Endoscopic and Surgical Gastrostomy and Jejunostomy Tube Placement

2018 ◽  
Vol 02 (01) ◽  
pp. 053-061
Author(s):  
Kevin El-Hayek ◽  
Marita Bauman
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Jejunostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Surgical Gastrostomy ◽  
Tools And Techniques ◽  
Invasive Techniques

AbstractEnteral access is a common request for consulting surgeons and interventionists. Prior to the 1980s, such a consultation often necessitated open surgical intervention whereas today, enteral access is often performed via several minimally invasive methods. Tools and techniques for minimally invasive enteral access have changed drastically due to advancements in the fields of endoscopy, laparoscopy, and interventional radiology. Percutaneous endoscopic gastrostomy tube placement is one such advancement. Since its first development, its basic principles have been applied to other minimally invasive techniques, which have resulted in an expansion of techniques for establishment of enteral access. In this article, we outline various endoscopic and surgical techniques for gastric and jejunal access.

The Ethics of Medically Assisted Nutrition and Hydration at the End of Life

2016 ◽  
Author(s):  
Daniel Sulmasy
Keyword(s):  
Tube Feeding ◽  
Nutritional Therapy ◽  
Treatment Modalities ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Jejunostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Dying Patients ◽  
Intravenous Hydration ◽  
Nutrition And Hydration ◽  
Surgical Gastrostomy

This chapter examines the ethics of medically supplying nutrition and hydration to dying patients. It first considers the available treatment modalities for patients who are unable to eat or drink, including nasogastric tube feeding, percutaneous endoscopic gastrostomy tube feeding, surgical gastrostomy or jejunostomy tube feeding, proctoclysis, intravenous hydration and nutrition, total or partial parenteral nutrition, and hypodermoclysis. Before discussing the ethics of their use in palliative medicine, the medical aspects of these techniques as well as their risks and benefits are outlined. The author then proposes a classification of four critical decisional junctures along the trajectory of disease progression and highlights a number of disabling, chronic, progressive, and eventually fatal diagnoses with differing trajectories toward death. Finally, it looks at a number of ethical controversies surrounding medically assisted nutrition and hydration, including the issue of religion and the moral and psychological aspects of stopping and starting nutritional therapy.

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

Endoscopic Techniques for Obtaining Enteral Access

2017 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

Endoscopic Techniques for Obtaining Enteral Access

2018 ◽  
Author(s):  
Marvin Ryou ◽  
Sanjay Salgado
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Enteral Feeding ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Nasogastric Feeding ◽  
Percutaneous Gastrostomy ◽  
Endoscopic Techniques ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Gastric Feeding

In the absence of contraindications, enteral feeding is recommended for patients who are expected to be intolerant of oral feedings beyond 7 days. Enteral access can be accomplished by a variety of means, including surgical, endoscopic, or radiographic methods. This review focuses on endoscopy-guided options for enteral access. These methods include gastric feeding, which can be accomplished by orogastric, nasogastric, or percutaneous endoscopic gastrostomy tube placement, and postpyloric feeding, accessed through oral or nasal jejunal tubes, percutaneous gastrostomy with a jejunal extension, or direct percutaneous jejunostomy. The indications, techniques, complications, and comparative data of these placement options are outlined, and special clinical considerations (including establishing access in patients with dementia or cirrhosis and those on anticoagulation) are discussed. This review contains 5 figures, 1 table, and 33 references. Key words: direct percutaneous jejunostomy, endoscopy, enteral access in cirrhosis, enteral access in dementia, enteral feeding, enteric access, nasogastric feeding tubes, percutaneous endoscopic gastrojejunostomy tubes, percutaneous endoscopic gastrostomy tubes

scholarly journals Percutaneous Endoscopic Gastrostomy Tube Gone Wrong: Endoscopic Closure to the Rescue

2021 ◽  
Vol 12 (03) ◽  
pp. 169-171
Author(s):  
Jahnvi Dhar ◽  
Naveen Kumar ◽  
Pankaj Gupta ◽  
Rakesh Kochhar ◽  
Jayanta Samanta
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Tube Placement ◽  
Endoscopic Management ◽  
Unusual Complication ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
First Line ◽  
Endoscopic Gastrostomy ◽  
Endoscopic Closure ◽  
Enteral Access ◽  
Peg Tube

AbstractPercutaneous endoscopic gastrostomy (PEG) is one of the most commonly performed endoscopic procedures and a first-line treatment for the establishment of enteral access in those with intolerance or contraindication to oral feedings. A small amount of pneumoperitoneum in the immediate postprocedure period is well reported after PEG tube placement. However, pneumoperitoneum resulting from displaced gastric bumper within 24 hours postprocedure is uncommon and rarely reported in the literature. Timely diagnosis and early endoscopic management can help tackle such an unusual complication.

scholarly journals Revisional Techniques for Secondary Cleft Lip Deformities

2021 ◽  
Vol 35 (02) ◽  
pp. 065-071
Author(s):  
Shayan M. Sarrami ◽  
Anna J. Skochdopole ◽  
Andrew M. Ferry ◽  
Edward P. Buchanan ◽  
Larry H. Hollier ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Early Life ◽  
Cleft Lip ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Minimally Invasive Techniques ◽  
Adjacent Tissue ◽  
Tissue Transfer ◽  
Invasive Techniques

AbstractSecondary deformities of repaired cleft lips are an unfortunate complication despite the meticulous approach of modern primary procedures. Most of these surgeries take place in the patient's early life and must be strategically planned to provide optimal cosmesis with minimal interventions. Depending on the level of severity, treatment of the secondary deformities ranges from noninvasive or minimally invasive techniques to complete revision cheiloplasty. Many novel topical, injectable, and laser therapies have allotted physicians more technical flexibility in treating superficial distortions. Nonetheless, surgical techniques such as diamond excision and adjacent tissue transfer remain popular and useful reconstructive modalities. Deformities involving the orbicularis oris must be completely taken down to allow full access to the muscle. Complete revision cheiloplasty requires recreation of the cleft defect and reconstruction similar to the primary repair. Due to the myriad of presentations of these secondary deformities, familiarity with the various treatments available is imperative for any cleft surgeon.

4734 Endoscopists' perspective on percutaneous endoscopic gastrostomy tube placement.

2000 ◽  
Vol 51 (4) ◽  
pp. AB217
Author(s):  
Sean R. Lacey ◽  
Elizabeth O'Toole ◽  
Richard C. Wong ◽  
Gregory S. Cooper ◽  
Stuart Youngner
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Gastrostomy Tube ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Gastrostomy Tube Placement
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