Successful placement of percutaneous gastrojejunostomy using steerable glidewire—a modified controlled push technique

Enteral nutrition access devices

“…The extension tube is grasped endoscopically with a forceps or a snare and dragged into the jejunum 31 or advanced over an endoscopically placed guidewire or stiffening catheter. 32,33 An ultrathin endoscope (either through a 28F PEG tube or through a mature abdominal wall tract) can also be used to place the guidewire into the jejunum. 34,35 Endoscopic clips have been used to anchor the tubes and prevent retrograde migration.…”

Acute Complications Associated with Bedside Placement of Feeding Tubes

“…Unfortunately, early "drag and shove" techniques, initially described by Ponsky and Aszodi 86 in 1984, were universally unsuccessful in accomplishing this goal. Numerous newer techniques have been described, with varying degrees of success, including a classic guidewire-assisted technique described by Duckworth et al, 87 a steerable guidewire technique modified by Parasher et al, 88 and a unique PEG lumen snare with retrograde wire pullthrough assisted technique described by Leichus et al 89 Subsequently, Baskin and Johanson 90 further modified the steerable guidewire technique with the use of an ultrathin "pediatric" miniscope passed…”

Comparison of Radiological, Endoscopic, and Surgical Enteral Access Procedures

“…The supposed advantage to this technique is that it decreases the chance of the jejunal tube migrating back into the stomach, however, it does require passing the endoscope into the stomach three separate times. Another method 7,8 involves passing a guidewire through the gastrostomy tube and then using the endoscope to direct the guidewire into the jejunum. The jejunal tube is then passed over the guidewire.…”