GASTROSTOMY

Definition

Surgical creation of an opening through the abdominal wall into the stomach. A gastrostomy feeding tube insertion is the placement of a feeding tube through the skin and the stomach wall, directly into the stomach.

Description

Gastrostomy feeding tube insertion is often done through the mouth, by a procedure called endoscopy. Before the tube is inserted, numbing medicine is applied on the area, and the patient is given sleep medicines through a vein.

This procedure can also be done surgically while the patient is under general anesthesia (asleep and pain-free) A small, flexible, hollow tube with a balloon or special tip is inserted into the stomach through a small cut on the left side of the belly area. The surgeon uses stitches to close the stomach around the tube as well as the cut.

Purposes

Gastrostomy feeding tubes are put in for different reasons. They may be needed for a short while or permanently. This procedure may be recommended for:

• Babies with birth defects of the mouth, esophagus, or stomach (for example, esophageal atresia or tracheal esophageal fistula)
• Patients who cannot swallow correctly
• Patients who cannot take enough food by mouth to stay healthy
• Patients who often breathe in food when eating

Preparation

Prior to the operation, the doctor will perform endoscopy and take x rays of the gastrointestinal tract.

Blood and urine tests will also be performed, and the patient may meet with the anesthesiologist to evaluate any special conditions that might affect the administration of anesthesia.

Alternative Names

Gastrostomy tube insertion; G-tube insertion; PEG tube insertion; Stomach tube insertion; percutaneous endoscopic gastrostomy tube insertion

Risks

Risks for any anesthesia are:

• Reactions to medications
• Problems breathing

Risks for surgical or endoscopic feeding tube insertion are:

• Bleeding
• Infection
• 
  

After the Procedure

This is most often a simple surgery with a good outlook

Immediately after the operation, the patient is fed intravenously for at least 24 hours. Once bowel sounds are heard, indicating that the gastrointestinal system is working, the patient can begin clear liquid feedings through the tube. Gradually feedings are increased.

Patient education concerning use and care of the gastrostomy tube is very important. Patients and their families are taught how to recognize and prevent infection around the tube, how to feed through the tube, how to handle tube blockage, what to do if the tube pulls out, and what normal activities can be continued.

Outlook (Prognosis)

  T he stomach and abdomen will heal in 5 to 7 days. Moderate pain can be treated with medications. Feedings will start slowly with clear liquids, and increase slowly.

The patient/family will be taught:

• How to care for the skin around the tube
• Signs and symptoms of infection
• What to do if the tube is pulled out
• Signs and symptoms of tube blockage
• How to empty the stomach through the tube
• How and what to feed through the tube
• How to hide the tube under clothing
• What normal activities can be continued