Percutaneous endoscopic gastrostomy (PEG): Indications and technique

The technique of percutaneous endoscopic gastrostomy, popularized over the last two decades, is a safe and effective method of providing assisted alimentation for patients unable to maintain oral nutrition. Traditionally performed by gastroenterologists and general surgeons, the technique is now gaining acceptance among otolaryngologist-head and neck surgeons as an important surgical skill. The procedure is based on a knowledge of flexible esophagoscopy and the Seldinger technique. This article describes basic equipment, patient selection, and a straightforward method of placing percutaneous endoscopic gastrostomy tubes. Uncommon but potentially serious complications associated with the procedure will be discussed. As trained endoscopists often involved with the comprehensive care of patients with swallowing disorders, otolaryngologists are ideally suited to perform this procedure.