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Related Experiment Videos

PEG "Rescue": a practical NOTES technique.

Jeffrey M Marks1, Jeffrey L Ponsky, Jonathan P Pearl

  • 1Department of Surgery, Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, USA. jeffrey.marks@uhhospitals.org

Surgical Endoscopy
|April 4, 2007
PubMed
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Dislodged percutaneous endoscopic gastrostomy (PEG) tubes can be rescued using Natural Orifice Translumenal Endoscopic Surgery (NOTES). This minimally invasive approach avoids surgical complications and successfully re-established PEG tube function in a case of early dislodgement and leakage.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Dislodged percutaneous endoscopic gastrostomy (PEG) tubes are common complications requiring intervention.
  • Traditional surgical repair carries significant morbidity in vulnerable patients.

Observation:

  • A patient experienced early dislodgement of a PEG tube with intra-abdominal leakage and incomplete tract formation.
  • Bedside transgastric Natural Orifice Translumenal Endoscopic Surgery (NOTES) was performed for exploration and repair.

Findings:

  • NOTES facilitated peritoneoscopy, fluid evacuation, and successful re-establishment of the PEG tube through the original gastrotomy.
  • Postoperative imaging confirmed no intra-abdominal leakage, and tube feeds were resumed.
  • No complications were observed within 30 days of follow-up.

Related Experiment Videos

Implications:

  • NOTES offers a practical and effective method for PEG tube rescue.
  • This approach minimizes the morbidity associated with conventional surgical interventions.
  • PEG rescue via NOTES is a valuable application of emerging endoscopic techniques.