Percutaneous Endoscopic Gastrostomy (pull method) and Jejunal Extension Tube Placement

Abstract

Enteral feeding should be considered for patients with an intact and functional gastrointestinal tract. Percutaneous endoscopic gastrostomy (PEG) tube placement is indicated in patients requiring medium to long term enteral feeding (>30 days) and with impaired swallowing. In this video manuscript, we demonstrate the complete PEG procedure (pull method) in a 65 year old patient and placement of PEG jejunal extension tube in another patient who needed post-pyloric enteral feeding. PEG-pull method is the most widely used PEG technique. Appropriate patient selection, timing of the procedure, informed consent, antibiotic prophylaxis, adequate endoscopic air insufflation during PEG site selection, and optimal PEG site localization are the keys in this procedure.