Are there any alternatives to a gastrostomy device?

It is possible for the healthcare team to give your child nutrients and fluid through a tube that is placed in their nostrils and down into their stomach.

A PEG is a procedure to insert a feeding tube into your child’s stomach by pulling the tube down the throat into the stomach. The tube is then brought out of the stomach through a hole in the abdominal wall.

It is also possible for the healthcare team to give your child nutrients and fluid directly into their bloodstream.

What does the operation involve?

The operation is performed under a general anaesthetic and usually takes between 45 minutes and 1 hour.

This can be done as an open operation or keyhole surgery. If it is keyhole surgery, your surgeon will insert a telescope into your child’s abdomen through a small cut made around the belly button. If it is an open operation, your surgeon will make a cut in the upper part of your child's abdomen.

Your surgeon will make second small cut in the left upper part of your child’s tummy for the placement of the gastrostomy device. The stomach is grasped through this second small cut and the gastrostomy device is inserted through this cut through the abdominal wall into the stomach. The stomach is stitched to the tummy wall to stop it from becoming detached.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

• bleeding
• infection

Specific early complications

• allergic reaction to the equipment, materials or medication
• damage to teeth
• damage to the liver or intestine
• developing a hernia in the wound
• inflammation of the lining of the abdomen
• the device falling out before the stomach heals properly to the abdominal wall

Specific late complications

• blocked device after a number of months as the device deteriorates
• developing gastro-oesophageal reflux (acid reflux)
• tissue granulation around the exit site
• leaking from the exit site
• prolapse
• gastrocutaneous fistula

Consequences of this procedure

• pain
• unsightly scarring of the skin

How soon will my child recover?

You (or your child’s carer) will usually be trained by a specialist nurse or dietician who will show you how to feed your child using the device and how to prevent any infection.

Depending on the problem that made it difficult for your child to swallow, your child should be able to return to normal activities after 1 to 2 weeks.

If you have any problems with the feeding device or exit site, contact the healthcare team.

Your doctor will advise you on how long your child needs to have the device. If your child needs a gastrostomy device for a long time, your doctor will discuss with you plans to replace the gastrostomy tube with a gastrostomy button.

Summary

If your child is not able to eat and drink enough in the normal way, a gastrostomy device should allow your child to get the nutrients and fluid they need for healthy growth and development.

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