube  10  including an adaptor  28  coupled thereto. A selected, shortened length of the gastrostomy tube  10 , as shown in  FIG. 2 , may provide a gap  29  between the skin surface “S” of the patient and the exposed length of the gastrostomy tube  10 . In addition,  FIG. 3  shows a schematic representation of the shortened gastrostomy tube  10  including a feeding tube assembly  32  and feeding tube  30  operably coupled to the adaptor  28 . Such a method and adaptor  28  may allow for fluid communication between the feeding tube  30  and the gastrostomy tube  10  and may also provide a relatively “low-profile” feeding tube system for long term use, without removing the initially implanted gastrostomy tube  10 . 
         [0050]    Generally, a system or apparatus for use with a gastrostomy tube may include a stem that is inserted within a lumen of the gastrostomy tube. For example, in one embodiment,  FIG. 4  shows a cross-sectional view of an adaptor  80  comprising a connector  90  including a stem  120 , which may, optionally, include at least one barb feature  122 , inserted within a lumen of a gastrostomy tube  10 . In addition, adaptor  80  includes a one-way valve  100  positioned within a bore of the connector  90  and a compression sleeve  140  positioned about the connector  90 . One-way valve  100  is shown embodying a so-called “duckbill” or Heimlich valve; however, other types of one-way valves (flapper-type, ball-type, etc.), as known in the art, may be employed for controlling fluid communication with gastrostomy tube  10 . Such a one-way valve may be configured to prevent reflux (e.g., gastric liquid or gas) from exiting the gastrostomy tube  10  from a stomach. The connector  90 , as shown in  FIG. 4 , also includes locking region  130 , which is configured to be radially displaced or biased toward the gastrostomy tube  10  to compress the gastrostomy tube  10  between a portion of the stem  120  and the locking region  130 . In one embodiment, locking region  130  may comprise a plurality of circumferentially-spaced (about the stem  120 ) tines or prongs (e.g., a collet or similar structure) or, in another embodiment, locking region  130  may comprise a substantially tubular shape. Explaining further, the compression sleeve  140  may be positioned about the locking region  130  of the connector  90  and may be configured to generate a radially inward force upon the locking region  130 . Such a radially inward force may, in turn, bias at least a portion of the locking region  130  toward the gastrostomy tube  10  to effectively couple the gastrostomy tube  10  to the stem  120 . Optionally, as shown in  FIG. 4 , stem  120  may include at least one barb  122 . Further, a connector cap  144  may be affixed to compression sleeve  90  by way of a connection structure  145  (e.g., a so-called luer connection or any other connection structure as known in the art) or, such a feature may be incorporated into the connector  90 . In another embodiment, compression sleeve  140  and connector cap  144  may be combined into a single piece. Further, an engagement structure  134  (shown in  FIG. 4  as a recessed region) may comprise a so-called snap-lock, threaded connection, or any other connection structure as known in the art. Engagement structure  134  may be formed in connector cap  144 , connector  90 , or compression sleeve  140  and may be configured to operably couple a feeding tube to the adaptor  80 . During use, a feeding tube extension or assembly may be coupled to the adaptor  80  by contact with tapered surface  88  of one-way valve  100 . Optionally, a sealing element (e.g., an O-ring) may be positioned between tapered surface  88  and a surface of a feeding tube assembly to provide a fluid-tight (i.e., hydraulic, pneumatic, or both hydraulic and pneumatic) seal between the surfaces. Such contact may also cause the one-way valve  100  to at least partially open; thus, fluid communication through the one-way valve may be facilitated. A closure element  180  may be employed to close the interior bore of the adaptor  80  while not in use. 
         [0051]      FIG. 5  shows a partial, schematic, side cross-sectional view of another embodiment of connector  90 , particularly, stem  120  and locking region  130 . The locking region  130 , as shown in  FIG. 5 , has at least one tapered feature  190  configured to interfere with an interior surface of compression sleeve  140  ( FIG. 4 ) when the compression sleeve  140  ( FIG. 4 ) is assembled to the connector  90 . Accordingly, such interference may cause the locking region  130  to be deformed or displaced radially inwardly, as discussed above. In addition, at least one protrusion  192  may be formed upon locking region  130 . Protrusion  192  may extend generally radially inwardly and may be generally pointed, as shown in  FIG. 5 . Such a configuration may facilitate locking of a gastrostomy tube  10  ( FIG. 4 ) upon the stem  120 . The instant disclosure further contemplates that a plurality of barbs may be formed, at selected positions and having selected configurations, respectively, on the stem  120  and may allow for formation of a robust mechanical and fluid-tight coupling between a gastrostomy tube  10  ( FIG. 4 ) and a bore  121  defined by the stem  120 . 
