Percutaneous endoscopic gastrostomy is aprocedure in which a feeding tube is placed through the abdominal wall and into the stomach using a thin, flexible camera called an endoscope. The percutaneous endoscopic gastrostomy tube allows nutrition to be administered directly into the stomach, bypassing the mouth and esophagus.
The percutaneous endoscopic gastrostomy tube is usually placed in patients who may have had a nasogastric tube inserted into their stomach for a long period and found it to be uncomfortable and prone to dislodging (The nasogastric tube runs through the nose, down the esophagus, and into the stomach.). A nasogastric tube can also cause ulcers where it places pressure on sensitive skin and tissue as well as sinus infections. Furthermore, the nasogastric tube can cause reflux, which can lead to aspiration and lung infection. Therefore, in patients who require tube feeding, the percutaneous endoscopic gastrostomy tube is a good alternative choice.
- The patient receives the correct nutrition they need, improving their health.
- It is easier to use and more convenient than a nasogastric tube.
- PEG are associated with a lower rate of complications, including pneumonia due to aspiration and nasal inflammation/infection.
-Complications may arise with the placement of a PEG tube. These include; accidental tube dislodgement, aspiraion, bleeding, wound infection, pain near the PEG tube location, stomach leakage around the tube.
PEG tubes are usually placed with an endoscopic procedure. Endoscopic procedures use small incisions and a long, flexible instrument called an endoscope to help guide the instruments into your body while minimizing the amount of cuts the surgeons have to make. On the day of procedure, you will receive anesthesia and antibiotics. The anesthesia ensures that you remain calm and numb during the procedure. You may also receive a local anesthetic. A local anesthetic is an injection of numbing medicine. You receive this injection near where your surgeon makes the incision. During percutaneous endoscopic gastrostomy, the doctor will first make a small incision in your upper abdomen. The tube will be inserted through the incision and connected to your stomach. The entire procedure only takes around 20 to 30 minutes. Usually, you can return home the same day or the next morning.
Before surgery, you’ll meet with your surgeon to discuss the procedure. You will discuss with him/her about any pre-existing heart conditions that you may have, bleeding risks or medication allergies. Depending on your health and underlying conditions, you may need to make medication adjustments. Your healthcare team may recommend changes to: -Insulin dosage. -Medicines that thin your blood [anticoagulants] -Nonsteroidal anti-inflammatory drugs [NSAIDS], such as aspirin or ibuprofen You will also need to fast at least eight hours before the surgery.
It is normal to experience some pain after a percutaneous endoscopic gastrostomy. This pain might be from the incision. You may also have some cramping from gas buildup in your digestive system. This pain should decrease within 24 to 48 hours. You’ll have a bandage over the incision site. You may see some drainage around the incision for up to 48 hours. Usually, your surgeon will give you instructions to remove the bandage after one to two days. After the area around your feeding tube heals, you will then meet with a dietitian to help guide you through the process of using the PEG tube and starts you on enteral nutrition.
Common problems found with the placement of PEG tubes include:
1.The percutaneous endoscopic gastrostomy tube may become unsanitary, usually due to highly concentrated food and insufficient water being used to flush the tube after the feed.
2.The percutaneous endoscopic gastrostomy tube may leak or expand if it’s been used for a long time or if the food is too hot.
3. Food may not be able to be administered through the tube.
4.The percutaneous endoscopic gastrostomy tube can become dislodged. If this happens, cover the opening with a sterile gauze or bandage and return to the hospital immediately.
Is a percutaneous endoscopic gastrostomy considered a major procedure?
Not at all, this procedure is usually performed in the outpatient department along with local anesthesia. This procedure is commonly performed so there are many physicians that are versed in performing this procedure. You may then return home after the procedure is completed.
How long would I need to have the percutaneous endoscopic gastrostomy tube placed inside me?
Depending on your medical condition, the tube may be temporary or permanent. For example, patients with permanent neurologic damage may require a long-term feeding tube to be placed inside the. In either case, the feeding tube can be easily removed if necessary.
How is the feeding tube used for feeding?
The simplest method of infusing tube feeding through the PEG tube is called bolus feeding. Tube feed formula is placed within a large syringe and slowly administered to the patient through the plug cap on the end of the PEG feeding tube. In order to meet a patient’s nutritional needs, this may need to be repeated 4 to 6 times per day. Sometimes continuous feeding is preferable. With this method, a feeding pump is set up and connected to the PEG tube. The tube feed formula is placed in a large bag and attached to the pump. The tube feeding is continuously administered by the pump over 12-24 hours.