Open Technique

1. Stamm gastrostomy (5). The Stamm gastrostomy is considered the standard today. The procedure may be performed under general or local anesthesia as part of a major abdominal procedure or for feeding access alone. The aim of the procedure is to create a serosa-lined fistula between the stomach and the anterior abdominal wall (Fig. 4).

PEG-port cap

PEG-port cap

Port Stomach Feeding Peg Tube

Internal bolster

Fig. 3. A low-profile PEG port. For patients who are mobile, a low-profile PEG port eliminates the need for a permanently protruding feeding tube. A resealable cap allows attachment of a separate tube for feeding.

Internal bolster

Fig. 3. A low-profile PEG port. For patients who are mobile, a low-profile PEG port eliminates the need for a permanently protruding feeding tube. A resealable cap allows attachment of a separate tube for feeding.

Peg Tube Ports Pictures
Fig. 4. An internally anchored PEG tube. Surgically placed PEG tubes can be anchored to the external surface of the stomach, which may be preferable in situations where there is a problem using the surface of the stomach closest to the abdominal wall.

2. Witzel gastrostomy. The Witzel gastrostomy is a modification of the Stamm gastrostomy. A serosal tunnel is created around the gastrostomy tube to prevent leakage of gastric contents. The anterior gastric wall fixed to the posterior abdominal wall along the length of the serosal tunnel (Fig. 5) (5).

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