Percutaneous Endoscopic Gastrostomy (PEG)
Percutaneous endoscopic gastrostomy (PEG) is a surgical procedure that places a tube for feeding without having to perform an open operation on the abdomen (laparotomy). It is used in patients who will be unable to take in food by mouth for a prolonged period of time. A gastrostomy, or surgical opening into the stomach, is made through the skin. A long, thin tube equipped with a light and a video camera (endoscope) is passed orally into the stomach to assist with the placement of the feeding tube and secure it in place.
The purpose of a percutaneous endoscopic gastronomy is to feed fluids and nutrition to those patients who cannot swallow food. Irrespective of the age of the patient or their medical condition, the purpose of percutaneous endoscopic gastronomy is to provide fluids and nutrition directly into the stomach.
PEG is done by a physician. The physician may be a general surgeon or a gastroenterologist (gastrointestinal specialist). The procedure is performed in our GI Suite as an outpatient or inpatient procedure. You will not be able to have anything by the mouth (eat/drink) for at least eight hours prior to the procedure. An hour prior to the procedure, you will be given prophylactic antibiotics through an IV to reduce the risk of infection. Local anesthesia (usually lidocaine or another spray) is used to numb the throat. In your IV, you will be given a sedative to help you relax. Then the endoscope is passed through the mouth, throat and esophagus into the stomach. The physician then makes a small incision (cut) in the skin of the abdomen over the stomach and pushes a needle through the skin and into the stomach. The tube for feeding then is pushed through the needle and into the stomach. The tube is then secured in place to the skin and a dressing will be applied to your abdomen.
Dietary and Case Management staff will provide instructions regarding tube care and diet. Patients usually can go home the same day, but a responsible adult will have to drive you home after the procedure is completed because of the sedation.
Possible complications include infection of the puncture site (as in any kind of surgery), dislodgment of the tube with leakage of the liquid diet that is fed through the tube into the abdomen, clogging of the tube, pain and bleeding.