Oesophagostomy Placement, Maintenance, Care and Removal

There are two recommended methods of oesophagostomy tube placement the first is recommended for cats and small dogs, the second for dogs that require a larger tube size than 10fr.

Both methods can be left in place from 1 day to several weeks

Method One; Van Noort Technique

1. With your patient under general anaesthetic place them in right lateral recumbancy
2. Insert the introduction tube into the oesophagus via the oral cavity
3. Rotate the tube until you can feel the slot in the distal portion of the tube
4. Introduce the needle with peel away sheath through the skin into the distal portion of the tube
5. Whilst holding the sheath in place remove the needle from the sheath
6. Again holding the sheath in place remove the introduction tube
7. Measure and pre mark the desired length on the catheter prior to introduction
8. Introduce the catheter through the sheath into the oesophagus stopping when you reach your pre-marked length
9. Grasping either side of the sheath pull down and out to leave only the catheter in place
10. Secure catheter with suitable suture (i.e. Chinese finger trap suture)
11. Cover over with sterile dressing and light bandage

Method Two; Global technique

1. As 1 above
2. Using the introduction tube from the gastrostomy set
3. Insert the tube into the oesophagus via the oral cavity
4. Palpate the flared distal end of the tube through the skin and introduce the needle with peel away sheath into the tube percutaneously
5. Whilst holding the peel away sheath remove the needle and then the introduction tube
6. Redirect the sheath by withdrawing it slightly flipping it 180 degrees then advance it into the distal oesophagus
7. As 7 – 10 above

Maintenance and care feeding

1. Remove the bandage and sterile dressing
2. Prior to feeding flush the catheter through with sterile water
3. As the catheters are of a narrow bore you must use a speciality liquid food (i.e. Fortol)
4. After the desired amount of food has been administered again flush with sterile water
5. Clean the stoma site with iodine solution (or similar)
6. Redress with a sterile dressing and cover with a light bandage

Removal

When you are ready to remove the catheter take off the dressing, remove the suture and pull the catheter out. No sutures are needed but can be placed if preferred the stoma should knit together within 24 hours.

Equipment List

For Global technique

OTCS12 set comprising 12fr catheter, peel away needle and 3 sheaths
OTCS14 set comprising 14fr catheter, peel away needle and 3 sheaths
OTC1260 12fr catheter from above set OTC1460 14fr catheter from above set
NPOS875 1 needle with 3 peel away sheaths (for use with 12fr sets)
NPOS775 1 needle with 3 peel away sheaths (for use with 14fr sets)

For Van Noort technique

OTCS1000VN set comprising 10fr catheter, wire guide, needle with peel away sheaths
OTC1040VN catheter and wire guide only from above set
GTI18365ITVN stainless steel introduction tube
NPOS1055 3 needle with 3 peel away sheaths

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