Percutaneous Endoscopic Gastrostomy

Percutaneous endoscopic gastrostomy (PEG) has become one of the most frequently used procedures to administer nutrition and also as an alternative to the surgical approach or nasogastric tubes. The technique is simple, safe and cheap; it can be performed by any moderately experienced endoscopist and so, since the original description in 1980, has become a popular method around the world. The main PEG indication is the nutrition of patients that cannot swallow, although there are other utilities. Contraindications and complications are very unusual in clinical practice. There are three technical modalities for the placement of the gastrostomy tube, with no one being better than the other. This chapter tries to explain in a very practical way the main aspects of the procedure and it especially focuses on technical points, incorporating some useful tricks that can help solve some eventually embarrassing situations.