         [0052]    In a further aspect of the instant disclosure, at least one protrusion formed upon a locking region of a connector may be positioned proximate to a maximum radial extent of a barb formed on a stem of a connector. For example, in one embodiment,  FIG. 6  shows a partial, schematic, side cross-sectional view of a stem  120  that has a barb  122  that includes a maximum radial extent located at a longitudinal position “L1” (with respect to a longitudinal axis  11  of stem  120 ) from a distal surface  194  of the connector  90 . Further, protrusion  192  may be located proximate to the maximum radial extent of barb  122 . Also, as shown in  FIG. 6 , protrusion  192  may be located at a longitudinal distance from distal surface  194  of connector  90  that exceeds the longitudinal distance between the maximum radial extent of barb  122  and distal surface  194  of connector  90 . Such a configuration may provide a relatively robust coupling and fluid-tight connection between the bore  121  defined by stem  120  and the gastrostomy tube  10 . As illustrated in  FIGS. 4-6  the locking region  130  extends from and is integral with the connector  90 . 
         [0053]    In another embodiment, at least one protrusion formed upon a locking region of a connector may be positioned proximate to a distal surface of the connector. For example, in one embodiment,  FIG. 7  shows a partial, schematic, side cross-sectional view of a locking region  130  that has a barb  122 . Further, protrusion  192  may be located proximate to the distal surface  194  of the connector  90 . Also, as shown in  FIG. 7 , protrusion  192  may be located at a longitudinal distance “L2” from distal surface  194  of connector  90  that is less than the longitudinal distance between the maximum radial extent of barb  122  and distal surface  194  of connector  90 . Such a configuration may provide a relatively robust coupling and fluid-tight connection between the bore  121  defined by stem  120  and the gastrostomy tube  10 . 
         [0054]      FIG. 8  shows a perspective view of an embodiment of an adaptor  280 . More specifically, adaptor  280  may be configured generally as described above in relation to adaptor  80 , but may also include an angled portion  222  (e.g., forming a right angle with respect to a longitudinal axis of the gastrostomy tube  10 ). As described above, locking region  130  may be compressed toward the gastrostomy tube  10  by a compression sleeve  220 . Since compression sleeve  220  may be difficult to position over angled portion  222  of adaptor  280 , compression sleeve  220  may be embody a clam-shell design or may be separate pieces that lock or interconnect to one another around gastrostomy tube  10 , subsequent to positioning of a stem of adaptor  280  within gastrostomy tube  10 , as discussed below. Of course, adaptor  280  may also include a one-way valve, as discussed above, and may include features that to allow attachment of a straight feeding tube to port opening  282  to achieve a low-profile design.  FIG. 9  shows a perspective view of another embodiment of an angled portion  222  of an adaptor including a threaded port  240  and a threaded housing  250  for attachment to the threaded port  240 . Further, threaded housing  250  may include a one-way valve. Such a configuration may be desirable so that the one-way valve may be removed and replaced if needed. 
         [0055]    In further detail,  FIG. 10  shows a one-way valve  101  in a perspective view that comprises a frame element  348  (e.g., a substantially cylindrical frame) defining an opening  345  and including a first flap  342  extending over about half of the cross-sectional area of the opening  345  and a second flap  344  extending over the remaining cross-sectional area of the opening  345 . Further, first flap  342  and second flap  344  may contact one another along mating line  340  (i.e., a slit) and may be configured to generally resist the flow of fluid between first flap  342  and second flap  344 . However, one-way valve  101  may be configured so that fluid flow is allowed between first flap  342  and second flap  344  (through slit or mating line  340 ) when a syringe or other suitably shaped device applies a force to flaps  342  and  344 . Thus, a syringe may engage flaps  342  and  344  so that the edges (forming mating line  340 ), respectively, separate from one another to allow fluid flow between flaps  342  and  344 .  FIG. 11  shows a perspective view of another embodiment of a one-way valve  103 , configured as a duckbill valve, including protruding feature  356 , which is separated, at its distal end, along mating line  350  into a first half  352  and a second half  354 . Similar to one-way valve  101 , first half  352  and second half  354  are configured to prevent fluid flow there-between (i.e., along mating line  350 ), unless a syringe or other suitably shaped device contacts the first half  352  and second half  354 . In yet a further embodiment of a one-way valve,  FIG. 12  shows a perspective view of another one-way valve  105  (configured as a duckbill valve) including a land area  360  of protruding feature  356  having a length “L” and concave side surfaces  355  and  353 . Repeated use and stresses in the material forming one-way valve  105  may cause the mating line  350  to remain at least partially open due to the material “creep” or permanent deformation, as known in the art. Configuring the side surfaces  353  and  355  to exhibit a concave shape may resist such material creep and may also facilitate or bias the one-way valve  105  to close. 
