Miyerkules, Mayo 2, 2012 | 3:56 AM | 11 Cotton Candy
What is a PEG?
A percutaneous endoscopic gastrostomy (PEG) is a procedure to place a feeding tube through your skin and into your stomach to give you the nutrients and fluids you need.
Are there any alternatives to a PEG?
It is possible to be given nutrients and fluids through a naso-gastric tube
The feeding tube can be placed directly into your stomach by an operation.
It is also possible to be given nutrients and fluids directly into your bloodstream (total parenteral nutrition
PROCEDURE
1. Topical anesthesia administered to back of oropharynx if patient is awake.
2. Gastroscope is inserted through a mouth guard and down the esophagus to the stomach.A percutaneous endoscopic gastrostomy (PEG) is a procedure to place a feeding tube through your skin and into your stomach to give you the nutrients and fluids you need.
Are there any alternatives to a PEG?
It is possible to be given nutrients and fluids through a naso-gastric tube
The feeding tube can be placed directly into your stomach by an operation.
It is also possible to be given nutrients and fluids directly into your bloodstream (total parenteral nutrition
PROCEDURE
1. Topical anesthesia administered to back of oropharynx if patient is awake.
3. Stomach is fully inflated with air to displace the adjacent colon inferiorly and push the anterior wall of the stomach against the inside of the abdominal wall over the maximal area possible.
4. The lighted end of the gastroscope is turned upward toward the anterior stomach wall.
5. The room lights are dimmed and the site of transillumination of the scope is noted and marked. It should be halfway between the umbilicus and the left costal margin.
6. The gastroscope is then pulled back into the stomach and palpation is done on the outside of the anterior abdominal wall and confirmed by the view from the gastroscope.
7. Local anesthesia is injected at the marked skin site and a 1 cm vertical incision is made.
8. A 16 gauge intravenous needle is inserted through the skin, abdominal wall and the anterior wall of the stomach in a fairly rapid manner to decrease the chance of the anterior stomach wall “floating away” from the abdominal wall.
9. The inner needle is withdrawn the cannula left in place.
10. A long silk of nylon suture is placed through the cannula and into the stomach.
11. The polypectomy snare is inserted through the gastroscope and into the stomach.
12. The polypectomy snare is used to grab the suture and then the suture, snare, and scope are pulled out (through the mouth).
13. A tapered Pezzer catheter (aka mushroom catheter) or PEG tube is then tied to the suture end at the mouth and a sterile lubricant is applied to the tapered end.
14. Usually gentle but firm pressure the end of the suture at the abdominal wall is then used to pull the catheter down the esophagus and into the stomach and out the abdominal wall.
15. The gastroscope is then reinserted to insure that PEG is positioned up against the wall of the stomach and to inspect for bleeding or stomach tears.
16. An external crosspiece is then fitted onto the abdominal wall to hold the PEG tube in place.
17. A non-absorbable suture is used to additionally fasten the PEG tube in place.
18. The skin incision is left open with placement of a topical antibiotic.
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