Videos | Primary Button Gastrostomy The Interventionists View | Which Medical Device

This video shows my technique for insertion of a primary button gastrostomy in a patient with a head and neck tumour.

The technique is simple but the potential for misplacement is high unless the correct procedure is followed. Careful checks of tube position should always be made once the tube is inserted. Cone beam CT can be helpful if in doubt.

The procedure was recorded with a GoPro Hero 3 camera.

Dr Phil Haslam, Consultant Interventional Radiologist

Gastrostomy Information

• Oropharyngeal carcinoma
• Inoperable/unstentable oesophageal carcinoma
• Stroke
• Degenerative neurological conditions such as motor neurone disease.
• Gastric decompression

• Ascites
• Peritonitis
• Small bowel obstruction
• Disseminated intra-abdmominal malignancy

• Bleeding diathesis
• Previous gastric surgery
• Active gastric ulceration
• Pregnancy

• An NG tube should be placed prior to the procedure
• 200ml dilute barium may be given the night before to highlight the colon
• Nil by mouth for two hours prior to the procedure

• Post sedation observations and observation for haemorrhage
• Fasting for 6 hours
• Water via gastrostomy 25mls/hr for 6 hours
• Increase to 50mls/hr if no pain or other complications
• Commence feeding regime the following day
• T fasteners can be cut at 48hrs

Dr Phil Haslam