The gastrostomy is a a surgical procedure in which a tube is inserted into the stomach. This intervention is performed with minimally invasive surgery, specifically with endoscopic techniques, so it can also be called percutaneous endoscopic gastrostomy or simply use the acronym PEG.
The introduction of a probe into the stomach It allows you to feed yourself safely to patients who cannot perform the digestive function normally.
AND very common to use in patients with dysphagia (typical of ALS); that is, with difficulty in swallowing the food bolus. But also in people who have suffered a stroke or any other process that causes neurological damage.
If we compare the percutaneous endoscopic gastrostomy with the nasogastric tube (the one that goes from the nose to the stomach), we find many advantages. First of all, the significant reduction of complications, such as in the case of infections or injuries associated with the pharynx due to rubbing of the tube.
By omitting most of the digestive tract, patient safety is increased and, moreover, it improves your psychological sphere since it is more discreet to use the PEG. This is especially true for young patients who are often concerned about the aesthetic limitation of a nasogastric tube.
Go into the gastrostomy tube
The gastric tube offers great advantages, both medical and aesthetic, for the patient compared to the nasogastric alternative. Let’s see below how it is positioned.
How does it position itself?
As we mentioned earlier, it’s a fairly simple process. We will tell you step by step for the placement of the gastric tube according to the data provided by the American Society of Gastrointestinal Endoscopy.
First of all, an intravenous solution is given to sedate the patient in the endoscopy room. The most appropriate region of the abdomen is determined based on the results of the endoscopy, defined by the United States National Library of Medicine. as a way of looking inside the body. Subsequently, it is thoroughly disinfected.
This area is then locally anesthetized and the incision is made on the abdominal wall. It’s a small cut, more or less than 1 cm, so recovery is fast and with little risk.
soon after, a trocar is inserted up to the stomach with a wire into the endoscope as a guide. The trocar is a sort of hollow needle capable of penetrating the stomach and reaching the inside of the organ.
Finally the endoscope is extracted by dragging the wire up to the patient’s mouth and the probe is positioned which will come out of the abdominal incision. For added security, manufacturers include a balloon that is inflated to keep the tube from moving. Therefore, it stays attached and can be covered comfortably.
When should the gastrostomy tube be replaced?
The gastrostomy tube is a fairly safe procedure. However, when it comes to patients who require enteral nutrition in the long run there may be complications forcing it to be removed.
No doubt, The most common complication is infection. although bleeding may also occur, as indicated by the Medical Encyclopedia MedlinePlus.
If it is an infection, it can originate from the gastrostomy orifice in the abdominal wall or from the tube itself. In any case, it is mandatory to withdraw it and start an antibiotic regimen to eradicate the infection before a framework shock septic.
How do you replace a gastrostomy tube?
First of all, you have to sterilize and disinfect the field you will be working on and the power is turned off so that the probe is clean.
Next, it is checked that the balloon of the catheter to be placed is functioning correctly. To do this, sterile water is introduced into the valve to inflate the balloon. If it inflates correctly and there are no leaks, we can use it.
The area is thoroughly cleaned around the stomach tube hole of the patient and deflates the balloon that prevented the gastrostomy from coming out. Now that the tube is no longer functional and unattached, it can be removed by pulling firmly with one hand while pressing on the abdomen with the other.
Finally, the new tube is inserted through the same hole as the gastrostomy. Ideally, the tube should form a right angle to the abdomen for ease of placement.
Finally, the balloon is inflated to secure the new tube and is carefully drawn until it stops against the gastric wall. Always disinfect at the end of this process to ensure the new probe does not become infected.
A decision of force majeure
In short, the gastrostomy tube is used in cases of force majeure when the patient, for some reason, such as a stroke, cannot feed himself.
While inserting the feeding tube is simple, it is still an operation and, therefore, complications can arise. Obviously, the doctor will evaluate the need to place it or notaccording to the personal needs of each patient.
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