         [0056]      FIG. 13  shows a perspective view of a further embodiment of an adaptor  300  including an outlet port  270  that forms an angle (i.e., is not generally aligned with) with respect to a gastrostomy tube  10  to which it is coupled. In addition, recess  294  may be formed laterally (i.e., substantially perpendicular to a longitudinal axis of gastrostomy tube  10 ) through the body of adaptor  300  to allow access to the end region of gastrostomy tube  10  positioned upon a stem (discussed below) of the adaptor  300 . As shown in  FIG. 13 , compression clip  292  (and compression clip  290  shown in  FIGS. 14 and 15 , discussed below) may be positioned within recess  294  and may radially inwardly compress and mechanically couple gastrostomy tube  10  to the adaptor  300 . In further detail,  FIG. 14  shows a perspective view of compression clips  290  and  292  positioned about gastrostomy tube  10  and stem  301  of adaptor  300 . As shown in FIG.  14 , compression clip  292  may include a pair of upper movable arms  296  and a pair of lower movable arms  296 , wherein each set of movable arms has an arcuate surface for contacting at least a portion of the gastrostomy tube  10  to compress the portion of the gastrostomy tube  10  radially inwardly against stem  301 . Also as shown in  FIG. 14 , compression clip  290  may include a pair of movable arms  297  and may be positioned longitudinally between the upper and lower pair of movable arms  296  of compression clip  292 .  FIG. 15  shows a schematic side cross-sectional view of adaptor  300  illustrating the location of compression clips  290  and  292  positioned within recess  294  and about gastrostomy tube  10  and stem  301 . 
         [0057]      FIG. 16  shows a perspective view of a feeding tube assembly  306  including a coupler  304  with a radially protruding feature  302  and a stem portion  305  and feeding tube  309  extending from the stem portion  305 . Coupler  304  may be configured for mechanically coupling to a connector  312  (e.g., connector  90  as discussed above or a base element as discussed below). More particularly, protruding feature  302  may align with groove  310  formed in recess  307  of the connector  312 . Further, protruding feature  302  may fit into or otherwise engage a lip or other feature (e.g., another recess such as recess  134  as shown in  FIG. 4 ) formed into the surface of recess  307 . 
         [0058]    Another aspect of the instant disclosure relates to a gastrostomy tube adaptor that has a clamping mechanism that may be installed upon a base element including a stem. More particularly, a clamping mechanism may be configured to at least partially circumferentially contact and correspondingly radially compress a gastrostomy tube onto a stem of the base element. For example, a clamping mechanism may include two separate pieces that couple to one another to compress a gastrostomy tube onto a stem of the base element. More generally, a system for providing fluid communication with a gastrostomy tube may include a plurality of separate pieces, which, when assembled, are configured to compress at least a portion of an end region of a gastrostomy tube positionable upon a stem. Such a configuration may simplify the design of an adaptor for converting a gastrostomy tube to a low-profile in comparison to the adaptor described above including a connector with a locking region. Explaining further, a common base element may be used in combination with a selected clamping apparatus to provide flexibility. In one embodiment,  FIG. 17  shows a perspective view of base element  450  including a stem  460  positioned within a gastrostomy tube  10 . Bore  451  of base element  450  is in fluid communication with the lumen of gastrostomy tube  10 . As explained below, a feeding tube may be selectively coupled to base element  450  and may be used to provide nourishment into a stomach of a patient through the gastrostomy tube  10 . 
