Percutaneous Endoscopic Gastrostomy

Procedure in detail:
The patient was correctly identified and a time out procedure was performed. The patient was positioned in reverse Trendelenburg. A bite block was placed. C-spine precautions were maintained. The gastroscope was inserted through the mouth and down the esophagus. The stomach appeared normal with no lesions identified. We then located the appropriate site for PEG using 1 finger palpation and transillumination. This site was then prepped and draped in sterile fashion. Local anesthesia was injected subcutaneously around the area of tube insertion. A needle was then easily passed transabdominally into the gastric lumen under endoscopic visualization. The catheter was then inserted into the abdomen, through which was placed the blue guide wire. The wire was snared endoscopically and brought out through the mouth. We then placed the gastrostomy tube transorally using the push-pull technique. The G-tube lay in appropriate position without undue tension (2cm at the skin). EGD was used to confirm placement. NG tube was removed and the stomach was desuflated. 

At this point, the G-tube was secured in position on the skin with sutures.

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