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The PEG procedure is an alternative to open surgical gastrostomy insertion, and does not require a general anesthetic; mild sedation is typically used. PEG tubes may also be extended into the small intestine by passing a jejunal extension tube (PEG-J tube) through the PEG tube and into the jejunum via the pylorus. [1]
A jejunostomy is different from a jejunal feeding tube. A jejunal feeding tube is an alternative to a gastrostomy feeding tube and is commonly used when gastric enteral feeding is contraindicated or carries significant risks. The advantage over a gastrostomy is its low risk of aspiration due to its distal placement.
A gastric feeding tube (G-tube or "button") is a tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. One type is the percutaneous endoscopic gastrostomy (PEG) tube which is placed endoscopically. The position of the endoscope can be visualized on the outside of the person's abdomen ...
The Stamm gastrostomy is an open technique, [4] requiring an upper midline laparotomy and gastrotomy, with the catheter brought out in the left hypochondrium.It was first devised in 1894 by the American Gastric Surgeon, Martin Stamm (1847–1918), who was educated greatly in surgery when he visited Germany.
These tubes often have guidewires to facilitate insertion. If feeding is required for a longer period of time, other options, such as placement of a PEG tube, should be considered. [citation needed] Function of an NG tube properly placed and used for suction is maintained by flushing.
Buried bumper syndrome tends to be a late complication of gastrostomy tube placement, but can rarely occur as early as 1 to 3 weeks after tube placement. [4] [5] Most cases occur more than 1 year after initial placement of the PEG tube. [2] Excessive tightening of the external bumper is the primary risk factor for buried bumper syndrome.
Once this has been completed, the endoscope is withdrawn into the stomach and a more thorough examination is performed including a J-maneuver. This involves retroflexing the tip of the scope so it resembles a 'J' shape in order to examine the fundus and gastroesophageal junction. Any additional procedures are performed at this stage.
Gastroenterostomy, anastomosis of gastric cardia to jejunum. A gastroenterostomy is the surgical creation of a connection between the stomach and the jejunum.The operation can sometimes be performed at the same time as a partial gastrectomy (the removal of part of the stomach).