         [0059]      FIG. 18  shows a perspective view of a clamping apparatus  410  including a first half  412  and a second half  414 . First half  412  includes locking arms  416 , each of locking arms  416  including a protruding feature  417  for engaging a suitably shaped engagement surface  423  formed in grooves  422  of second half  414 . First half  412  and second half  414  may each include an arcuate surface  418 ,  420 , respectively, configured for compressing a portion of a gastrostomy tube positioned upon a stem about which the clamping apparatus  410  is positioned. In further detail,  FIG. 19  shows a schematic, top-elevation view of clamping apparatus  410  positioned about gastrostomy tube  10  and stem  460 . As may be appreciated, upon movement of first half  412  and second half  414  toward one another, protruding features  417  may move along tapered regions  419 , respectively, and may effectively lockingly engage engagement surfaces  423  of second half  414 .  FIG. 20  shows a schematic, top-elevation view of first half  412  and second half  414  coupled to one another via protruding features  417  engaging engagement surfaces  423 . In addition, it may be appreciated that the gastrostomy tube  10  may be compressed by the arcuate surfaces  418 ,  420  (shown as substantially semi-cylindrical in  FIGS. 18 and 19 ) against stem  460 .  FIG. 21  shows a perspective view of a gastrostomy tube assembly  408  including the clamping apparatus  410  installed upon base element  450  including stem  460  positioned within gastrostomy tube  10 . Optionally, a closure element  452  may be coupled to the base element  450  to close the bore extending therethrough. Also, optionally, a one-way valve may be positioned within the base element  450 . The first half  412  of the system and the second half  414  of the system may include complementary locking features, e.g., protruding features  417 , configured to engage one another to form a circular arcuate surface  418 ,  420 . 
         [0060]      FIG. 22  shows a perspective view of another embodiment of a clamping apparatus  404  including a hinge mechanism  430 , clamp elements  432 ,  433 , and halves  437 ,  439 . More specifically, halves  437 ,  439  may comprise a pliant material such as silicone, while clamp elements  432 ,  433  may comprise a relatively rigid material such as a rigid plastic (e.g., polyethylene, polypropylene, etc.) or a metal. Such a configuration may provide a relatively comfortable gastrostomy tube apparatus for a patient&#39;s use. Optionally, halves  437 ,  439  may substantially surround clamp elements  432 ,  433 . Arcuate surfaces  448 ,  446  (shown as substantially semi-cylindrical) of clamp elements  432 ,  433  may be configured for compressing a gastrostomy tube against a stem about which the clamping apparatus  404  is positioned. Annular recess  436  may be configured for accepting, upon placement of the clamping apparatus about a gastrostomy tube within which a base element is positioned, a corresponding annular flange of a base element. Thus, each of halves  437 ,  439  may be separated by rotation about hinge mechanism  430  and positioned about a gastrostomy tube. As shown in  FIG. 22 , clamp element  432  includes a locking feature  441  that extends from clamp element face  434  for securing clamp element  432  to clamp element  433 . Accordingly, clamp elements  432 ,  433  may include complementary locking features (e.g., protruding features, pins, or any other locking features as known in the art) configured to secure clamp elements  432 ,  433  to one another.  FIG. 23  shows a perspective view of clamping apparatus  404  assembled to the base element  450 . Further,  FIG. 24  shows a schematic side cross-sectional view of clamping apparatus  404  assembled to base element  450 . As shown in  FIG. 24 , clamping elements  432 ,  433  may be configured to compress gastrostomy tube  10  onto stem  460  of base element  450 . Thus, bore  451  of base element  450  may be in fluid communication with a lumen of gastrostomy tube  10 . Optionally, base element  450  may be configured to accept a one-way valve configured to allow fluid to flow in a direction toward or into gastrostomy tube  10 , but inhibit fluid flow from gastrostomy tube  10  toward base element  450 . The first half  437  of the system and the second half  439  of the system may include complementary locking features configured to engage one another to form a circular arcuate surface  446 ,  448 . 
