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Endoscopic Gastrostomy

Gastrostomy is that the creation of a synthetic external opening into the stomach for nutritional support or gastric decompression. Typically this might include an incision within the patient's epigastrium as a part of a proper operation. It may be performed through surgical approach, percutaneous approach by interventional radiology, or percutaneous endoscopic gastrostomy. This provides enteral nutrition (making use of the natural digestion process of the gastrointestinal tract) despite bypassing the mouth; enteral nutrition is mostly preferable to parenteral nutrition (which is simply used when the alimentary canal must be avoided). The PEG procedure is an alternate to open surgical gastrostomy insertion, and doesn't require a general anesthetic; mild sedation is often used. PEG tubes with rigid, fixed "bumpers" are removed endoscopically. The PEG tube is pushed into the stomach so that part of the tube is visible behind the bumper. An endoscopy snare is then passed through the endoscope, and passed over the bumper so that the tube adjacent to the bumper is grasped. The external part of the tube is then cut, and the tube is withdrawn into the stomach, and then pulled up into the esophagus and removed through the mouth. The PEG site heals without intervention.

 

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