Percutaneous Endoscopic Gastrostomy (PEG)
What is percutaneous endoscopic gastrostomy (PEG)?
Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure for placing a tube for feeding without having to perform an open operation on the abdomen (laparotomy). It is used in patients who will be unable to take in food by mouth for a prolonged period of time. A gastrostomy, or surgical opening into the stomach, is made through the skin using a flexible, lighted instrument (endoscope) passed orally into the stomach to assist with the placement of the tube and secure it in place.
What is the purpose of percutaneous endoscopic gastronomy?
The purpose of a percutaneous endoscopic gastronomy is to feed those patients who cannot swallow food. Irrespective of the age of the patient or their medical condition, the purpose of percutaneous endoscopic gastronomy is to provide fluids and nutrition directly into the stomach.
Where is percutaneous endoscopic gastronomy done?
It is not necessary to perform a percutaneous endoscopic gastronomy in an operating room. PEG is performed in a hospital or outpatient surgical facility.
Who can be a suitable option for performing percutaneous endoscopic gastronomy?
Percutaneous endoscopic gastronomy is done by a physician. The physician may be a general surgeon, an otolaryngologist (ENT specialist), radiologist, or a gastroenterologist (gastrointestinal specialist).
How is percutaneous endoscopic gastronomy done?
Local anesthesia (usually lidocaine or another spray) is used to anesthetize the throat. An endoscope (a flexible tube with a camera and a light on the end) is passed through the mouth, throat and esophagus into the stomach. The physician then makes a small incision (cut) in the skin of the abdomen over the stomach and pushes a needle through the skin and into the stomach. The tube for feeding then is pushed through the needle and into the stomach. The tube then is sutured (tied) in place to the skin.
What are the possible complications with percutaneous endoscopic gastronomy?
Possible complications include infection of the puncture site (as in any kind of surgery,) dislodgement of the tube with leakage of the liquid diet that is fed through the tube into the abdomen, and clogging of the tube.
What are the advantages of percutaneous endoscopic gastronomy?
Percutaneous endoscopic gastronomy takes less time, carries less risk and costs less than a surgical gastrostomy which requires opening the abdomen. Percutaneous endoscopic gastronomy is a commonly-performed so there are many physicians with experience in performing the procedure. When possible, percutaneous endoscopic gastronomy is preferable to a surgical gastrostomy.
When can the percutaneous endoscopic gastronomy patient go home?
The patient usually can go home the same day or the next morning.
Percutaneous Endoscopic Gastrostomy at a Glance
- Percutaneous endoscopic gastronomy is a procedure that allows nutritional support for patients who cannot take food orally. Percutaneous endoscopic gastronomy involves placement of a tube through the abdominal wall and into the stomach through which nutritional liquids can be infused.
- Percutaneous endoscopic gastronomy is a surgical procedure; however, it does not require opening the abdomen or an operating room. Percutaneous endoscopic gastronomy also does not require general anesthesia.
- Complications of percutaneous endoscopic gastronomy include infection, leakage of nutritional liquids that are infused and clogging of the tube.
- Percutaneous endoscopic gastronomy is preferable to surgical gastrostomy