         [0061]      FIG. 25  shows an exploded assembly view of another embodiment of a gastrostomy tube adaptor assembly  510  including feeding tube assembly  502 , locking hub  504 , one-way valve  100 , base element  506 , and compression ring  508 . In further detail, a gastrostomy tube may be positioned about stem  501  of base element  506  and locking elements  514  of locking hub  504  may each engage a complementary engagement feature formed within compression ring  508 . More specifically, longitudinal movement between locking hub  504  and compression ring  508  may cause locking elements  514  to engage or otherwise be retained by a complementary engagement feature formed within compression ring  508 . Also, regions  520  may be configured to move locking elements  514  inwardly upon application of force thereon (e.g., by squeezing of a hand of a user) to release each of the locking elements  514  from a respective complementary engagement feature formed within compression ring  508 . Further, compression ring  508  may be configured to compress (e.g., radially inwardly compress) a gastrostomy tube positioned between the compression ring  508  and the stem  501  of the base element  506 . For example,  FIG. 26  shows a schematic side cross-sectional view of an assembly of locking hub  504 , one-way valve  100 , base element  506 , and compression ring  508 , as shown in  FIG. 25 . As shown in  FIG. 26 , locking hub  504  includes an annular recess  505  configured for engaging locking features  512  ( FIG. 25 ) of feeding tube assembly  502  ( FIG. 25 ). Such a configuration, when locking hub  504  and feeding tube assembly  502  ( FIG. 25 ) are coupled to one another, may allow for rotation of feeding tube assembly  502  ( FIG. 25 ) with respect to locking hub  504 . Also, pressure applied generally to region  509  ( FIG. 25 ) may cause locking feature  512  to release from annular recess  505 . Thus, feeding tube assembly  502  ( FIG. 25 ) may be selectively released from locking hub  504  when desired. Also, as shown in  FIG. 26 , compression ring  508  may be configured for inwardly radially compressing at least a portion of an end region of gastrostomy tube  10  positioned upon stem  501  of base element  506 . 
         [0062]      FIG. 27  shows an exploded assembly view of a gastrostomy tube adaptor assembly  550  including feeding tube assembly  552 , washer element  553 , one-way valve  100 , base element  560 , and compression ring  570 . More specifically, as shown in  FIG. 27 , base element  560  includes tines  562  extending longitudinally from base element  560  that have a threaded exterior surface. Tines  562  extend from base  560  proximate to stem  561  and may be configured to be radially inwardly biased to compress at least a portion of an end region of a gastrostomy tube positioned about stem  561  of base element  560 . Thus, compression ring  570  may include a threaded interior surface for threading along the threaded exterior surface of tines  562  so that tines  562  are biased radially inwardly. Thus,  FIG. 28  shows a schematic side cross-sectional view of base element  560 , washer element  553 , one-way valve  100 , compression ring  570 , and gastrostomy tube  10 . As shown in  FIG. 28 , compression ring  570  may inwardly radially compress tines  562  toward the end region of gastrostomy tube  10  positioned upon stem  561  of base element  560 . Such a configuration may provide an effective and fluid-tight coupling between the base element  560  and the gastrostomy tube  10 . In addition, feeding tube assembly  552  ( FIG. 27 ) may be configured to couple to base element  560 . In one embodiment, feeding tube assembly  552  ( FIG. 27 ) may be configured to couple to an annular recess  563  ( FIG. 28 ) formed in base element  560 . In another embodiment, base element  560  can be configured similarly to region  520 , illustrated in  FIG. 25 . In such an embodiment base element  560  can act as a release configured to move the plurality of tines  562  inward upon application of a force to the base element  560 . Force on the release (base element  560 ) can release the compression ring  570 , or in another embodiment, a compression sleeve such as compression sleeve  220  illustrated in  FIG. 8 . 
         [0063]      FIG. 29  shows one embodiment of feeding tube assembly  552  including a cap body  555  comprising a pliant material that is shaped to substantially conformably accommodate the shape of base element  560  and couple to annular recess  563 . Such a configuration may allow for relatively secure coupling between cap body  555  and base element  560  and may allow selective removal of cap body  555  from base element  560 , when desired. In another embodiment, a movable locking feature may be selectively positioned within or removed from annular recess  563  of base element  560  to allow for coupling or removal of feeding tube assembly  552  to and from base element  560 , respectively. For example,  FIG. 30  shows a schematic, side cross-sectional view of a movable locking element  577  that may be selectively positioned within annular recess  563  of base element  560 . In one embodiment, movable locking element  577  may be positionable by way of a handle operable by a user&#39;s hand. For example,  FIGS. 31 and 32  show, in top-elevation views, respectively, a movable locking element  577  operably coupled to a handle region  578 . As shown in  FIG. 31 , locking element  577  may be positioned toward base element  560 , to engage a portion or corresponding feature (e.g., annular recess  563 ) of the base element  560 . Also, as shown in  FIG. 32 , locking element  577  may be positioned away from base element  560 . It may be appreciated that movement of the locking element  577  between the position shown in  FIG. 31  and the position shown in  FIG. 32  may be accomplished by application of a force upon handle region  578  to cause the locking element  577  to pivot about a hinge mechanism  559 . Further, of course, locking element  557  may be biased toward the position shown in  FIG. 31  (i.e., in a locked position) by a biasing element, the hinge elasticity, or as otherwise known in the art. 
