Procedure: Replace G-tube

Indication: Loss of G tube for feeding

Date: [  ]

Operators:   John Doe, MD (Attending)/Jane Doe, MD (Fellow)     

Medications: Lidocaine 2% local  

Fluoroscopy time:  1 minutes

Catheter:   Balloon 20 F

Complications:  None immediate.

 

Procedure:

The risks, benefits, and alternatives to the procedure and sedation were explained to the patient. Written informed consent was obtained.  A time out/call to order was performed prior to procedure initiation.

The anterior abdominal wall was prepped and draped in sterile fashion. A scout radiograph was obtained.

Contrast was injected through the skin opening and followed into the stomach. A Kumpe catheter was used to follow this into the stomach. A wire was advanced through the Kumpe catheter into the stomach under fluoroscopic control. The tract leading from skin to gastric lumen was dilated with a 8 x 4 conquest balloon.

The balloon was retracted; a 20 French gastrostomy tube was loaded over the balloon. This was advanced over the wire and position in the skin tract. The balloon was partially inflated and the gastrostomy tube and balloon catheter were advanced into the stomach under fluoroscopic control. Contrast was injected into the balloon of the feeding tube which was then retracted to the anterior abdominal wall. The wire and catheter were removed and contrast was instilled through the feeding tube to verify adequate location within the gastric lumen. 

Successful placement of the PEG tube was confirmed. Sterile dressings were placed and the patient discharged from Angio-Seal suite in good condition.

 

Findings: 

  1. Near occlusion of gastrostomy tract post inadvertent loss of gastrostomy feeding tube outside the hospital.  
  2. Successful balloon dilation of gastrostomy tract and placement of a 20 F Balloon Gastrostomy tube.  

 

Impression:

Successful replacement of the gastrostomy tube after inadvertent loss of feeding tube.