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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.
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.
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.
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.
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.
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.
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.
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
Why Choose Us for Your Child's Surgery
CHOP’s pediatric general surgeons are experts in the surgical and postoperative care of premature babies, neonates, children and adolescents.
Find tips to prepare for your preoperative visit with CHOP’s pediatric general surgeons, and resources to help prepare your child for surgery.
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1 Department of Medical Education, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. kozu@research.twmu.ac.jp
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1 Department of Medical Education, Tokyo Women's Medical University School of Medicine, Tokyo, Japan. kozu@research.twmu.ac.jp
There are 79 medical schools in Japan--42 national, 8 prefectural (i.e., founded by a local government), and 29 private--representing approximately one school for every 1.6 million people. Undergraduate medical education is six years long, typically consisting of four years of preclinical education and then two years of clinical education. High school graduates are eligible to enter medical school. In 36 schools, college graduates are offered admission, but they account for fewer than 10% of the available positions. There were 46,800 medical students in 2006; 32.8% were women. Since 1990, Japanese medical education has undergone significant changes, with some medical schools implementing integrated curricula, problem-based learning tutorials, and clinical clerkships. A model core curriculum was proposed by the government in 2001 that outlined a core structure for undergraduate medical education, with 1,218 specific behavioral objectives. A nationwide common achievement test was instituted in 2005; students must pass this test to qualify for preclinical medical education. It is similar to the United States Medical Licensing Examination step 1, although the Japanese test is not a licensing examination. The National Examination for Physicians is a 500-item examination that is administered once a year. In 2006, 8,602 applicants took the examination, and 7,742 of them (90.0%) passed. A new law requires postgraduate training for two years after graduation. Residents are paid reasonably, and the work hours are limited to 40 hours a week. In 2004, a matching system was started; the match rate was 95.6% (46.2% for the university hospitals and 49.4% for other teaching hospitals). Sustained and meaningful change in Japanese medical education is continuing.
Teo A. Teo A. Med Educ. 2007 Mar;41(3):302-8. doi: 10.1111/j.1365-2929.2007.02691.x. Med Educ. 2007. PMID: 17316216
Onishi H, Yoshida I. Onishi H, et al. Med Teach. 2004 Aug;26(5):403-8. doi: 10.1080/01421590412331270492. Med Teach. 2004. PMID: 15369878 Review.
Norcini J, Anderson MB, McKinley DW. Norcini J, et al. Surgery. 2006 Sep;140(3):338-46. doi: 10.1016/j.surg.2006.06.001. Epub 2006 Jul 28. Surgery. 2006. PMID: 16934591
Hoffman K, Hosokawa M, Blake R Jr, Headrick L, Johnson G. Hoffman K, et al. Acad Med. 2006 Jul;81(7):617-25. doi: 10.1097/01.ACM.0000232411.97399.c6. Acad Med. 2006. PMID: 16799282
Kumasaka K. Kumasaka K. Rinsho Byori. 2003 Apr;51(4):362-6. Rinsho Byori. 2003. PMID: 12747261 Review. Japanese.
Chaou CH, Yu SR, Chang YC, Ma SD, Tseng HM, Hsieh MJ, Fang JT. Chaou CH, et al. BMC Med Educ. 2021 May 6;21(1):260. doi: 10.1186/s12909-021-02679-8. BMC Med Educ. 2021. PMID: 33957907 Free PMC article.
Kasai H, Shikino K, Saito G, Tsukamoto T, Takahashi Y, Kuriyama A, Tanaka K, Onodera M, Yokoh H, Tatusmi K, Yoshino I, Ikusaka M, Sakao S, Ito S. Kasai H, et al. BMC Med Educ. 2021 Mar 8;21(1):149. doi: 10.1186/s12909-021-02586-y. BMC Med Educ. 2021. PMID: 33685442 Free PMC article.
Ohta R, Ryu Y, Sano C. Ohta R, et al. Int J Environ Res Public Health. 2021 Feb 7;18(4):1575. doi: 10.3390/ijerph18041575. Int J Environ Res Public Health. 2021. PMID: 33562329 Free PMC article. Review.
Matsuyama Y, Nakaya M, Leppink J, van der Vleuten C, Asada Y, Lebowitz AJ, Sasahara T, Yamamoto Y, Matsumura M, Gomi A, Ishikawa S, Okazaki H. Matsuyama Y, et al. BMC Med Educ. 2021 Jan 7;21(1):30. doi: 10.1186/s12909-020-02460-3. BMC Med Educ. 2021. PMID: 33413338 Free PMC article. Clinical Trial.
Soemantri D, Karunathilake I, Yang JH, Chang SC, Lin CH, Nadarajah VD, Nishigori H, Samarasekera DD, Lee SS, Tanchoco LR, Ponnamperuma G. Soemantri D, et al. Korean J Med Educ. 2020 Sep;32(3):243-256. doi: 10.3946/kjme.2020.169. Epub 2020 Jul 21. Korean J Med Educ. 2020. PMID: 32723988 Free PMC article.
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