Gastrostomy: Permanent and Temporary Overview

This is surgery to place a tube through the abdomen and into the stomach. Gastrostomy can be done as:

• Endoscopic procedure: a more common and less invasive procedure called percutaneous endoscopic gastrostomy (PEG)
• Open procedure: a long incision is made in the abdomen

Prior to Procedure

Your doctor will likely do the following:

• Medical history
• Review of medicines
• Physical exam
• Assessment of swallowing ability
• Blood and urine tests
• X-rays of the abdomen
• Endoscopic examination of stomach—An endoscope is a long tube with a camera at the end that can be put down the throat into the stomach.

Leading up to your procedure:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
• Arrange for a ride to and from the hospital.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

If you are unable to undergo PEG, the doctor will do this open procedure. In some cases, gastrostomy may be done at the same time as another stomach surgery. The doctor will make an incision through the skin, abdominal wall, and into the stomach. A tube will then be placed through the skin and into the stomach. This tube will be stitched in place. The doctor will then close the incision.

Immediately After Procedure

The doctor will make sure that the tube is placed correctly. You will be moved to the recovery room and monitored closely.

How Long Will It Take?

1 hour or longer

How Much Will It Hurt?

You will have pain after the surgery. Ask your doctor about medicine to help with the pain.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is several days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

• Depending on your condition, you may need to get nutrition through IV fluids for the first day or two after the tube placement or until your intestine is working normally. You will then be started on clear liquids. You will gradually move to thicker liquids.

• Keep the tube insertion site clean and dry.

• Wash your hands before touching the area.

• If antibiotics are ordered, take all of the pills. Do not stop, even if you feel healthy.

• Learn how to administer tube feedings. Also, learn how to flush out your tube. This will decrease the risk of blockages.

• Learn what to do if you have a serious complication (eg, dislodged tube or aspiration).

• Be sure to follow your doctor’s instructions.

RESOURCES:

The American College of Gastroenterology
http://www.acg.gi.org/

American Society for Gastrointestinal Endoscopy
http://www.asge.org/

CANADIAN RESOURCES

The Canadian Association of Gastroenterology
http://www.cag-acg.org/home.htm/

Health Canada
http://www.hc-sc.gc.ca/index-eng.php/

References:

American Society for Gastrointestinal Endoscopy website. Available at: http://www.asge.org . Accessed September 4, 2009.

Cecil RL, Goldman L, Bennett J. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.

Sleisenger M, Fordtran J, Feldman M, Scharschmidt B. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 6th ed. Philadelphia, PA: WB Saunders Co; 1998.