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Only smaller diameter (12 Fr or less in adults) nasogastric tubes are appropriate for long-term feeding, so as to avoid irritation and erosion of the nasal mucosa. These tubes often have guidewires to facilitate insertion. If feeding is required for a longer period of time, other options, such as placement of a PEG tube, should be considered.
The PEG procedure is an alternative to open surgical gastrostomy insertion, and does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube (PEG-J tube) through the PEG tube and into the jejunum via the pylorus. [1]
A gastric feeding tube (G-tube or "button") is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. One type is the percutaneous endoscopic gastrostomy (PEG) tube which is placed endoscopically. The position of the endoscope can be visualized on the outside of the person's abdomen ...
The Stamm gastrostomy is an open technique, [4] requiring an upper midline laparotomy and gastrotomy, with the catheter brought out in the left hypochondrium.It was first devised in 1894 by the American Gastric Surgeon, Martin Stamm (1847–1918), who was educated greatly in surgery when he visited Germany.
Any additional procedures are performed at this stage. The air in the stomach is aspirated before removing the endoscope. Still photographs can be made during the procedure and later shown to the patient to help explain any findings. In its most basic use, the endoscope is used to inspect the internal anatomy of the digestive tract.
A jejunal feeding tube is an alternative to a gastrostomy feeding tube and is commonly used when gastric enteral feeding is contraindicated or carries significant risks. The advantage over a gastrostomy is its low risk of aspiration due to its distal placement. Disadvantages include small bowel obstruction, ischemia, and requirement for ...
A self-expandable metallic stent (or SEMS) is a metallic tube, or stent that holds open a structure in the gastrointestinal tract to allow the passage of food, chyme, stool, or other secretions related to digestion. Surgeons insert SEMS by endoscopy, inserting a fibre optic camera—either through the mouth or colon—to reach an area of narrowing.
Buried bumper syndrome tends to be a late complication of gastrostomy tube placement, but can rarely occur as early as 1 to 3 weeks after tube placement. [4] [5] Most cases occur more than 1 year after initial placement of the PEG tube. [2] Excessive tightening of the external bumper is the primary risk factor for buried bumper syndrome.