Percutaneous Endoscopic Gastrostomy Tube Replacement

BackgroundEnteral feeding should be considered for patients with an intact and functional gastrointestinal tract. Percutaneous endoscopic gastrostomy (PEG) tube placement is indicated in patients requiring medium to long term enteral feeding (>30 days) and with impaired swallowing. Previously placed PEG tube can dislodge or be inadvertently removed, blocked, or damaged. Gastrostomy tube replacement is not infrequently performed.Patients and methodsIn this video manuscript, the author demonstrates step-by-step PEG tube replacement in several clinical scenarios: standard gastrostomy feeding tube (with internal retention balloon or with internal collapsible bumper) removal and replacement; low-profile feeding tube replacement; and feeding tube replacement over a wire guide.ConclusionsPEG tube replacement can be easily replaced at bed-side in most cases. Occasionally, in difficult cases gastrostomy feeding tube replacement needs endoscopic guidance and assistance.