PEG "rescue": A practical NOTES technique

Jeffrey M. Marks*, Jeffrey L. Ponsky, Jonathan P. Pearl, Michael F. McGee

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

116 Scopus citations


Dislodged percutaneous endoscopic gastrostomy (PEG) tubes occur commonly and may require urgent surgical intervention in a susceptible patient population. Natural orifice translumenal endoscopic surgery (NOTES) may facilitate PEG rescue and avoid the morbidity associated with contemporary surgical techniques. We report a case of a dislodged PEG tube in the early post-operative period with evidence of incomplete gastrocutaneous tract formation and intra-abdominal leakage. Bedside transgastric NOTES exploration facilitated peritoneoscopy, evacuation of intra-abdominal fluid, and re-establishment of the PEG tube through the original gastrotomy tract. Tube feeds were resumed and postoperative contrast fluoroscopy demonstrated no intra-abdominal leakage from the replaced PEG tube. No postoperative complications related to the NOTES procedure were noted at 30 days of follow-up. PEG rescue represents a unique, practical, and empowering application of the burgeoning experience of NOTES.

Original languageEnglish (US)
Pages (from-to)816-819
Number of pages4
JournalSurgical Endoscopy and Other Interventional Techniques
Issue number5
StatePublished - May 2007


  • Endoscopy
  • Minimally Invasive Surgery
  • PEG

ASJC Scopus subject areas

  • Surgery


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