Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure for inserting a feeding tube into the stomach through a small incision in the abdomen. It is performed when a person is unable to swallow or receive nourishment orally and can be done as an outpatient procedure. Complications may arise, but PEG is believed to have advantages over surgical gastronomy.
Sometimes a situation develops where a person is unable to swallow or is otherwise unable to receive nourishment orally. In that case, intravenous feeding may be an option, or it may be desirable to insert a feeding tube. Percutaneous endoscopic gastrostomy, abbreviated PEG, is a surgical procedure for inserting a feeding tube.
There are several types of feeding tube insertions, which differ depending on the location and method of insertion. One type is a nasogastric tube, in which a tube is inserted through the nose and into the stomach. After certain procedures, such as an esophagectomy, in which all or part of the esophagus is removed; or gastrectomy, in which all or part of the stomach is removed, a feeding tube through a percutaneous jejunostomy may be used, with the tube inserted into part of the small intestine. A stomach tube is another possibility, and can be inserted through an open laparotomy, in which a large opening is made through a surgical incision, or through a percutaneous endoscopic gastrostomy, which can be done with a very small incision.
The term percutaneous endoscopic gastrostomy clarifies the details of how to insert this particular type of feeding tube. Percutaneous is synonymous with transdermal, which means “through the skin”. An endoscope is a long, thin optical instrument containing a light source and camera and used to examine deep areas of the human body. A gastrostomy refers to an opening into the stomach through the abdominal wall.
Percutaneous endoscopic gastrostomy is a type of feeding tube insertion that is performed when the patient is expected to be unable to take food by mouth for some time. Unlike other feeding tube insertions, percutaneous endoscopic gastrostomy can be performed as an outpatient procedure. It can be performed by doctors with a variety of specialties.
There are four basic steps to a percutaneous endoscopic gastrostomy. First, the throat is anesthetized and an endoscope is passed into the stomach. Second, a small incision is made in the abdomen above the stomach and a needle is inserted into the stomach. Third, the feeding tube is passed through the needle into the stomach. Finally, the feed tube is fixed in place.
There are several possible complications that can arise when using a feeding tube with this method of insertion. The incision site could become infected, the tube could be dislodged, or the tube could become blocked. However, this procedure is believed to have advantages over a surgical gastronomy, which takes more time and costs more.
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