Placement of Feeding Tubes
Unfortunately, there are numerous reasons why patients might lose the ability to eat. Some reasons include oral or esophageal cancer, Lou Gehrig’s disease, stroke, advanced Alzheimer’s disease, prolonged intubation, head trauma, or extensive oral and facial surgery. Whatever the reason, people who can’t eat need to find another way to acquire the nutrients that they require. While patients can temporarily use intravenous nutrition, this can have a multitude of side effects and requires a central line. The placement of a feeding tube allows ideal nutrition with far fewer side effects compared to intravenous nutrition. There are several options for feeding tube placement.
Percutaneous Endoscopic Gastrostomy Tube
The first option is a percutaneous endoscopic gastrostomy tube or a PEG tube. This is a minimally invasive technique to place a gastric feeding tube. A gastroscope is placed into the mouth and the stomach is inflated with air. Then a needle and wire and placed through the abdominal wall into the stomach. The feeding tube is threaded over the wire and pulled into place on the abdominal wall. Alternatively a longer feeding tube with the end placed into the small bowel, a gastrojejunal feeding tube, can also be utilized. The most feared complication using this method is puncturing the colon or small bowel during tube placement. For this reason, this technique is usually not used in patients who have had prior upper abdominal surgery. However, there are always exceptions.
Open Gastrostomy Tube
The next option for a feeding tube is an open gastrostomy tube. Again, the feeding tube resides in the stomach. However, the surgeon makes an abdominal incision. The stomach is freed of surrounding tissue, an incision is made in the gastric tissue, and the feeding tube is sutured into place.The tube is then tunneled through the abdominal wall. This method is most often used for patients who have had abdominal surgery. Recovery time is relatively short. Patients can usually start using the tube in 48 hours.
Jejunal Feeding Tube
The last method used for feeding tubes is a jejunal feeding tube or otherwise known as J-Tube. This feeding tube is placed directly into the small bowel. The procedure is used for those patients who may require gastric surgery or in patients with pancreatic disease. The process is similar to an open gastrostomy. After the abdominal incision is made the tube is sutured into the small bowel and the abdomen closed. These tubes can twist or fall out so it is imperative that surgeons appropriately suture tube site to the abdominal wall. Again, most patients do well with minimal recovery time if this is the patient’s only procedure at that time.
Clearly, there are a number of important complications that make placing a feeding tube a serious procedure. Therefore, everyone looking for a feeding tube placement on the West Coast of Florida should look a great board-certified general surgeon. Dr. Jenna Kazil understands the complexities involved with placing a feeding tube and is the lead double board-certified vascular and general surgeon at Florida Surgical Clinic. Jenna Kazil, MD, FACS, RPVI is a skillful surgical specialist working as a general and vascular surgeon seeing patients from Desoto, Hardee, Hillsborough, Manatee, Pinellas, and Sarasota counties. Patients needing placement of a feeding tube or any other general or vascular surgery should contact the Florida Surgical Clinic today to schedule an appointment for all their vascular and general surgical needs. Call today for more information!