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Why is a PEG tube insterted in stomach?

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General Surgeon
Practicing since : 2008
Answered : 5373 Questions
Is there any reason why a long gastro tube would be inserted into a patient rather than a low profile Mic-Key button for feeding? Is different equipment used for the placement of these tubes? Is specific training needed for initial placement of the low profile "button type" port?
Posted Sat, 8 Feb 2014 in Digestion and Bowels
Answered by Dr. Grzegorz Stanko 4 hours later
Brief Answer: Detailed below. Detailed Answer: Hello! Thank you for the query. I assume that by "long gastro tube" you mean classic gastrostomy tube (called PEG tube). Both Mic-Key Button and PEG tube are generally the same thing. The only difference is that Mic-Key Button is shorter (there is no long tube hanging outside the abdomen) and gives more comfort to the patient. Feeding through both is the same, insertion is also similar (both can be placed endoscopically). So no specific training is necessary to place it. Sometimes it is necessary to bypass stomach and place the tube to duodenum. In such case, the tube inside the stomach must be longer. Hope this will help. Feel free to ask further questions. Regards.
Above answer was peer-reviewed by
Follow-up: Why is a PEG tube insterted in stomach? 1 hour later
My 96 year old mother had to have a tube replacement yesterday as the site of her previous tube was very "angry", irritated,sore and seemed to have infection. When the Dr replaced/relocated the tube, he changed from a low profile Mic-Key type to the normal or long tube. When I questioned the reason for the change he advised that the necessary equipment to place the low profile tube was not available at the hospital that he was working in. I am very much aware that an endoscopy procedure must be performed to initiate a new site but I see absolutely no reason that the low profile type could not be placed with basically the same equipment. This is the second time that he has placed the long tube in my mother. After the first time, I requested changing to the low profile because she is very active and the bulkiness of the long tube, as well as having to use tape to keep it from being pulled on by her clothing, naturally causing constant irritation of other tissue on the abdomen. He did the swap to the low profile at about 6 months after the original placement. Needless to say, anytime removal and reinsertion takes place a certain amount of discomfort is involved. Why put a person her age through 2 procedures when 1 would suffice? As I stated earlier, his response was "that the facility did not have the necessary equipment". What is so different in an endcoscopy procedure from one to the other. Both require site location from outside, insertion of camera/endoscope, wire insertion, attachment and pull through of feeding tube appliance. Depending of type, inflation of balloon on low profile type or setting of retainer on the long tube. Am I missing something that requires any major equipment for the to placement of the low profile tube? Just simply do not understand the explanation that I received. As further conversation went..."we can change to the low profile when she come back to see me in 2 months". Just simply do not like this approach. Back to square one: Put normal/long tube in for several months and do another procedure and change to low profile later! My husband had a Mic Key PEG placed at the very start of tube feedings and kept the low profile type for 8 years (of course changing when necessary). Never had the regular long type. Never had to go through 2 procedures. Do not understand his explanation or reasoning on the need for 2 procedures!
Answered by Dr. Grzegorz Stanko 8 minutes later
Brief Answer: Detailed below. Detailed Answer: Endoscopy is necessary only in making a hole in the stomach and abdominal wall. Once the hole is done and the tube is placed, stomach simply accretes to abdominal wall and it needs to take a long time before the hole will be closed (it can get closed if there is no tube placed). So in simple words, it is easy to replace the tube to any available if there is a hole already done. So next time she will visit a doctor, simple replacement will be enough. No need to do any other procedure. You just remove the tube and put a new one into the hole. And there is no difference between inserting Mic Key type and long tube. According to your explanation, the only reason she didn't get Mic Key, is because it wasn't available in the hospital. But it can be replaced to Mic Key in any time. No need to wait 2 months. Hope this sounds clear for you. If I have missed something, feel free to ask. Regards.
Above answer was peer-reviewed by
Follow-up: Why is a PEG tube insterted in stomach? 1 hour later
No, I apparently didn't make myself clear on what actually took place. The Dr. said the hospital did not have the "necessary equipment to instal the Mic-Key into the abdomen". The actual Mic-Key appliance that is to be put in when we come back in 2 months was physically given to us and we were told to bring it with us when we came back for our 2 month visit. Makes me wonder why he has done this type of procedure on both occasions. Put one type in...given us the low profile type before she was discharged from the hospital (which meant the appliance was available at the time the procedure was performed) and instructed us to bring it with us when we returned for the 2 month visit and informed us that it would be changed them.
Answered by Dr. Grzegorz Stanko 24 minutes later
Brief Answer: . Detailed Answer: Well, what doctor said to you does not make sense for me either. There is no special equipment necessary to install Mic-Key. All you need is Mic-Key itself. Its just a short tube with a balloon at the end to fix it to the stomach. It is so easy procedure, that you would be able to replace it at home if instructed. So I have no idea why the doctor didnt replace it for Mic-Key. Regards.
Above answer was peer-reviewed by
Follow-up: Why is a PEG tube insterted in stomach? 1 hour later
Thank you. I was beginning to think I was completely stupid. Over the 8 year period that my husband had his feeding tube (Mic-Key) I changed it probably 15-20 times. At the time of initial placement his doctor instructed me verbally and with a video on how to change it whenever I saw the need after performing the weekly check test. As bad as I hate to say it, I feel like this doctor that I am dealing with is really in the "dark ages" and hasn't kept up with new procedures or is very "money hungry". Sorry about expressing my feelings in this manner, but at least now I have a little more insight into what his actions might be. Probably will make some changes soon. Not very confident in his general ethics or professionalism. Thanks so very much for your input it was most helpful.
Answered by Dr. Grzegorz Stanko 8 hours later
Brief Answer: . Detailed Answer: You are welcome.
Above answer was peer-reviewed by
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