         [0064]    In an additional embodiment, a feeding tube assembly may include an open sliding connection structure for coupling to a base element. For example,  FIG. 33  shows a perspective view of a feeding tube assembly  590  including legs  592  defining gap “g” within which flange  603  of base element  560  may be positioned. Also,  FIG. 34  shows a schematic side cross-sectional view of feeding tube assembly  590  installed upon base element  560 . As illustrated in  FIGS. 33-34 , feeding tube assembly  590  may be selectively coupled to gastrostomy tube  10  through base element  560 . Base element  560  acts as an adapter allowing connection of the feeding tube assembly and gastrostomy tube  10 . As may be appreciated, feeding tube assembly  590  may slide onto base element  560  so that legs  592  ( FIG. 33 ) are positioned within a portion of annular recess  563  (extending on opposite sides of annular recess  563 ). Such a configuration may allow for rotation of feeding tube assembly  590  (about a longitudinal axis of base element  560 ). In addition, a sealing element  600  may be configured to seal between the base element  560  and the feeding tube assembly  590 , as shown in  FIG. 34 . Accordingly, the example feeding tube assembly  590  illustrated in  FIGS. 33-34  may be capable of selectively coupling to a compression structure (sealing element  600 ) and rotatable, when coupled to the compression structure, about a longitudinal axis of the compression structure. Such a configuration may provide a relatively robust and easy to use gastrostomy tube apparatus or system. 
         [0065]    In a further embodiment, a pliant ring, made from a pliant material, may be compressed by a base element to compress a portion of a gastrostomy tube positioned over a stem extending from the base element. For example, in one embodiment,  FIG. 35  shows a schematic view of a pliant ring  614 , which can act as a compression ring, positioned about a gastrostomy tube  10  and a base element  612  including a stem  616  configured for positioning within the lumen defined by gastrostomy tube  10 . As shown in  FIG. 35 , base element  612  includes a recess  620  configured for accepting pliant ring  614 . Further, recess  620  and pliant ring  614  are configured to compress at least a portion of an end region of gastrostomy tube  10  positioned upon stem  616  of base element  612 . Also, as shown in  FIG. 35 , pliant ring  614  (the compression ring) includes annular flange  626  configured to fit and be positioned within annular recess  624  of base element  612 . More specifically, as shown in  FIG. 36 , the gastrostomy tube adaptor  610  can include pliant ring  614  may be assembled to base element  612 . Such a configuration may compress at least a portion of gastrostomy tube  10  onto stem  616  and may effectively provide fluid communication between a bore  613  of base element  612  and the lumen of gastrostomy tube  10 . Accordingly, as illustrated in  FIGS. 35-36 , recess  620  of base element  612  may be defined by a lip (near  624 ) that further includes a second recess, annular recess  624 . The second recess  624  may engage the flange  626  of the compression ring (pliant ring  614 ). In another embodiment,  FIG. 37  shows a base element  632  having a recess  640  configured for accepting pliant ring  634 . A protrusion  644  (e.g., an annular protrusion) may extend from pliant ring  634  and may engage a recess  642  (e.g., an annular recess) formed in base element  632 . A rim  644 , formed by recess  642  may hold pliant ring  634  in place. Such a configuration may couple pliant ring  634  to base element  632 . In addition, at least a portion of an end region of gastrostomy tube  10  may be compressed between stem  636  of base element  632  and pliant ring  634 . 
         [0066]    Although the apparatuses and systems described above have been discussed in the context of low-profile gastrostomy feeding tube embodiments, it should be understood that such apparatuses and systems are not limited to low-profile use and could be used with a gastrostomy feeding tube in any (e.g., high-profile) arrangement, if desired, without limitation. Moreover, such apparatuses and systems are not limited to use with gastrostomy feeding tubes and may be used with various other medical catheters, including drainage catheters, without limitation. 
         [0067]    While certain embodiments and details have been included herein for purposes of illustrating aspects of the instant disclosure, it will be apparent to those skilled in the art that various changes in the systems, apparatuses, and methods disclosed herein may be made without departing from the scope of the instant disclosure, which is defined, in part, in the appended claims. The words “including” and “having,” as used herein including the claims, shall have the same meaning as the word “comprising.”