This minimally invasive procedure is used to insert a feeding tube into the stomach of a patient who is unable to take sufficient food by mouth. It can also be performed to decompress or shrink the stomach in cases of bowel obstruction.

For patients who are unable to chew and swallow food, tube feeding can safely and significantly increase the quality of life by maintaining appropriate weight levels and nutritional requirements.

The procedure is performed by an interventional radiologist who uses fluoroscopy to guide the tube insertion. Gastrostomy tubes are available in different sizes. Often a small tube is initially inserted and requires further procedures to gradually upsize the tube. Gastrostomy tubes are required to be changed periodically due to tube degradation from stomach acids.

Gastrostomy/Feeding Tube Insertion Guidelines

When Your Procedure Is Scheduled

• Our scheduler will give you a date and time for your procedure at Overlake Hospital Medical Center. You will need to arrive at the hospital two hours before the procedure to allow the admitting and nursing staffs to get you ready.
• Please let the scheduler know if you take Coumadin, Plavix, Insulin or Metformin. You will need to receive specialized instructions.
• Please notify us if you’ve had a previous reaction to contrast dye.
• If you have any questions regarding your procedure, you may call us at 425-688-5507.
• The admitting department will attempt to call you the night before your procedure to confirm your arrival time.
• Please plan to leave any jewelry or valuables at home.
• Since you will be given a sedative, you must arrange for someone to drive you home after the procedure. 
• If a family member or friend will be assisting you in caring for the tube, they should be present to hear the instructions after the insertion.

Preparation

• Your doctor will have ordered some blood work to be done before the procedure. If this has not been done, alert your doctor right away. Patients over the age of 65 or with a history of heart disease may be required to have an electrocardiogram (EKG) which measures heart activity. If these tests are not done prior to your appointment, your procedure will be delayed or cancelled.
• Do not eat any solid food for six hours before your procedure.
• Don't drink any liquids for two hours before your procedure.
• If you are on prescription medications, take them at the regularly scheduled time with small sips of water.
• If you take insulin, take only half your scheduled dose.
• You need to be at the hospital’s admitting area two hours before you procedure’s scheduled start time. This is located at the large desk at the hospital’s main entrance (across from Stanza’s Café).
• You will be taken down to your room where you will meet your nurse. You will be asked to change into a patient gown. An IV will be started and blood drawn for lab tests. The nurse will ask you for your medical history. If possible, bring a list of all the medications you take and when you take them.
• The nurse will also ask you about allergies. If you are allergic to radiology/contrast dye please let them know.
• If there is a possibility that you’re pregnant, please let the nurse know. You will be asked to sign a form if you are a female of childbearing age (12-57).
• The nurse or tech will clean and shave, as necessary, an area around the feeding tube’s point of entry.
• Before the procedure, the interventional nurse will meet with you and your family to review the procedure and answer any questions you might have.

What to Expect During the Procedure

• The procedure takes under 1 hour. You will meet the interventional radiologist who will go over the consent form and answer any questions you might still have.
• You will receive sedation medication during the procedure to help you relax.
• During the procedure the nurse will be monitoring your heart, blood pressure and the oxygen level in your blood.
• If you experience pain during the procedure, DO NOT keep it to yourself! Tell the doctor, and he or she will take appropriate measures.
• After an injection of local anesthetic, the doctor will use the x-ray equipment to guide a needle through the skin (just under ribs on the left side of the abdomen) down into the stomach. A small wire is inserted through the needle into the stomach and the needle is removed. The gastrostomy tube is then slid over the wire down into the stomach.
• Once the tube is in place and secured, a small amount of x-ray contrast is injected through the gastrostomy tube and x-rays are taken to check its position.
• Occasionally stitches are used to secure the position of the tube in the stomach. These are removed between seven to ten days after the procedure.

What to Expect After the Procedure

• Pain is possible after the procedure, but it usually stops on its own after 24 to 48 hours. If you develop sharp cramping pain, do not eat or drink anything and do not put anything through the tube for 12 hours. If the pain is too intense to bear, If the pain is too intense to bear, call us at 425-688-5005 so we can assist you.
• If you are an inpatient, you will be taken back to your room for further instructions.
• If you are an outpatient, you'll be held for observation for up to one hour to allow the medicine to wear off.
• Afterwards, you'll receive wound care instructions and a supply kit. You will normally then return to your clinic and meet with a dietitian, who will instruct you on how to use the feeding tube.
• You will be given written instructions and a phone number to call if you have any questions or concerns.
• One of the interventional nurses will do a follow-up call the next day after your discharge. Write down any questions you might have for them.
• To speak to an interventional nurse, please call 425-688-5005. It is best to call between 8AM and 4PM Monday thru Friday. You can leave a message on the voicemail, and a nurse will return your call as soon as possible.
• If you are on Coumadin and have been told not to take it before your procedure, you need to check with your physician, and/or the Anti-Coagulation Clinic for instructions.
• If you an insulin-dependent diabetic, restart your regular dosing when you get home. Check your sugar regularly and if you have a concern, contact your diabetic doctor.
• You may resume taking all of your normal medications once you are home.
• Should the tube accidentally come out, it must be reinstated within twenty-four hours or the incision will begin to heal and new surgery may be required.
• The tube is marked at the point where it should be level with the incision and should be checked daily to make sure that it is still properly in place. Excessive tension on the tube may result in pressure necrosis (death of an area of tissue) of the interior abdominal wall.