gastrostomy

Gastrostomy 

Definition

Gastrostomy is a surgical procedure for inserting a tube through the abdomen wall and into the stomach. The tube is used for feeding or drainage.

Purpose

Gastrostomy is performed because a patient temporarily or permanently needs to be fed directly through a tube in the stomach. Reasons for feeding by gastrostomy include birth defects of the mouth, esophagus, or stomach, and problems sucking or swallowing.

Gastrostomy is also performed to provide drainage for the stomach when it is necessary to bypass a long-standing obstruction of the stomach outlet into the small intestine. Obstructions may be caused by peptic ulcer scarring or a tumor.

Precautions

Gastrostomy is a relatively simple procedure. As with any surgery, patients are more likely to experience complications if they are smokers, obese, use alcohol heavily, or use illicit drugs. In addition, some prescription medications may increase risks associated with anesthesia.

Description

Gastrostomy, also called gastrostomy tube insertion, is surgery performed by a general surgeon to give an external opening into the stomach. Surgery is performed either when the patient is under general anesthesia-where the patient feels as if he is in a deep sleep and has no awareness of what is happening-or under local anesthesia. With local anesthesia, the patient is awake, but the part of the body cut during the operation is numbed.

A small incision is made on the left side of the abdomen; then, an incision is made through the stomach. A small, flexible, hollow tube, usually made of polyvinylchloride or rubber, is inserted into the stomach. The stomach is stitched closed around the tube, and the incision is closed. The procedure is performed at a hospital or free-standing surgery center.

The length of time the patient needs to remain in the hospital depends on the age of the patient and the patient's general health. In some cases, the hospital stay can be as short as one day, but often is longer.

Gastrostomy is a procedure in which the surgeon makes an opening into the stomach and inserts a feeding tube for feeding or for drainage.

(Illustration by Electronic Illustrators Group.)

Normally, the stomach and abdomen heal in five to seven days.

The cost of the surgery varies, depending on the age and health of the patient. Younger, sicker patients require more intensive, thus more expensive, care.

Preparation

Prior to the operation, the doctor will perform endoscopy and take x rays of the gastrointestinal tract. Blood and urine tests will also be performed, and the patient may meet with the anesthesiologist to evaluate any special conditions that might affect the administration of anesthesia.

Aftercare

Immediately after the operation, the patient is fed intravenously for at least 24 hours. Once bowel sounds are heard, indicating that the gastrointestinal system is working, the patient can begin clear liquid feedings through the tube. Gradually feedings are increased.

Patient education concerning use and care of the gastrostomy tube is very important. Patients and their families are taught how to recognize and prevent infection around the tube, how to feed through the tube, how to handle tube blockage, what to do if the tube pulls out, and what normal activities can be continued.

Risks

There are few risks associated with this surgery. The main complications are infection, bleeding, dislodgment of the tube, stomach bloating, nausea, and diarrhea.

Normal results

The patient is able to eat through the gastrostomy tube, or the stomach can be drained through the tube.

Resources

Other

"Stomach Tube Insertion." HealthAnswers.com. http://www.healthanswers.com.

Key terms

Endoscopy — A procedure in which an instrument containing a camera is inserted into the gastrointestinal tract so that the doctor can visually inspect the gastrointestinal system.

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gastrostomy /gas·tros·to·my/ (gas-tros´tah-me) surgical creation of an artificial opening into the stomach, or the opening so established.

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gas·tros·to·my (g-strst-m)

n.

Surgical construction of a permanent opening from the external surface of the abdominal wall into the stomach, usually for inserting a feeding tube.

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gastrostomy

[gastros′təmē]

Etymology: Gk, gaster + stoma, mouth

surgical creation of an artificial opening into the stomach through the abdominal wall. It is performed to prevent malnutrition and starvation in patients who have esophageal cancer or tracheoesophageal fistula, who may be unconscious for a prolonged period, or who are unable to swallow as a result of a cerebrovascular accident, Alzheimer's disease, or another disorder. It also permits retrograde dilation of an esophageal stricture. The anterior wall of the stomach is drawn forward and sutured to the abdominal wall. A Foley catheter or other tube or a special prosthesis is then inserted into an incision in the stomach, and the opening is tightly sutured to prevent leakage of the stomach contents. The device is clamped and is opened when liquid food supplement is instilled. After surgery glucose water may be given, followed by a slow continuous feeding of a warm blended formula to increase absorption. The skin is kept clean and dry around the site. Skin irritation indicates leakage of gastric secretions and digestive enzymes.

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gastrostomy,

n the surgical creation of an artificial opening into the stomach through the abdominal wall, used to feed a patient who has cancer of the esophagus or other kind of barrier to oral feeding.

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gastrostomy

the creation of an opening into the stomach.

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blind gastrostomy

placement of a gastric feeding tube without laparotomy or endoscope, simply by manipulating the end of the tube through the stomach and body wall.

percutaneous gastrostomy

used for placement of a gastric feeding tube. An endoscope is used to position an incision through the body wall and stomach wall, to grasp and withdraw a suture inserted through the opening and to guide the placement of the tube which is pulled back into the stomach and through the opening by traction on the suture which has been attached to the distal end of the tube.

tube gastrostomy

as part of the surgical correction of gastric dilatation-volvulus, an inflatable catheter can be used to maintain traction on the stomach, provide fixation, and allow decompression.

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gastrostomy

GI disease A surgical opening into the stomach which can be used for feeding usually via a gastrostomy tube. See PEG tube.