Nasal unsedated seated percutaneous endoscopic gastrostomy (nuPEG): a safe and effective technique for percutaneous endoscopic gastrostomy placement in high-risk candidates

We wish to congratulate McCulloch et al on introducing the nuPEG approach in high-risk patients, such as those with neurodegenerative disorders.1 In turn, we recently adopted this approach but have adapted it to enable a faster procedural time, by using the pull-through technique rather than the Pexact technique described. As described by McCulloch et al , the patient is semi-upright, with pharyngeal local anaesthesia but no sedation. Transnasal endoscopy is done, and for the PEG we use a conventional 15 Fr Freka PEG tubes with a retaining flange. With the endoscope in the stomach, the abdominal …