| Theme |
The Present State of Percutaneous Endoscopic Gastrostomy (PEG) |
| Title |
Introducer Method for Percutaneous Endoscopic Gastrostomy |
| Author |
Hirohisa Takeuchi |
Department of Surgery, Kyorin University School of Medicine |
| Author |
Masanori Sugiyama |
Department of Surgery, Kyorin University School of Medicine |
| Author |
Koichiro Kojima |
Department of Surgery, Kyorin University School of Medicine |
| [ Summary ] |
The introducer method is an effective procedure for percutaneous endoscopic gastrostomy (PEG). In this method, a catheter is inserted through the abdominal wall into the stomach after fixation of the gastric wall to the abdominal wall. In contrast to the pull method, the catheter is not passed perorally and the procedure is accomplished with only one insertion of the gastroscope. The introducer method is useful, especially for cases of pharyngoesophageal stenosis or those patients with MRSA in the oral cavity. This method is subclassified into the original and modified methods. In the former, a balloon catheter is placed after puncturing the abdominal wall and the gastric wall with a thick trocar needle. In the latter, a fine needle is introduced, the tract is expanded using a dilator, and then a bumper catheter is placed. Potential complications are (1) erroneous puncture of other organs during required multiple punctures of the abdominal wall, (2) postoperative bleeding, and (3) failed fixation of the gastric wall. The original introducer method requires early replacement of the catheter. This procedure is often associated with technical difficulties. Measures to solve these problems have been developed. |