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Efficacy and accuracy of the transillumination-guided gastric tube placement in neonates

Journal of Perinatology (2026)Cite this article

Subjects

Abstract

Objective

To evaluate the efficacy and safety of Tumguide®, a radiation-free, transillumination-guided system for gastric tube (GT) placement in neonates.

Study design

This single-center prospective observational study enrolled neonates requiring GT placement. Tumguide® was used to guide placement. Primary outcomes were intragastric placement success rate and accuracy, defined as radiographically confirmed positioning not requiring adjustment.

Results

A total of 71 procedures were performed in 55 neonates. Median gestational age was 37.1 weeks, and median birth weight was 2480 g. The overall intragastric placement success rate was 99%, with 73% accuracy. No adverse events were reported. Protocol modifications significantly improved accuracy from 17% to 85% (p < 0.001). Tumguide® maintained high accuracy across varying body weights.

Conclusions

Tumguide® enables accurate and successful GT placement in neonates. Its real-time visualization and compatibility with small-caliber tubes support its utility as a practical alternative to traditional methods.

Clinical Trial Registration (if any)

This study was registered in the University Hospital Medical Information Network Clinical Trials Registry in Japan (ID: UMIN000055947, URL: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000063917).

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Fig. 1: The Tumguide® system and gastric tube.
Fig. 2: Transillumination with the Tumguide® system for gastric tube placement and protocol modification.
Fig. 3: Relationship between body weight and gastric tube insertion length in Phase 2.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank the nursing staff for their essential contributions to the successful completion of this study.

Funding

Partial funding for this study was provided by internal research grants from the International University of Health and Welfare. The funding source had no role in the design or conduct of the study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan

    Hironori Shimozawa, Ayaka Yamakami, Masashi Sagara, Kazuki Ogura, Tadahiro Mitani, Yuji Gunji & Daisuke Matsubara

  2. Department of Pediatrics, Jichi Medical University, Shimotsuke, Tochigi, Japan

    Hironori Shimozawa, Ayaka Yamakami, Masashi Sagara, Kazuki Ogura, Tadahiro Mitani & Daisuke Matsubara

  3. Department of Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan

    Junji Takahashi

  4. Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan

    Daisuke Matsubara

Authors
  1. Hironori Shimozawa
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  2. Ayaka Yamakami
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  3. Masashi Sagara
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  4. Kazuki Ogura
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  6. Yuji Gunji
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  7. Junji Takahashi
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  8. Daisuke Matsubara
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Contributions

HS conceptualized and designed the study, oversaw the project, performed the procedures, analyzed the data, drafted the initial manuscript, and submitted the final manuscript. AY, MS, and KO contributed to clinical procedures and data collection. TM, DM, and YG assisted with manuscript preparation and critically reviewed and revised the text for significant intellectual content. JT served as advisor for the Tumguide® system. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Hironori Shimozawa.

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The authors declare no competing interests.

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Shimozawa, H., Yamakami, A., Sagara, M. et al. Efficacy and accuracy of the transillumination-guided gastric tube placement in neonates. J Perinatol (2026). https://doi.org/10.1038/s41372-026-02643-8

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