Gastrostomy tubes are feeding tubes placed through the abdomen into the stomach. Gastrostomy tubes are used to give children formula, liquids, and medicines. These tubes are placed by aPediatric Surgeon or by a Pediatric Gastroenterologist. A gastrostomy tube is placed one of two ways: 1) percutaneously and 2) surgically.
At hospital discharge, a referral will be made to have a nurse visit your home. The nurse will help you care for the gastrostomy tube and give feedings and medications and, in general, serve as a resource in your home.
- Surgically Inserted Gastrostomy Tubes
- Percutaneous Endoscopic Gastronomy (PEG) Tubes
- Gastrostomy Tube Homecare
Surgically Inserted Gastrostomy Tubes
The pediatric surgeon places a gastrostomy tube in the operating room under general anesthesia. This operation is done through a small incision (cut) on the abdomen. The surgeon may place a temporary tube, called a Malecot®, into the gastrostomy opening. The Malecot® will be stitched to the skin and left in place for several weeks. The Malecot® allows the gastrostomy tract to heal well before a ballon type gastrostomy tube is inserted. A Malecot® tube is made of latex, is about twelve inches long, and most of the tube extends out of the abdomen. However, in most cases a MIC-KEY® ballon-type gastrostomy tube will be placed in the operating room. The surgeon will discuss with you the best type of tube for your child.
After the gastrostomy tube is placed your child will remain in the hospital for observation and care. An IV (intravenous line) will be placed in the operating room before the procedure and this will be used to give fluids, antibiotics and pain medications while your child is recovering. Feedings are usually started the day after the gastronomy is placed.
Changing the Malecot® To a MIC-KEY® Gastrostomy Tube
After a few weeks, the Malecot® will be removed by the surgeon or the surgical nurse and a MIC-KEY® skin level tube will be placed. MIC-KEY® skin level gastrostomy tubes are made of silicone. They are held in the stomach by a water-filled balloon. When the nurse inserts the MIC® device, she will teach you how to take care of the tube.
For more information see Gastrostomy Tube Homecare
Percutaneous Endoscopic Gastrostomy (PEG) Tube
A PEG Tube, or Percutaneous Endoscopic Gastrostomy tube, is placed by a Pediatric Gastroenterologist in the operating room. The PEG tube is inserted using a telescopic instrument, called an endoscope. The endoscope is a small tube with a light and camera on the end that lets the Gastroenterologist see into the esophagus (food tube) and stomach. The endoscope allows the doctor to choose the best location in the stomach to place the PEG tube. Once the location is chosen, a small opening is made on the outside of abdomen into the stomach. After the opening is made, the top part of the PEG tube is pulled up out of the stomach through this opening. The top of the tube rests on the skin and the bottom part of the PEG, which is shaped like bulb, remains inside the stomach. This bulb shape anchors the tube in the stomach and prevents it from coming out.
After the PEG tube is placed your child will be admitted to the hospital for observation and care. The hospital stay is usually three days. Prior to the procedure, an IV (intravenous line) will be placed in the operating room. This will be used to give fluids, antibiotics and pain medication, for one to two days, as your child is recovering. Feedings will be started through the PEG tube within one or two days.
The PEG tube which is made of silicon, must stay in the stomach for about three months to allow the tract (hole) to heal between the abdomen and the stomach. The tract must be well healed so it is safe for the gastrostomy tube to be changed.
For more information see Gastrostomy Tube Homecare