Video Endoscopic Sequence 1 of 6.

Percutaneous Endoscopic Gastrostomy.

 A 78 year-old female that has impaired her swallowing due
 to a Parkinson disease.

 The most common indications for PEG are neurologic
 conditions associated with impaired swallowing and
 neoplasms of the oropharynx, larynx and esophagus.
 Other indications include facial trauma and the need for
 supplemental feedings in patients with miscellaneous
 catabolic conditions.
 
 For more endoscopic details download the video clips of
 the entire sequence by clicking on the endoscopic images.
 All endoscopic images shown in this Atlas contains
 video clips.   

Video Endoscopic Sequence 2 of 6.

 Endoscopic view of the wire being threaded through the
 cannula.
 The most widely used technique of PEG is the "pull"
 method.

Video Endoscopic Sequence 3 of 6.

 Endoscopic view of the wire being grasped with the snare.

 The basic elements common to all of these techniques are:
 (1) gastric insufflation to bring the stomach into apposition
 to the abdominal wall;
 (2) percutaneous placement of a tapered cannula into the
 stomach;
 (3) passage of a suture or guidewire into the
 stomach;
 (4) placement of the gastostomy tube; and verification of
 the proper position. 

Video Endoscopic Sequence 4 of 6.

 Endoscopic view of the percutaneus endoscopic
 gastrostomy tube´s internal bolster after correct placement.

 

Video Endoscopic Sequence 5 of 6.

 A close up of the gastrostomy tube.

Video Endoscopic Sequence 6 of 6.

 Another endoscopic view.

 

Video Endoscopic Sequence 1 of 3.

 Percutaneous Endoscopic Gastrostomy, the sequence of
 this procedure is carry out in the images and video clips.
 Local anesthesia is followed by an injection with
 xylocaine.
 
 

Video Endoscopic Sequence 2 of 3.

 Percutaneous Endoscopic Gastrostomy is carry out in a
 female patient that suffered a stroke, as a sequel, her
 swallowing function was altered. The video clip display the
 catheter with a nylon thread and biopsy forcep which takes
 the nylon thread to her mouth.
  

Video Endoscopic Sequence 3 of 3.

 The PEG tube stands for percutaneous (though the
 skin). Endoscopy Gastrostomy (stomach tube).
 A hand made gastrostomy device from a perzzev catheter
 is introduced from her mouth to her gastric body then it
 placed in the stomach wall.

Perzzev Catheter.

 That catheter was placed under a laparotomy of a gastric
 carcinoma.
 The video clip displays a secretion coming from washing
 the proximal tip.

 See the video sequence of this case of gastric carcinoma.