Name of the Procedure:

Replacement of Gastrostomy Tube, Percutaneous, Includes Removal, without Imaging or Endoscopic Guidance; Requiring Revision of Gastrostomy Tract
Common names: Gastrostomy tube replacement, G-tube change

Summary

Involves removing an old gastrostomy tube (G-tube) and inserting a new one through the abdominal wall into the stomach. This version doesn't use imaging or endoscopic guidance but requires revising the tract where the G-tube sits.

Purpose

Addresses issues like dislodged, clogged, or damaged G-tubes. The goal is to restore feeding access for patients who rely on G-tubes for nutrition.

Indications

• Dislodged or pulled-out G-tube
• Clogged or non-functioning G-tube
• Irritation or infection around the G-tube site
• Need for a different type or size of G-tube

Preparation

• Fasting for a few hours before the procedure
• Adjustment or discontinuation of certain medications (as directed by the healthcare provider)
• Pre-procedure assessment including blood tests if needed

Procedure Description

1. The area around the old G-tube is cleaned and prepped.
2. Local anesthesia is administered to numb the area.
3. The old G-tube is carefully removed.
4. The gastrostomy tract is assessed and revised if necessary to accommodate the new tube.
5. A new G-tube is inserted through the stoma into the stomach.
6. Ensuring proper positioning and securing the new tube.

Tools: G-tube, anesthesia, sterile equipment (gloves, drapes, disinfectant)

Duration

Typically, 30 minutes to an hour.

Setting

Performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Physician (e.g., gastroenterologist or surgeon)
• Nurse or medical assistant

Risks and Complications

Common:

• Minor bleeding
• Infection at the insertion site Rare:
• Incorrect placement of the new tube
• Perforation of the stomach or abdominal wall
• Persistent pain at the site

Benefits

• Restores adequate nutrition and medication administration route
• Minimal downtime for patients who rely on G-tubes for sustenance
• Quick recovery time

Recovery

• Monitoring for a few hours post-procedure for complications
• Instructions on site care, cleaning, and signs of infection
• Typically, normal activities can be resumed in a day or two
• Follow-up appointment to ensure proper G-tube function

Alternatives

• Endoscopic or imaging-guided G-tube placement Pros: Higher accuracy in tricky cases Cons: More involved procedure, higher cost, possible need for sedation

Patient Experience

During:

• Minimal discomfort or pain due to local anesthesia After:
• Mild pain around the insertion site controlled with over-the-counter pain relievers
• Feeling of pressure or tightness around the new G-tube initially, which diminishes over a few days