Percutaneous Endoscopic Gastrostomy (PEG) Tube Placement

1. Introduction

2. Endoscope Advancement into Stomach

3. Confirm Location with 1:1 Movement and Transillumination

4. Local Anesthetic and Incision

5. Finder Needle and Catheter Sheath Insertion Through Stomach Wall

6. Removing Needle and Replacing with Looped Wire Through Remaining Catheter

7. Snaring Wire Endoscopically and Pulling it out of the Mouth

8. Endoscopically Advance PEG Tube into the Stomach and Bring PEG Tubing out Through Incision

9. Reestablishing Endoscopic Visualization and Determining Appropriate PEG Placement and Length

10. Cutting the Wire off and Placing External Bumper and Lock

11. Cutting the Tube to Length, Attaching the Bag Adapter, and Dressing

12. Tips for Endoscopy