Primary Button Gastrostomy The Interventionists View - 08 June 2014

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This video shows my technique for insertion of a primary button gastrostomy in a patient with a head and neck tumour.

The technique is simple but the potential for misplacement is high unless the correct procedure is followed. Careful checks of tube position should always be made once the tube is inserted. Cone beam CT can be helpful if in doubt.

The procedure was recorded with a GoPro Hero 3 camera.

Dr Phil Haslam, Consultant Interventional Radiologist


Gastrostomy Information

Prolonged enteral feeding requirement usually due to:
  • Oropharyngeal carcinoma
  • Inoperable/unstentable oesophageal carcinoma
  • Stroke
  • Degenerative neurological conditions such as motor neurone disease.
  • Gastric decompression
  • Ascites
  • Peritonitis
  • Small bowel obstruction
  • Disseminated intra-abdmominal malignancy
  • Bleeding diathesis
  • Previous gastric surgery
  • Active gastric ulceration
  • Pregnancy
Patient Preparation:
  • An NG tube should be placed prior to the procedure
  • 200ml dilute barium may be given the night before to highlight the colon
  • Nil by mouth for two hours prior to the procedure
Immediate post procedure care:
  • Post sedation observations and observation for haemorrhage
  • Fasting for 6 hours
  • Water via gastrostomy 25mls/hr for 6 hours
  • Increase to 50mls/hr if no pain or other complications
  • Commence feeding regime the following day
  • T fasteners can be cut at 48hrs

Dr Phil Haslam

comment on this video

User comments:

Review By smabays
Jun 12, 2014

Hi Phil - nice video as always! Great image quality too. Very useful video to show trainees. Simon Bays.

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