PEG Tube Insertion
What is a PEG tube?
A PEG is a feeding tube placed inside the stomach using a Gastroscope. To insert the tube, an endoscope is passed through your mouth, down the gullet into the stomach. Once in the stomach, a bright light will be shone showing the position of endoscope tip inside the stomach, to help find the right position to place the feeding tube.
Why do I need a PEG?
You will need a PEG if you are not able to safely take enough nutrition and fluid by mouth to maintain a healthy body. This could be because you have had a Stroke, suffered a neurological illness like Multiple Sclerosis or Motor Neurone Disease, or you’re getting treatments like radiotherapy for head and neck cancer.
What does the procedure involve?
- A small cannula or plastic tube will be inserted into a vein so that a sedative can be given for the medical procedure. This would help you feel more relaxed and sleepy.
- Your throat may be sprayed with an anaesthetic that has a numbing effect so you won’t feel any pain.
- A small device for recording the pulse and breathing will be attached to your finger and you will be given oxygen through a nasal cannula for the duration of the medical procedure
- You will be asked to lie on your left side at first, then you’ll turn onto your back once the Gastroscope has been inserted.
- While you are lying on your left side, a small mouth guard will be placed in your mouth.
- After you are sedated, the Endoscopist will gently insert the gastroscope through your mouth and into your stomach.
- The stomach will be gently filed with air so that the lining can be visible.
- The air is taken out at the end of the test.
- An assistant will give some local anaesthetic to the skin, and then make a small incision in the abdomen through which a wire will be inserted and pulled up through the mouth.
- The wire is attached to the PEG tube and pulled back up through the mouth into position.
- A biopsy may also be done during the examination to be sent to the laboratory for more tests.
- A video or photographs may also be taken.
- The nurse may need to remove saliva from your mouth during the medical procedure using a small suction tube.
After the examination
- You will be taken to the recovery room to rest.
- You may still have a little wind but this will go naturally.
- You will normally stay in hospital for some days to learn about the care of your PEG and to check for complications.
- You may have a minor sore throat, but this will pass.
Are there any significant risks?
PEG placement is usually a safe and well-tolerated medical procedure. The risk of complications are higher than in a Gastroscopy because more medical procedures are needed to place the tube. The frequency of complications is usually between 5 and 10%. Rarely, the condition of some patients may deteriorate after the medical procedure because of more serious complications in about 3% of patients. The risks include:
- Damage to crowned teeth.
- A reaction to the sedative. The sedative can change your breathing by making it slow and shallow.
- Bleeding from the gastrostomy site or from one of the other organs in the abdomen.
- Perforation, which is a little tear in the wall of the bowel may occur. This is rare. This would require a stay in hospital and treatment with antibiotics and may require surgical repair.
- Infection at the gastrostomy site or within the abdomen.
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