Sometimes a situation develops in which a person is unable to swallow or otherwise unable to receive nourishment by mouth. In such a case, intravenous nourishment may be an option, or inserting a feeding tube may be desirable. Percutaneous endoscopic gastrostomy, abbreviated PEG, is one surgical procedure for inserting a feeding tube.
There are several types of feeding tube insertions, differing depending on 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 oesophagus is removed or gastrectomy, in which all or part of the stomach is removed, a feeding tube through a percutaneous jejunostomy, with the tube inserted into part of the small intestine, may be used. A tube into the stomach is another possibility, and it may be inserted through an open laparotomy, in which a large opening is made by surgical incision or by a percutaneous endoscopic gastrostomy, which can be done with a very small incision.
The term percutaneous endoscopic gastrostomy clarifies the details of the method of insertion of this particular type of feeding tube. Percutaneous is a synonym for transdermal, meaning “through the skin.” An endoscope is a long, slender optical instrument containing a light source and a camera and used to examine areas deep within the human body. Gastrostomy refers to an opening into the stomach through the abdominal wall.
Percutaneous endoscopic gastrostomy is a type of feeding tube insertion that is done when the patient is not expected to be able to take food by mouth for quite some time. Unlike some of the other feeding tube insertions, percutaneous endoscopic gastrostomy can be done on an outpatient basis. It can be performed by physicians with a variety of specialities.
There are four basic steps to a percutaneous endoscopic gastrostomy. First, the throat is anaesthetised and an endoscope is passed into the stomach. Second, a small incision is made in the abdomen over the stomach and a needle is inserted into the stomach. Third, the feeding tube is slid through the needle into the stomach. Finally, the feeding tube is secured in place.
There are several possible complications that may arise when using a feeding tube with this method of insertion. The point of incision may become infected, the tube may be dislodged, or the tube may become clogged. Nevertheless, this procedure is considered to have advantages over a surgical gastronomy, which takes longer and costs more.