Gastrostomy Tubes (G-Tube)
What is a gastrostomy tube?
A gastrostomy tube, often called a G-tube, is a surgically placed device used to give direct access to your child's stomach for supplemental feeding, hydration or medication. G-tubes are used for a variety of medical conditions, but the most common use is for feedings to enhance your child’s nutrition. When a child is unable to eat enough food by mouth, a G-tube helps deliver enough calories and nutrients to support their growth.
Types of G-tubes
There are many different types of gastrostomy tubes that may be used to help your child. The type of tube selected depends on each patient's unique medical condition. Your child’s doctor will determine the best type of G-tube for your child and explain this in detail at the time of the evaluation. Below are two of the most common types of G-tubes to help you understand what to expect. Some names of tubes which may be placed include: AMT mini-one, MIC, MIC-Key, and Cor-Pak.
One of the most common types of G-tubes is a low-profile tube sometimes called a “button.” This type of tube lays on top of the abdominal wall and is kept in place in the stomach by a water-filled balloon. A special extension tube is attached when administering medications or feedings. During your child’s hospital admission, you will learn how to use, clean and care for the G-tube.
Low Profile Button G-Tube (above image)
This image shows a commonly used G-tube called a low-profile button. This type of tube is placed surgically in the operating room. It creates a path to the stomach so nutrition and medications can be administered directly. Most tubes have a water-filled balloon which helps keep the tube securely in place in the stomach.
Sometimes a longer tube is used instead of the low-profile button. These longer tubes are also surgically placed into the stomach and held in place with either stitches or a water-filled balloon.
Sometimes a Hollister dressing is kept in place around a long tube. A Hollister dressing is a large circular dressing that allows the tube to stay in place with a ziplock-type device. If a long tube is the right choice for your child, we will teach you how to use and care for it. We will also show you how to keep it secure and change the dressing.
How is a G-tube placed?
G-tubes can be placed surgically in the operating room, or percutaneously, through a small incision, by a radiologist. Your child’s doctor will determine the best procedure for your child.
Surgically placed G-tube
If a surgically placed tube is needed, it will be placed by a pediatric surgeon in the operating room. The surgeon will make one or more small incisions in the belly area, then make an opening into the stomach called a stoma. A tube will be placed through the belly opening and into the stomach.
Preparing for G-tube surgery
You and your child will meet with one of the general surgeons at Children’s Hospital of Philadelphia (CHOP) for an appointment prior to G-tube surgery. At this appointment, we will explain the details of the procedure and you’ll have a chance to ask questions and address any concerns. The procedure will then be scheduled for a later date.
Following surgery, all children will be admitted to the hospital for a few days to safely begin feedings. During this admission, you will be taught how to care for the G-tube, including how to administer feedings, how to clean and care for the stoma, and how to apply a gauze dressing if needed.
Follow-up after G-tube surgery
Your child will be seen for an appointment with general surgery about four to six weeks after being discharged from the hospital. In many instances, the G-tube will be changed at this appointment. Additional follow-ups will be scheduled, if needed.
Percutaneous endoscopic gastrostomy (PEG) tube placement
A PEG tube is another type of G-tube. A radiologist usually performs this type of tube placement in the Interventional Radiology while your child is asleep. Find more information on this type of tube.
When to call your doctor
Although G-tubes are generally easy to use without much maintenance, there are some potential problems your child may experience. If you have any concerns about your child’s G-tube, please call us immediately. We can discuss whether your child should be seen in our clinic or if they require immediate, emergency medical attention.
Most tubes are secured by a balloon inside the abdomen or by stitches, but they can still become dislodged or removed from the stomach. If this happens before your first follow-up appointment, please call your child’s surgeon immediately. If this happens after your first change, a parent/caregiver or trained professional can replace the G-tube. If you have concerns about dislodgement of your child's tube, please call your child’s surgeon.
Leaking around a G-tube is common. You will learn how to apply a dressing under the tube, like a piece of gauze, in case the G-tube leaks. Sometimes the drainage becomes excessive and will soak the dressing very quickly. If this is the case, call your child’s surgeon or pediatrician to make an appointment to have your child's G-tube evaluated.
Granulation tissue is typically dark pink or red and is the body’s natural response to the tube. This tissue may cause some leakage and irritation around your child’s G-tube site. Granulation tissue can be treated with topical steroid creams or with cauterization with silver nitrate. If you have a concern about granulation tissue, call your child’s care team to discuss and to determine whether your child needs an appointment for an evaluation.
Reviewed by: Surgical Advanced Practice Nurses
Date: July 2019