Usefulness of Introducer Technique Combined with a Commercially Available Anchoring Device for Percutaneous Endoscopic Gastrostomy

Background and Purpose: The pull or push technique for percutaneous endoscopic gastrostomy (PEG) placement has some disadvantages. We have safely performed PEG with the introducer technique using an anchoring device that secures the stomach to the abdominal wall. Patients and Methods: Two patients with neurologic impairment and one with lockjaw underwent PEG with the introducer technique because of feeding difficulties. In the former patients, retroflexion of the neck developed excessively, and periodic changing of the feeding tube was hard to perform. With the patient under general anesthesia, two fixing sutures for gastropexy were placed 2 cm apart using the anchoring device. Between the fixing sutures, a puncture needle with a peel-away sheath was passed into the stomach, and a 13F Silastic catheter was passed through the sheath. The catheter was secured after a balloon was inflated. Feeding was started 24 hours after the catheter insertion. Results: The operative times for the various cases were 42, 6...