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Gastrostomy feeding tubes designed for insertion of the distal tip into the stomach using a percutaneous endoscopic procedure. Typically, an endoscope is introduced through the mouth and into the stomach, and a hollow needle with a wire is pushed through the abdominal wall (i.e., percutaneous) into the stomach; then the wire is grabbed with an endoscopic tool and pulled up through the mouth. The feeding tube is attached to the wire and pulled down into the stomach and out through the opening in the abdominal wall. These tubes typically consist of a soft, clear, large bore (14 to 28 French diameter is typical) silicone tube with a small rectangular crossbar called a bolster over it next to the skin, secured by a soft balloon or mushroom distal tip on the inside; they are commonly known as peri-epigastric tubes (PEG). Gastrostomy feeding tubes are mostly used for feeding patients who require long-term enteral feeding but who are unable to maintain sufficient oral intake (e.g., patients who have severe neurologic impairment; they are also used for patients who have tumors of the mouth, larynx, or esophagus. Some of these tubes may be used to administer medications; dedicated gastrostomy feeding tubes with tips that are advanced into the jejunum for jejunal feeding are also available. PEGs may be replaced by low-profile devices known as gastrostomy buttons for long-term feeding needs.
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