Accurate PEG tube placement with magnetic positional imaging.
BACKGROUND
Percutaneous endoscopic gastrostomy (PEG) is a common procedure and accounts for an increasing proportion of an endoscopist's workload. Serious complications can occur from inaccurate abdominal wall puncture. Electronic three-dimensional imaging has been used to aid colonoscopy. We adapted the principles of this technique to PEG insertion in a procedure called magnetic positional imaging.


METHODS
Magnetic positional imaging was used to determine the abdominal wall puncture site and angle of insertion that would provide the shortest distance from abdominal wall to the stomach. The pull-through technique was used to perform PEG.


RESULTS
PEG insertion with magnetic positional imaging was performed on four patients without complications. The average distance between the internal and external sensors was 5 mm.


CONCLUSIONS
A new technique, magnetic positional imaging, facilitates the pull-through technique for PEG. Additional studies are needed to clarify the potential benefit in endoscopic practice.
Kitchen
P A
PA
St. Marks Hospital, Harrow, Middlesex, England.
Saunders
B
B
Halligan
S
S
Bladen
J
J
Bell
D G
DG
Williams
C B
CB
D000009:Abdominal Muscles; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D020699:Gastroscopes; D005773:Gastroscopy / Q000379:methods; D005774:Gastrostomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008280:Magnetics / Q000295:instrumentation; D008875:Middle Aged; D011677:Punctures