Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement
Amory C. de Roulet, MD, MPH
Massachusetts General Hospital
Percutaneous Endoscopic Gastrostomy (PEG) is a minimally-invasive medical procedure that creates a safe and effective route for enteral nutrition, fluid administration, and medication delivery. PEG tubes are primarily used for long-term enteral nutrition in patients with impaired swallowing or inadequate oral intake, decompression of the gastrointestinal tract, and administration of medications. This detailed video demonstration of the PEG tube placement procedure is a crucial educational resource for medical professionals. It provides comprehensive visualization of a complex procedure, demonstrates real-time problem-solving, emphasizes safety considerations, and offers valuable tips for practitioners.
Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement
Katherine H. Albutt, MD
Massachusetts General Hospital
For long-term enteral nutrition, percutaneous endoscopic gastrostomy (PEG) is considered the standard of care; however, it often leads to a number of complications: tube migration, blockage, inadvertent tube slipping and removal, and less often, perforation. PEG involves insertion of a feeding tube through the skin and into the stomach, with the assistance of endoscopic intraluminal visualization of the stomach. PEG is a blind procedure, making it difficult to detect organs interposed between the stomach and the abdominal wall (e.g., colon, small intestine, greater omentum). To avoid these complications, laparoscopic-assisted PEG (LAPEG) was introduced.
LAPEG tube placement stands out as a minimally invasive surgical intervention that combines the techniques of laparoscopy and endoscopy to establish enteral access for nutritional support. The laparoscopic approach provides visualization for the feeding tube insertion and for approximation of the gastric and abdominal walls. This method proves particularly beneficial for individuals who require long-term enteral feeding while having obstacles with conventional approaches to stomach access due to diverse medical conditions.
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