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Percutaneous gastrostomy is a technique where a narrow plastic tube is placed through the skin, directly into your stomach, to give you liquid nutrition. Because it is done through the skin, it is called percutaneous, and gastrostomy means making an opening into the stomach.
There are several reasons why you may not be able to eat normally. There may be a blockage at the back of your throat or in your gullet (oesophagus), and this is preventing food going down normally. It may be that you have a neurological condition or another medical issue which causes problems with your swallowing. In order to get the nutrition that you need the doctor has recommended you get fed directly into your stomach.
The Consultant in charge of your case, and the Interventional Radiologist (the doctor who specialises in Imaging Procedures) who will be carrying out the Gastrostomy.They will have discussed the situation, and feel that this is the best option for you. However, you will also have the opportunity for your opinion to be taken into account and if, after discussion with your doctors, you do not want the procedure carried out, then you can decide against it.
A specialist doctor called an Interventional Radiologist. Interventional Radiologists are experts in using X-ray equipment and in microsurgical techniques.
In the Imaging Department, in a special Interventional Radiology (IR) Procedure Room which is designed for these specialised procedures. You will be checked into the department by a nurse, who will ask some medical questions and fill out some paperwork. The Interventional Radiologist will then come and talk to you about the procedure. You will have the opportunity to ask any questions or raise any concerns, and only if you are happy to continue with the procedure will you be asked to sign the consent form.
It is performed in the IR procedure room.
To prepare for the procedure you will need to make sure you do the following:
You will need to have a blood test before your procedure. Please let us know if you are taking any antiplatelet medicines (for example, Aspirin, Clopidogrel) or any medicines that thin the blood (for example, Warfarin), as these may need to be stopped temporarily before the procedure. Call the IR department for advice as soon as you get your appointment letter on 01273 696955 Extension. 64240/64278 and ask to speak to one of the IR nursing team.
If you are taking medicines for diabetes (for example metformin) or using insulin, then these may need to be altered around the time of the procedure. Call the IR department on the numbers above for advice as soon as you get your appointment letter.
You cannot eat or drink anything (except water) for four hours before your procedure. You can drink water up to two hours before your procedure.
You will be admitted to a hospital ward after the procedure for observation and to be seen by a dietician.
Unfortunately, the procedure can hurt for a short period of time. The local anaesthetic can help with this and if required the nursing team can give you painkillers. When the local anaesthetic is injected it will sting to start with, but this soon wears off, and the skin and deeper tissues should then feel numb. Later you will be aware of the tubes being passed into your stomach, but this should just be a feeling of pressure and not pain. There will be nursing staff on hand to support you during the procedure.
Whilst every patient and every patient’s situation is different we allow an hour for the procedure.
You will not be able to have anything by mouth, NG tube or Gastrostomy tube for 6 hours after the procedure. After 6 hours, depending on your individual circumstances, you will be able to start with some fluids either by mouth or by the gastrostomy tube. The nurses on the ward will be given a feeding regime from the dieticians and they will follow that.
You will be required to recover in our recovery area on a trolley until a bed is ready for you and you are taken up to the ward. The nurses will carry out routine observations, blood pressure and pulse. You will be seen by a dietician on the ward.
This is a question that will be answered by the doctors looking after you. The tube needs to stay in place until you can eat and drink normally, and in some cases this might be for some time. You will have a specially trained dietician looking after you, who will decide how much liquid food you need to put down the tube, and will show you how to look after the tube. Seven to fourteen days after the procedure, sutures holding the buttons in place will dissolve and these should fall off the skin surface.
Gastrostomy insertion is generally a safe procedure, but complications can arise, as with any medical treatment:
Some of your questions should have been answered by this leaflet but remember that this is only a starting point for discussion about your treatment with the team looking after you.
Make sure you are satisfied that you have received enough information about the procedure before you sign the consent form.
Interventional Radiology: 01273 696955 Exension 64240.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: February 2018
Review Date: November 2022