Gastronomy

Indications for gastrostomy placement

Gastrostomy tubes may be placed for various reasons and can be needed for temporary or permanent use. Indications for gastrostomy placement may include:

• Genetic Anomalies: Issues with the mouth, esophagus, or stomach (such as esophageal atresia or tracheoesophageal fistula).
• Swallowing Difficulties: Conditions that affect swallowing, such as severe injuries, stroke, or dementia.

Endoscopic gastrostomy placement

The gastrostomy tube can be placed under endoscopic guidance by making a very small incision (Percutaneous Endoscopic Gastrostomy, or PEG). The PEG procedure can generally be performed with sedation rather than general anesthesia.

An endoscope is passed through the mouth into the esophagus and then into the stomach, allowing the gastroenterologist to see the stomach wall where the PEG tube will be placed. Under direct visualization with the endoscope, a PEG tube is passed through the skin into the abdominal wall, through a very small incision, and then into the stomach.

A balloon is then inflated at the end of the tube to hold the gastrostomy tube in place. This technique avoids the need for general anesthesia and a large incision in the abdominal wall.