Insertion, efficacy, and removal of a nonendoscopically removable percutaneous endoscopic gastrostomy (PEG) tube

Background: Externally removable PEG tubes require an internal bumper that can collapse to a size that is small enough to allow for its removal throug h the abdominal wall by external traction. Adequate force must be maintaine d to avoid accidental dislodgement of the tube prior to its desired removal . Methods: A nonendoscopically removable PEG (Inverta-PEG, Ross Products Divi sion, Abbott Laboratories, Columbus, OH, USA) was evaluated in a nonmasked, prospective clinical study involving 131 patients enrolled by 25 physician s. The over-the-wire (Sacks-Vine) technique was used for all placements. Af ter insertion, patients were followed weekly for 8 weeks. During week 9, th e PEGs were removed percutaneously (nonendoscopically), Insertion, efficacy , and removal performance were evaluated. Results: Complication rate during insertion was 1.5% and removal was 1.2%. Qualitatively, investigators rated ease of insertion and removal as very ea sy, easy, average, difficult, or very difficult. Investigators rated. 98.5% of insertions as very easy, easy, or average; 95.4% of removals were rated as very easy, easy, or average. Some patients exited the study prematurely due to leakage around the stoma (2.3%) and inadvertent tube removal (5.3%) . These complication rates were consistent with earlier reports of other PE G studies. Conclusions: These results demonstrate that Inverta-PEG is a safe and effec tive tube that can be removed nonendoscopically with ease in 95% of the cas es.