Features of MIC PEG Kit with ENFit Connectors
- Medical grade silicone construction
- Ventilated SECUR-LOK retention ring allows air circulation around stoma
- Multiple ports accommodate nutrition and medication delivery
- Radiopaque stripe and bumper aid catheter visualization
- Uniquely designed internal retention bumper
- Collapsible internal retention bumper
- Radiopaque stripe and bumper
- Tubing clamp
What Does MIC PEG Kit Include?
- Traction removable Pull PEG tube
- 5Fr retrieval snare (1.8mm x 260cm)
- Universal feeding adapter
- Bolus feeding adapter
- SECUR-LOK* retention ring
- 5ml vial 1% Lidocaine HCl
- 19G x 1.5 in. filter needle
- 25G x 1 in. needle
- Povidone Iodine swab stick packet
- Povidone Iodine ointment
- Fenestrated drape with adhesive tabs
- 12ml syringe
- Scalpel with #11 blade
- Introducer needle
- Looped placement wire
- Stainless steel scissors
- Stainless steel hemostat
- Tubing clamp
- Water-soluble lubricant
- 4 4 x 4 in. gauze sponges
- 2 2 x 2 in. slit gauze sponges
- Suture strand
- Directions for use
- Instruction insert
MIC Percutaneous Endoscopic Gastrostomy PEG Kit With ENFit Connectors Instruction Manual
What to buy with ENFit Connector PEG Kits
Indications of Gastrostomy Tubes
Gastrostomy tube feeding may be indicated for patients needing long-term enteral support or hydration secondary to a primary condition relating to the head and/ or neck. These conditions include stroke; cancer; head and neck tumors, Injuries, or trauma; and neurological disorders resulting in a chewing or swallowing abnormality. This device (sold in a kit) is intended as an initial placement device. The device is placed by the PULL technique.
Contraindications of PEG Tube
Contraindications for placement of a gastrostomy feeding tube include, but are not limited to colonic interposition, portal hypertension, peritonitis, morbid obesity and esophageal stenosis.
MIC PEG Tube Pull Placement Procedure
- Use a clinically approved method to prep and sedate the patient for an endoscopic procedure.
- Use a clinically approved procedure to perform the gastric endoscopy.
- With the patient in a supine position, insufflate the stomach with air and trans-illuminate the abdominal wall.
Caution: Proper selection of the insertion site is critical to the success of this procedure.
- Select gastrostomy site. This site (typically the upper left quadrant) should be free of major vessels, viscera, and scar tissue.
- Depress the intended insertion site with a finger. The endoscopist should clearly see the resulting depression on the anterior surface of the gastric wall.
- Prep and drape the skin at the selected insertion site. Locally anesthetize the insertion site.
- Following local anesthesia, make a 1 cm (approximate) incision through the skin with the scalpel.
- Insert the introducer needle system through the incision, advancing through the peritoneum and the stomach wall.
- When the introducer needle is observed in the stomach, remove the introducer needle from the introducer cannula by firmly holding the cannula hub and pulling back on the needle hub.
- Insert the retrieval snare intro the endoscope, and push the retrieval snare through endoscope until observed in the stomach.
- Place the looped placement wire through the introducer cannula into the stomach. Grasp the looped placement wire with a retrieval snare. Withdraw the retrieval snare into the endoscope channel.
- Remove the endoscope and the looped placement wire through the oropharynx. Pull approximately 5 inches (13 cm) of the looped placement wire from the mouth.
- Slowly and smoothly feed the looped placement wire into the introducer cannula as the endoscope is retracted. Keep the introducer cannula in place in the stomach with the distal end of the placement loop outside the abdomen.
- Connect the looped placement wire with the tube loop
- Lubricate the MIC* PEG Tube with a water-soluble lubricant. Apply traction to pull the placement loop and the tube back through the oropharynx, esophagus, and into the stomach.
- Re-enter the esophagus with the endoscope and visually follow the gastrostomy tube as it enters the stomach. Slide the introducer cannula out of the incision site and gently pull the PEG dilator tip through the abdominal wall.
- Use a rotating motion to slowly work the tube up and out until the internal bumper gently rests against the gastric mucosa.
Note: Graduated markings on the body of the tube will assist in determining the progress of the tube as it exits the abdomen.
Caution: Do not use excessive force to pull the tube into place. This could harm the patient and damage the tube.
- Cleanse the tube and stoma site and apply a sterile gauze dressing. Cut the tube loop wire with scissors and discard the tube loop and placement wire.
- Slide the external bolster over the proximal end of the MIC* PEG Tube and push the external bolster into place next to the sterile gauze dressing. Visually verify that the internal bumper is properly placed. Remove the endoscope. The external bolster should be positioned approximately 2 mm above the skin.
Caution: Do not apply excessive tension. There should be no compression of the gastric mucosa or the skin. Optionally, a suture loop (not supplied) may be tied around the external bolster to minimize movement of the MIC* PEG Tube while the stoma is healing.
- Cut the MIC* PEG Tube straight across, leaving an appropriate length to attach a MIC* Feedhead Adapter. Discard the removed portion of the tubing.
- Slide the clamp on the MIC* PEG Tube.
- Insert the barb connector of the MIC* Feedhead Adapter completely into the proximal end of the MIC* PEG Tube.