Balloon-Assisted, Fluoroscopically Guided Percutaneous Gastrostomy Tube Placement

Fluoroscopic placement of gastrostomy tubes requires creation and dilation of a percutaneous tract through which the tube is placed. Given the relatively large caliber of these tubes, aggressive dilation of the percutaneous tract is necessary prior to their insertion. Tract dilation is most commonly performed via the use of several sequential dilators or a single telescoping serial dilator. These methods are cumbersome and relatively time-consuming, and as a result this portion of the procedure can result in considerable patient discomfort as well as technical complications. This chapter describes the use of a balloon catheter for gastrostomy creation. It describes clinical scenarios that would benefit from gastrostomy tube placement. The procedure is described in a step-by-step manner with a focus on gastrostomy tract dilatation.