Related Experiment Video
Updated: Aug 5, 2026
Operative Technique and Nuances for the Stereoelectroencephalographic (SEEG) Methodology Utilizing a Robotic Stereotactic Guidance System
Published on: June 9, 2023
Should single-stage PEG buttons become the procedure of choice for PEG placement in children?
Jonathan S Evans1, Margaret Thorne, Salik Taufiq
1Division of Pediatric Gastroenterology and Nutrition, Nemours Children's Clinic, Jacksonville, Florida 32207, USA.
Insights
Single-stage PEG buttons (PEG-B) offer a safe and effective alternative to traditional PEG tubes (PEG-T) for pediatric enteral access. PEG-Bs significantly extend the time until the first device change, providing a longer-lasting solution for children.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Medical device technology
Background:
- Single-stage percutaneous endoscopic gastrostomy buttons (PEG-B) are skin-level devices for pediatric enteral access.
- While offering advantages, PEG-Bs have seen limited adoption compared to traditional PEG tubes (PEG-T).
Purpose of the Study:
- To compare the clinical experience and outcomes of PEG-B versus PEG-T placement in children.
- To evaluate the safety and efficacy of PEG-B in a pediatric population.
Main Methods:
- Retrospective chart review of pediatric patients undergoing PEG procedures between 1997 and 2002.
- Analysis of patient demographics, indications, postoperative complications, and interval to first tube change.
Main Results:
- 145 PEG-B and 93 PEG-T cases were analyzed; patient characteristics were similar between groups.
- The interval to the first tube change was significantly longer for PEG-B (314 days) than PEG-T (78 days).
- PEG-B demonstrated a comparable safety profile to PEG-T, even in infants weighing less than 5 kg.
Conclusions:
- PEG-B placement is recommended as the preferred procedure over PEG-T for children requiring gastrostomy devices.
- PEG-B offers equivalent safety and a significantly longer interval before the first device replacement.
Background:
Single-stage PEG buttons (PEG-B) allow initial placement of a skin-level gastrostomy device for children who require enteral access. They offer significant advantages over traditionally placed PEG tubes (PEG-T) but have not been widely accepted into practice.
Objective:
To review our experience with PEG-Bs compared with PEG-Ts.
Hypothesis:
PEG-B shares a similar safety profile with PEG-T but delays the need for an initial device change well beyond the change that usually occurs at 6 to 8 weeks after PEG-T placement.
Design:
Retrospective chart review.
Setting:
Nemours Children's Clinic, Jacksonville, Florida.
Patients:
All children undergoing both PEG procedures and attending our clinic from 1997 to 2002.
Main Outcome Measurements:
Age, sex, weight, indications, postoperative complications, interval until first tube change and first tube change complications.
Results:
Totals of 145 and 93 patients were identified in the PEG-B and PEG-T groups, respectively. Patient characteristics were similar in the 2 groups with respect to age, weight, indications, and postoperative complications. The interval until first tube change, however, was significantly longer in the PEG-B group (314 days) than in the PEG-T (78 days) (P < .0001). In addition, the PEG-B was found to be as safe as the PEG-T for small infants who weighed less than 5 kg.
Conclusions:
PEG-B placement should be considered as the procedure of choice over PEG-T placement for children. It offers similar safety profiles, even for small patients and a significantly longer interval until first device change.
