Gastrostomy: evaluation of a new tube using an old technique

Formerly, for gastrostomy, we passed a No. 18 French red rubber catheter through the antrum of the stomach with the tip directed toward the fundus. We used this method with great success, both for decompression and feeding. Recently, a tube made of silicone rubber and thus resistant to gastric secretions was manufactured for us by the Medical Innovations Corporation of Milpitas, Calif. The tip of the tube is long enough to reach to within 3 cm of the fundus. A doughnut-shaped inflatable balloon fits nicely against the gastric mucosa, and a "Secur-Lok" ring external to the abdominal wall slides down to the skin, allowing the tube to be held in position without the use of sutures. We believe that the tube placed using the above technique is effective, comfortable, and reliable. This study was done to evaluate its efficacy. We report a series of 90 patients in whom this new gastrostomy tube was placed. We discuss the lasting qualities of the tube, the function of the doughnut-shaped balloon, the hypothesis we have developed to explain why there has been no esophageal reflux with this tube, and the efficacy of the Secur-Lok ring in holding the tube in position without the use of sutures.