Name of the Procedure:

• Common Name: Feeding Tube Placement
• Technical Terms: Gastrostomy Tube Placement, Jejunostomy Tube Placement

Summary

A gastrostomy or jejunostomy tube is a type of feeding tube that is surgically inserted into the stomach or small intestine to provide nutrition directly to the gastrointestinal tract. It's typically recommended for patients who cannot consume food orally.

Purpose

• Medical Conditions: Severe swallowing disorders, obstructed or narrowing of the esophagus, severe neurological conditions like stroke or ALS, and digestive tract surgery.
• Goals: To ensure adequate nutrition and hydration, prevent malnutrition, and maintain or improve the patient's overall health and quality of life.

Indications

• Difficulty swallowing (dysphagia)
• Chronic neurological disorders (e.g., ALS, severe stroke)
• Esophageal or throat cancer
• Severe anorexia or other significant eating disorders
• Chronic aspiration pneumonia

Preparation

• Pre-procedure Instructions: Fast for several hours before the procedure (usually overnight), stop taking certain medications as instructed by your healthcare provider.
• Diagnostic Tests: Blood tests, imaging studies (like X-rays or ultrasounds), and a thorough physical examination may be required.

Procedure Description

1. Step-by-Step:
   • The patient is positioned and prepped in a sterile environment.
   • Sedation or general anesthesia is administered.
   • The insertion site is cleaned and sterilized.
   • A small incision is made in the abdominal wall.
   • The tube is inserted into the stomach (gastrostomy) or small intestine (jejunostomy) using specialized instruments.
   • The tube is secured in place, and the incision is closed with sutures or surgical adhesive.
2. Tools and Technology: Endoscope, surgical instruments, gastrostomy or jejunostomy tube.
3. Anesthesia/Sedation: Local anesthesia with sedation or general anesthesia, depending on the patient’s condition and the procedure complexity.

Duration

The procedure typically takes between 30 to 60 minutes.

Setting

Usually performed in a hospital operating room or a dedicated outpatient surgical center.

Personnel

• Surgeon or gastroenterologist
• Anesthesiologist
• Operating room nurses
• Surgical assistants

Risks and Complications

• Common Risks: Infection at the insertion site, tube dislodgment or blockage, minor bleeding.
• Rare Complications: Peritonitis (infection inside the abdomen), injury to surrounding organs, granulation tissue formation.

Benefits

• Expected Benefits: Improved nutritional intake and hydration, reduced risk of aspiration pneumonia, improved overall health, and quality of life.
• Realization Time: Benefits are often realized shortly after the tube is placed and regular feedings begin.

Recovery

• Post-procedure Care: Keep the incision site clean and dry, follow specific feeding and medication instructions, monitor for signs of infection.
• Recovery Time: Most patients recover within a few days to a week; follow-up appointments are necessary to monitor the tube and the patient’s overall condition.

Alternatives

• Other Options: Nasogastric tube (short-term solution), Total Parenteral Nutrition (TPN).
• Pros and Cons: TPN bypasses the gastrointestinal tract but requires a central venous catheter and can have metabolic complications; a nasogastric tube is less invasive but not suited for long-term use.

Patient Experience

• During the Procedure: Minimal discomfort due to sedation or anesthesia.
• After the Procedure: Mild discomfort or soreness at the insertion site, pain management will be provided. The patient will need some time to adjust to the new feeding routine and tube care.