Placement, Maintenance, Care And Removal Of A Global Gastrostomy Set

Placement

Please note that peg tubes must be left in place for a minimum of seven to ten days.

1. With your patient under general anaesthetic place them in right lateral recumbancy.
2. Place the stainless steel introduction tube into the patents stomach via the oral cavity and rotate until the flared distal end of the tube is palpable through the skin.
3. Using a syringe, pass air into the stomach via the introduction tube to confirm position
4. Pass the introduction needle percutaneously into the distal end of the tube
5. Pass the threaded wire (threaded end first) down through the needle
6. Whilst holding the wire securely remove the introduction tube and the needle leaving only the threaded wire in place
7. Using a sharp pair of scissors remove the distal flared end of the peg tube, insert the tapered catheter adaptor and secure in place with a ligature
8. Screw the adaptor onto the threaded wire
9. Whilst applying counter pressure to the skin pull the silicone peg tube through and out the flank until you reach the end of the tube and it is secure
10. Using a catheter fixation disc or suitable suture secure the tube and fit a stopcock to the open end
11. Cover stoma site with a sterile dressing and apply a light bandage around the abdomen to protect and secure the peg tube

Maintenance and care

Feeding

1. Remove the bandage and check placement of the tube by flushing a few mls of sterile water through it
2. As the tube is placed directly into the stomach and is wide bore you may feed anything from a specialised feeding preparation such as Fortol to home liquidised dog/cat food according to your patients needs
3. After you have administered the desired amount of food you should flush the tube through with sterile water again
4. Clean the stoma site with an iodine (or similar) solution
5. Re-dress with a sterile dressing and a light bandage

Removal

You may either remove the peg tube by applying counter pressure to the stoma site and pulling the tube through in its entirety (to aid with this the tube may be cut off and a pair of forceps inserted into the tube to elongate the mushroom tip), or by pulling the tube tight and cutting it off as near to the skin as possible, the mushroom tip should then pass through the remainder of the digestive tract by itself. (the latter is not advisable in cats and small dogs or smaller animals where the xl mushroom tip has been selected)

Then a couple of simple interrupted sutures can be placed in the skin to aid healing and a dressing placed over it to keep it clean for the first 2-3 days.

Equipment List

GTIS1000 set including introduction tube, percutaneous needle, threaded wire and tapered catheter adaptor suitable for animals up to 10kg in weight

GTIS2000 set including introduction tube, percutaneous needle, threaded wire and tapered catheter adaptor suitable for animals over 10kg

PPT16 Peg feeding tube 16fg 39cm long

PT 16XL Peg feeding tube 16fg 39cm long with extra large mushroom tip

PT20 Peg feeding tube 20fg 39cm long

PT20XL Peg feeding tube 20f 39cm long with extra large mushroom tip

FD100 Catheter fixation disc

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