a A heavy-gauge suture is passed through the abdominal wall into the stomach, retrieved endoscopically, and brought out through the mouth. The tube is tied to the suture and pulled down the esophagus into the stomach, where the internal bumper engages against the stomach wall
b The PEG tube in place c Components of the PEG tube
Fig. 4.33 Technique of PEG placement b The endoscope is advanced into the a The puncture site is aseptically prepared and draped. The examina- stomach tion room is darkened c The puncture site is illuminated from within the stomach, and the abdominal wall is observed for transillumination d Internal illumination of the puncture site is maintained
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