Percutaneous endoscopic gastrostomy-20 years later: a historical perspective

Area of Science:

• Surgical Innovation
• Minimally Invasive Procedures
• Pediatric Surgery

Background:

• Percutaneous endoscopic gastrostomy (PEG) was introduced in 1980, based on a sutureless approximation technique.
• Initially developed for pediatric feeding difficulties, PEG has become a global standard for gastric access.

Observation:

• Over 836 publications and 483 citations highlight PEG's impact.
• More than 216,000 PEGs are performed annually in the U.S. by 12 manufacturers.
• Expanded applications include jejunostomy, cecostomy, and managing complications.

Findings:

• PEG has demonstrated exponential growth over two decades.
• Technical refinements and improved guidelines have enhanced procedure safety.
• The underlying surgical concept has spurred numerous innovative applications.

Implications:

• PEG significantly impacts nutritional management, especially in adult patients.
• The procedure's principles have led to diverse interventions beyond simple feeding.
• PEG represents a key contribution from pediatric surgery to broader surgical practice.