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Feeding tube insertion - gastrostomy

Definition

A gastrostomy feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall, directly into the stomach.

Alternative Names

Gastrostomy tube insertion; G-tube insertion; PEG tube insertion; Stomach tube insertion; Percutaneous endoscopic gastrostomy tube insertion

Description

Gastrostomy feeding tube insertion is done in part using a procedure called endoscopy. For information on how this procedure is done, see: Esophagogastroduodenoscopy (EGD).

After the endoscopy tube is inserted, the skin over the left side of belly (abdomen) area is cleaned and numbed. The doctor makes a small surgical cut in this area and inserts a small, flexible, hollow tube with a balloon or special tip into the stomach. The doctor uses stitches to close the stomach around the tube.

Why the Procedure Is Performed

Gastrostomy feeding tubes are put in for different reasons. They may be needed for a short while or permanently. This procedure may be recommended for:

• Babies with birth defects of the mouth, esophagus, or stomach (for example, esophageal atresia or tracheal esophageal fistula)
• Patients who cannot swallow correctly
• Patients who cannot take enough food by mouth to stay healthy
• Patients who often breathe in food when eating

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

Risks for surgical or endoscopic feeding tube insertion are:

• Bleeding
• Infection

Before the Procedure

You will be given a sedative and a painkiller. In most cases, these medicines are given through a vein (IV line) in your arm. You should feel no pain and not remember the procedure.

A numbing medicine may be sprayed into your mouth to prevent the urge to cough or gag when the endoscope is inserted. A mouth guard will be inserted to protect your teeth and the endoscope.

Dentures must be removed.

After the Procedure

This is most often a simple surgery with a good outlook.

Outlook (Prognosis)

The stomach and abdomen will heal in 5 to 7 days. Moderate pain can be treated with medications. Feedings will start slowly with clear liquids, and increase slowly.

The patient/family will be taught:

• How to care for the skin around the tube
• Signs and symptoms of infection
• What to do if the tube is pulled out
• Signs and symptoms of tube blockage
• How to empty the stomach through the tube
• How and what to feed through the tube
• How to hide the tube under clothing
• What normal activities can be continued

References

Tawa NE Jr, Fischer JE, In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 7.