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Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement

Katherine H. Albutt, MD
Massachusetts General Hospital

1. Introduction

2. Insufflation and Access to the Abdomen

3. Abdominal Exploration

4. Advance Endoscope to Stomach and Insufflate

  1. Place Second Port

5. Thread Wire into Stomach and out Through the Mouth

  1. Determine Approach and Location for Tube
  2. Skin Incision at Location for Tube Exit
  3. Puncture Stomach Wall
  4. Hook Needle and Pass Wire Through
  5. Bring Wire out Through the Mouth

6. Use the Wire to Pull the Tube into the Stomach and out Through the Abdominal Wall

7. Oppose Stomach and Abdominal Walls Without Tension and Secure Tube

  1. Confirm Tube is Mobile Within the Stomach

8. Closure

9. Post-op Remarks