Percutaneous Endoscopic Gastrostomy (PEG)
A percutaneous endoscopic gastrostomy (PEG) is a surgery to place a feeding tube. Feeding tubes, or PEG tubes, allow you to receive nutrition through your stomach. You may need a PEG tube if you have difficulty swallowing or can't get all the nutrition you need by mouth.
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OVERVIEW

peg tube
What is percutaneous endoscopic gastrostomy?

A percutaneous endoscopic gastrostomy (PEG) is a procedure to place a feeding tube. These feeding tubes are often called PEG tubes or G tubes. The tube allows you to receive nutrition directly through your stomach. This type of feeding is also known as enteral feeding or enteral nutrition.


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Who needs a PEG tube?

You may benefit from a PEG tube if you have difficulty swallowing (dysphagia). Causes of dysphagia may include:

Brain injury.
Head and neck cancer.
Stroke.
Chronic appetite loss due to severe illnesses like cancer.
Feeding tubes may also be useful if you have a condition that interferes with how your body processes nutrition. For example, you may benefit from a PEG tube if you have cystic fibrosis or receive dialysis for kidney failure. Someone in a coma may receive a PEG tube to help keep them alive.



Gastrostomy Tube (G-Tube)
Reviewed by: Loren Berman, MD and Kate M. Cronan, MD
Pediatric General Surgery at Nemours Children's Health

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Sonda de gastrostomía
What Is a G-Tube?
Some kids have medical problems that make it hard for them to get enough nutrition by mouth. A gastrostomy tube (also called a G-tube) is a tube inserted through the belly that brings nutrition directly to the stomach. It's one of the ways doctors can make sure kids who have trouble eating get the fluid and calories they need.

A surgeon puts in a G-tube during a short procedure called a gastrostomy. The G-tube can stay in place for as long as a child needs it.

Kids who have had a gastrostomy (ga-STROSS-teh-mee) can get back to their normal activities fairly quickly after they have healed.

Who Needs a G-Tube?
Kids need G-tubes for different kinds of health problems, including:

congenital (present at birth) problems of the mouth, esophagus, stomach, or intestines
sucking and swallowing disorders (due to premature birth, injury, a developmental delay, or another condition)
failure to thrive (when a child can't gain weight and grow normally)
extreme problems with taking medicines
What Happens Before G-Tube Placement?
Doctors often order several tests before a child can get a G-tube. The most common test is an X-ray of the upper gastrointestinal (GI) system. This lets the doctor see the upper part of the digestive system.

Sometimes the surgeon asks the family to meet with specialists, such as a gastroenterologist, dietitian, or social worker. This is to prepare a care plan so everything will be set up when the child goes home with the G-tube.

To get ready for the procedure, you will need to carefully follow instructions about when your child must stop eating and drinking. When you get to the hospital, the doctor will describe what will happen and answer any questions. The anesthesiology team will ask about your child's medical history and when your child last ate and drank.

Before the procedure begins, the care team sets up monitors to keep track of your child's vital signs (like blood pressure and oxygen level) and puts in an intravenous line (IV) to give medicines and anesthesia.

Your child will go to the operating room, and you'll go to a waiting area. A hospital staff member will tell you when the procedure is over.

What Happens During G-Tube Placement?
There are three ways doctors can insert a G-tube. Sometimes a combination of methods is used.

The laparoscopic technique is done by making two small incisions (cuts) in the belly. One is for inserting the G-tube, and the other is where the surgeon inserts a tiny telescope called a laparoscope. The laparoscope helps the surgeon see the stomach and other organs and guide the G-tube into place.
Open surgery is done with larger incisions. Surgeons choose this method to guide the G-tube into place when other methods are not a good choice — for example, if there is scar tissue from a past surgery or if the child needs another surgery done at the same time.
The PEG procedure stands for percutaneous (through the skin) endoscopic gastrostomy. The surgeon inserts an endoscope (a thin, flexible tube with a tiny camera and light at the tip) through the mouth and into the stomach to guide the G-tube into place.


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Care for your J Tube (Jejunostomy) is vital. Get advice on flushing, replacing dressing and learn how to reduce the risk of tube clogs. Presented by Roswell Park's Patient Education Department.

To ensure nutrition immediately after stomach cancer surgery, two common methods are utilized: nasojejunal tube and feeding jejunostomy. Both methods involve inserting a small tube into the small intestine, which remains untouched by the surgery. These tubes are used to provide nutrition in the form of calorie-dense and protein-dense energy powders. The powders are mixed with regular liquids such as buttermilk, water, or dal and fed through the tubes.

As the patient's condition improves, they are gradually encouraged to begin oral intake. The oral intake is increased gradually based on the patient's ability to tolerate it. Once it is determined that the oral intake is sufficient, the tube feeding can be discontinued, and the patient can transition to a full diet.

By employing these methods, immediate post-surgery nutrition is ensured, helping the patient recover and regain strength. The gradual transition from tube feeding to oral intake is an important step in the recovery process. It is important to follow the guidance of healthcare professionals and dietitians to provide adequate nutrition and promote the patient's overall well-being.
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Welcome to the American College of Surgeons (ACS) Feeding Tube Home Skills Program.

You and your family are important members of the surgical team. Watching these videos should help you understand how to care for yourself or family member after an operation. The easy-to-follow instructions cover your operation, what an enteral feeding tube is, feeding tube supplies, mouth and skin care, feeding through an enteral tube, medication, replacing the gastrostomy tube, and problem solving and emergencies.

The standardized interactive program has been developed by the ACS with input from the American Pediatric Surgical Nurses Association, American Pediatric Surgical Association, American Society of Parenteral and Enteral Nutrition, the ACS Commission on Cancer, and the Wound, Ostomy and Continence Nurses Society (WOCN®).