Gastrostomy Insertion (PEG Tube)
A gastrostomy is a procedure where a short tube is placed directly into the stomach through the abdominal wall. This is sometimes referred to as a Percutaneous Endoscopic Gastrostomy (PEG) .The gastrostomy tube may be placed in the stomach for only a short time or can be permanently used to provide nutritional support. Gastrostomy feeding tubes are put in for different reasons:
Preparation
In most cases you would have been admitted to the hospital and the decision to insert a gastrostomy tube has been discussed with you by the doctor looking after you on the ward. A staff member will provide you with the appropriate individual instructions upon booking your appointment. This procedure will require general anaesthetic therefore you will need to fast from midnight the night before your appointment. This will ensure that your stomach is empty and eliminate the risk of aspiration (food or fluid in the lungs). 
Please inform the clerk at the time of booking your procedure if you are currently taking medication that thin your blood (eg, Aspirin, Plavix, Warfarin) as these may need to be stopped a few days prior to your procedure. It may be useful to bring a LIST of medications to your appointment. You will need to have a blood test a few days prior to your appointment to assess your kidney function and blood clotting times. If your blood sample was taken outside the hospital then please obtain a copy of the results and bring it with you on the day of your procedure. You will need to bring any previous films (x-ray/CT/MRI/US) along to your appointment. This procedure involves the use of intravenous contrast; see Intravenous Contrast For health and safety reasons, family members cannot be present with you during the procedure. A staff member will be available to assist you at all times during the procedure if you have any concerns. A doctor will explain the procedure beforehand and you will be required to sign a consent form. If you require an interpreter, please inform the booking clerk at the time of booking. Procedure
You will be asked to change into a hospital gown. All jewellery and metal objects in the area to be scanned will need to be removed as this can cause artefact and obscure the images. A nasogastric tube (a tube in your nose that ends in your stomach) will be inserted If you have not already had one. You will be positioned on your back on the procedure table. A sterile sheet will be draped over you with your abdomen exposed. A cold cleaning solution will be applied to clean the skin. Air will be inserted into your stomach through the nasogastric tube in your nose. The air will distend your stomach so the wall of your stomach moves against the wall of your abdomen. This helps the insertion of the tube. The doctor will use image guidance to locate the stomach and local anaesthetic will be injected to numb the area of the abdomen where the tube will be positioned. A small cut will be made and the gastrostomy tube is inserted through and positioned into the stomach. Contrast agent will be injected into the tube and x-rays taken to ensure correct placement in the stomach. Once placement is confirmed a small balloon located at the end of the tube will be blown up with water to ensure the tube is kept in place. After the Procedure
It is recommended to start on clear fluids (water) through the tube. If water is tolerated then feeds and medication can be commenced. After 24 hours, you may bathe with mild soapy water and dry gently around the gastrostomy tube site. Ensure the area is clean and dry. You will need to turn the tube a full circle (360degrees) every day. Preparation Checklist
Don't forget to bring these along to your appointment
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Medical Imaging |
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