Percutaneous G-Tube Placement

Gastric feeding tubes are suitable for long-term use; though they sometimes need replacement if used long term. The G-tube can be useful where there is difficulty with swallowing because of neurologic or anatomic disorders (stroke, esophageal atresia, tracheoesophageal fistula), and to avoid the risk of aspiration pneumonia.

A clinical staff member will bring you into the pre-procedure area and ask you to change into a gown. An intravenous (IV) line will be inserted into a vein in your hand or arm. You will be given antibiotics. Your doctor will greet you, review the procedure, and answer any questions you may have. You will be brought into the procedure room, and you will be positioned on the procedure table. You will be connected to a monitor for your heart rate, blood pressure, and pulse. The technologist will shave, sterilize, and cover the area of your abdomen where the catheter will be inserted with a surgical drape. The doctors will wear sterile gowns and masks. After review of your x-rays and the use of the above techniques, the doctor will mark the area on your abdomen.

The procedure is done with sedatives and pain medicine. Many times the patient will be asleep”. There will be a clinical staff member or anesthesiologist checking your pulse, blood pressure, and temperature. A nasogastric tube is placed through your nose and your stomach will be filled with air. This helps with tube placement. This will make you feel full but should not cause you pain. Using fluoroscopy, a small needle is placed in the stomach. Lidocaine will be used onto your skin over your stomach in order to numb the place where the tube will go into your abdomen. This needle will then be exchanged for the soft tube. You may feel some pressure during the placement of the tube.

The tube will be secured in place with a skin suture.

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or – as you’re doing now- educate yourself about the procedure.

Another important part of your preparation will be guided by your doctor:

• Several days before the procedure, you will have a consultation with the interventional radiologist
• Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin, Warfarin, Plavix, Fragmin) for a time before the procedure.

Some of your preparation will need to be timed to the procedure:

• The day before the procedure (or the Friday before, if you’re scheduled for a Monday procedure), a clinical staff member from the Interventional Radiology Department will call you. The clinical staff member will give you any additional instructions, and will ask if you have any questions.
• Take your medications as instructed
• When you arrive, make sure the clinical staff member and radiologist know about any allergies you may have, especially allergies to local anesthetics (such as lidocaine), general anesthetics, or x-ray dye (contrast media). If there’s any chance you might be pregnant, tell your radiologist.

• Wear comfortable, loose-fitting clothes
• Wear comfortable shoes
• Avoid bringing jewelry or valuables

The benefits of Percutaneous G-Tube Placement could be:

• Provide nutritional support

Risks you should be aware of include:

• Like any catheterization procedure, there is risk of damage to blood vessels, bruising, bleeding, or infection at the puncture site
• As feeding tubes are placed as a procedure that punches a hole in the stomach and skin, this can lead to leaking of contents into the abdomen causing severe infection and death. This is a rare, but serious complication
• The most frequent complication is irritation around the site of the insertion, generally caused by stomach acid and feedings leaking around the site. Barrier creams, dressings, and frequent cleaning is generally recommended
• Especially in advanced dementia, patients can pull at the feeding tubes causing them to be dislodged and requiring a hospitalization to replace them
• Feeding tubes may become clogged or occluded if not flushed with water after each feeding. A clogged tube may need to be replaced

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.