First Year Fellows Endoscopy Course (July 29 - 30) | 2022-Feeding Tubes: Percutaneous Gastrostomy Tubes (PEG)

Video Transcription

Video Summary

In this video, Naina Coelho provides a brief overview of feeding tubes and specifically focuses on percutaneous endoscopic gastrostomy (PEG) tubes. She discusses the indications for PEG insertion, such as when a patient is unable to eat due to reasons like stroke, esophageal cancer, or radiation therapy. Coelho emphasizes the importance of assessing the patient's nutritional requirement and considering alternative options like jejunostomy tubes if necessary. She also mentions factors to consider before the procedure, including the patient's medications, anatomy, and abdominal hernia mesh placement. Informed consent is highlighted as a crucial aspect, especially when patients are unable to provide consent themselves. Coelho provides guidelines for the management of anticoagulation during PEG insertion, emphasizing the need to balance the risk of bleeding and embolism. She discusses the technical aspects of the procedure, including insufflating the stomach and identifying the appropriate insertion site. Coelho demonstrates the use of an angiocatheter and wire to guide the insertion of the PEG tube into the stomach. She emphasizes the importance of securing the bumper at the skin level and monitoring for potential complications like aspiration, bleeding, leakage, and granulation tissue formation. Coelho discusses the management of complications such as buried bumper syndrome and gastrocolic fistulas. She also mentions the options for tube replacement, including low-profile and balloon tubes. The video concludes with Coelho addressing scenarios that may require further evaluation or intervention, such as tube migration and leakage. No specific credit is mentioned in the video.

Asset Subtitle

Nayantara Coelho-Prabhu, MD

Keywords

feeding tubes

PEG tubes

indications for PEG insertion

nutritional requirement assessment

complications

tube replacement options

evaluation