Gastrostomy placement : when fluoroscopy helps the endoscopist.

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Medical Device Technology

Background:

• Percutaneous endoscopic gastrostomy (PEG) is a common procedure for nutritional support.
• PEG fails in a small percentage of patients, necessitating surgical or radiological alternatives.
• Surgical gastrostomy has higher complication rates and requires general anesthesia, unsuitable for some patients.

Observation:

• A hybrid radiological-endoscopic technique was used in four patients with prior PEG failure.
• This technique combined elements of both radiological and endoscopic approaches.
• The procedure was performed without the need for general anesthesia.

Findings:

• The hybrid technique achieved successful gastrostomy tube placement in all four patients.
• No complications were reported in relation to the procedure.
• This method provides a viable alternative when standard PEG is not feasible.

Implications:

• This hybrid approach offers a valuable option to circumvent general anesthesia and surgical complications.
• It expands treatment possibilities for patients with comorbidities or previous PEG failure.
• This technique enhances the safety and accessibility of gastrostomy placement in challenging cases.