A gastrostomy is a surgical procedure in which a physician creates an opening in the abdomen of a patient. This opening extends from the outside of the body into the stomach. The purpose of the opening is to allow the physician to insert a feeding tube directly into the stomach. A gastrostomy is done on patients who are unable to swallow or take food by mouth.
Patients who have suffered a stroke and have lost control of the esophagus may qualify for a gastrostomy. Also, patients with cancer of the head or neck who have difficulty swallowing may benefit from a feeding tube. This procedure may also help anyone with a severe disorder or blockage of the esophagus.
If an infant cannot take in enough nourishment by mouth, a gastrostomy would allow additional feedings to be done. The infant should still be encouraged to take food by mouth even after a feeding tube has been implanted. If the patient is still able to eat food normally, a feeding tube will not interfere with digestion of food that enters the stomach through the esophagus.
There are two methods that a surgeon can use to perform a gastrostomy. For the percutaneous endoscopic gastrostomy, the surgeon uses an endoscope, which is a tube with a light and a camera. The endoscope is guided down the mouth and into the stomach. An area of the stomach is illuminated and the surgeon then inserts the feeding tube through a small incision on the outside of the abdomen. For this procedure, the patient should only need a mild sedative.
An open gastrostomy is done while the patient is under general anesthesia and this procedure does not involve the use of an endoscope. The surgeon makes an incision on the left side of the abdomen and inserts the feeding tube. This procedure is usually done if the patient is already having surgery for another condition. It may take longer to heal because the incision is larger.
Once the feeding tube is in place, a rubber plug or a balloon on the inside of the stomach is used to hold the tube in place. A valve allows food to go into the stomach through the feeding tube and prevents food from leaking back out of the stomach. The tube protrudes about 3 to 5 inches (7.6 to 12.7 cm) from the abdomen and attaches to a bag of liquid food.
After the gastrostomy is complete, the patient will receive nourishment intravenously for the first 24 hours. Then the patient will gradually be fed clear liquids through the feeding tube, and this will be followed by liquid food. The patient will need to understand how to maintain the feeding tube at home by flushing and cleaning it.