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Gastrostomy tube placement – (a) endoscopic

image of Gastrostomy tube placement – (a) endoscopic
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Abstract

Endoscopic placement of gastrostomy tubes is used primarily for long-term nutritional support and where naso-oesophageal or oesophagostomy tube feeding is not possible.

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Figures

Image of Figure G.2:
Figure G.2: Commercial PEG kit.
Image of Figure G.3:
Figure G.3: The introducer needle is inserted percutaneously into the inflated stomach ideally at the junction of the body and the antrum.
Image of Figure G.4:
Figure G.4: The guidewire should be grasped with the forceps.
Image of Figure G.5:
Figure G.5: (a) The mushroom tip of the PEG tube is looped through the swaged-on wire loop to join it to the wire loop passing out of the mouth. (b) The wire loops are interlocked. (c) The wires are pulled tight to produce a knotless connection.
Image of Figure G.6:
Figure G.6: The guidewire is pulled to draw the feeding tube into the mouth, down the oesophagus, into the stomach and out through the stomach wall.
Image of Figure G.7:
Figure G.7: The bumper on the end of the tube should fit snugly against the stomach wall.
Image of Figure G.8:
Figure G.8: Once the tube is in place, it should be cut to the desired length and an adapter attached to the end of the tube.
Image of Figure G.9:
Figure G.9: The tube should be protected by gauze to prevent it from being removed by the patient.
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