PREOPERATIVE DIAGNOSIS: Patient removed the tube and we were unable to replace it because the ostomy was closing and we needed to do a complete new percutaneous gastrostomy.
POSTOPERATIVE DIAGNOSIS: Patient removed the tube and we were unable to replace it because the ostomy was closing and we needed to do a complete new percutaneous gastrostomy.
PROCEDURE PERFORMED: Esophagogastroduodenoscopy with replacement of gastrostomy tube.
DESCRIPTION OF PROCEDURE: This is a 54-year-old female who was evaluated for conscious sedation and was found to be a candidate. Under my supervision the patient received during the procedure Versed 4 mg. The patient was kept in the supine position. An Olympus endoscope was advanced without any difficulty to the esophagus. No ulcers or masses were seen. The GE junction was identified at 40 cm from the incisors. Then we advanced the panendoscope into the stomach. We were able to see the stoma. We then advanced through the pylorus and into the duodenum which looked normal. We advanced a guide wire that we pulled with polypectomy snare. Then we pulled the guide wire into the esophagus, through the mouth. Then we used the push technique to advance a 20 French gastrostomy tube. We advanced into the esophagus, into the stomach, through the abdominal wall and then we placed a sterile bumper.
The patient tolerated the procedure.