CT-Guided Percutaneous Gastrostomy: A Tutorial
Pre-procedure preparation includes passage of a nasogastric tube to facilitate filling the stomach with air. It is preferable to perform this before the patient comes to the CT table (i.e., patient hospital room or patient preparation area). Other preparation includes informed consent, coagulation studies, ability of the patient to tolerate supine positioning, and pre-sedation workup. A gastropexy kit should be available for the procedure. Gastropexy refers to mechanical attachment of the gastric wall to the abdominal wall to facilitate secure percutaneous gastric access. We use the Cope Gastrointestinal Suture Anchor Set (Cook Inc., Bloomington, IN, USA). This kit contains the following: a 17-gauge beveled needle, 12 cm long, with preloaded gastrointestinal suture anchor; a 0.035 inch guidewire, 75 cm long; and (as a backup) an additional blunt inserter with preloaded suture anchor.
Cook Gastropexy Kit
Contents of a Gastropexy kit: Needle, extra T-bar, and special guidwire
17Ga needle preloaded with T-bar (connected to thread and needle) to perform gastropexy
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