Nonendoscopic placement and use of percutaneous gastrostomy tubes in pigs (Sus scrofa domestica)

Swine have supplanted dogs and other large animal species in many biomedical applications and have become the model of choice for numerous areas of research. Anatomic, behavioral, and handling concerns often require pigs to be surgically instrumented for many procedures. Oral dosing in pigs can be accomplished by feeding substances in a palatable substrate, temporarily placing an oral or nasal gastric tube, or permanent surgical placement of an esophagostomy or gastrostomy tube. Oral and nasal gastric tube placement is difficult in conscious, unrestrained animals and is suitable only for short-term enteral access. Placing esophagostomy and gastrostomy tubes is suitable for long-term enteral access and allows easy and rapid administration of substances directly into the stomach. However, these methods frequently require major surgical manipulation for placement. Nonendoscopic percutaneous gastrostomy tube placement is used in companion animals to establish permanent or temporary enteral access. We successfully have adapted this procedure in swine as a method for short-term enteral access. This technique has several advantages over the traditional surgical method for gastrostomy tube placement. It is minimally invasive, results in less animal pain and distress, requires less procedural and recovery time, and is inexpensive. Disadvantages include the potential for splenic entrapment, splenic penetration, perforation of the esophagus, and other complications related to misplacement of the tube or applicator. This paper describes the equipment, technique, and potential complications for placing a nonendoscopic percutaneous gastrostomy tube in swine.