One of my earlier gastrostomy videos. These Balt T fasteners are no longer available individually and we now use the Cook Intuit ones as seen in my other video.
This video shows my technique for insertion of a primary button gastrostomy in a patient with a head and neck tumour.
The technique is simple but the potential for misplacement is high unless the correct procedure is followed. Careful checks of tube position should always be made once the tube is inserted. Cone beam CT can be helpful if in doubt.
The procedure was recorded with a GoPro Hero 3 camera.
Gastrostomy Information
Indications:
Prolonged enteral feeding requirement usually due to:
Oropharyngeal carcinoma
Inoperable/unstentable oesophageal carcinoma
Stroke
Degenerative neurological conditions such as motor neurone disease.
Gastric decompression
Contraindications:
Absolute:
Ascites
Peritonitis
Small bowel obstruction
Disseminated intra-abdmominal malignancy
Relative:
Bleeding diathesis
Previous gastric surgery
Active gastric ulceration
Pregnancy
Patient Preparation:
An NG tube should be placed prior to the procedure
200ml dilute barium may be given the night before to highlight the colon
Nil by mouth for two hours prior to the procedure
Immediate post procedure care:
Post sedation observations and observation for haemorrhage
Fasting for 6 hours
Water via gastrostomy 25mls/hr for 6 hours
Increase to 50mls/hr if no pain or other complications
Commence feeding regime the following day
T fasteners can be cut at 48hrs
Dr Phil Haslam, Consultant Interventional Radiologist
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