Gastrostomy and Primary Button

Standard Care (see Emergency Procedures below)

A gastrostomy button is placed in the child's stomach so that additional feedings and medicines may be given. The button is placed through an incision in the stomach and abdominal wall. The gastrostomy button is then sutured in place.

Site Care

Clean the site with half-strength hydrogen peroxide every 8 hours while in the hospital, and with soap and water at home. The site should be cleaned 2-3 times per day, depending on the amount of drainage. You do not need to apply any ointments to the site.

The gastrostomy button that is placed may cause the skin to react to something foreign. It is common for the button to have drainage that is yellow and may form a " crust". A small rim of cells that look like small, red bubbles, called granulation tissue, may form at the base of the button. This is a normal reaction to a foreign object in the skin and can be treated in clinic.

Securing the Tube

The primary button is sutured in place. Tape or net gauze can be used to secure the additional length of tubing from the feeding adaptor.

Bathing

You may sponge bath or shower 48 hours after the button is placed. Pat dry the button site. Do not soak or swim for one week after surgery.

Feeding Adapter

A feeding adapter will be attached to the gastrostomy button in the operating room. This will be used to feed the child and vent air from the stomach. The first adaptor change will be done in the clinic and then needs to be replaced every two weeks.

You should receive additional continuous feeding adaptors (#0121-12) from your home supply company.

VENTING: Removing gas from the stomach via the gastrostomy button

Sometimes it is difficult for the patient to "burp" after surgery. They may need help relieving the gas built up in the stomach. Venting the button does this. Venting involves the following steps:

  1. Remove the plunger from the 60cc syringe.
  2. Attach the syringe to the end of the feeding adaptor.
  3. Hold the syringe at least two inches above the child's abdomen.
  4. Open the clamp on the feeding adaptor.
  5. Hold the syringe in place until the air or stomach contents are expelled.
  6. After a couple of minutes, air should be expelled, and any remaining stomach contents should be allowed to flow into the stomach via the feeding adaptor.
  7. Clamp the tube and remove the syringe.

Activity

Do not lift objects greater than 5 pounds for one week. You may then resume your normal activities as tolerated.

Follow Up

You should have an appointment in the Pediatric Surgery Clinic 2 weeks after surgery. The sutures may be removed at this appointment. The first gastrostomy button will be changed in clinic in 2-3 months.

In the event your child's gastrostomy tube becomes dislodged DO NOT PANIC. It is important to replace the tube with the Foley catheter you keep in your emergency kit. The tract that the gastrostomy tube enters the stomach through can close very rapidly. It is very important to replace the tube as soon as possible. If your child's gastrostomy tube has been placed less than four weeks ago, go directly to the ER or call the Pediatric Surgery Clinic @ (734)-764-4151, Monday - Friday, 8am - 5pm.

IF THE GASTROSTOMY TUBE FALLS OUT

If placed more than four weeks ago, follow the Emergency Procedure for Replacing a Gastrostomy Tube:

Supplies in Emergency Kit:

  • Foley Catheter
  • Lubricant
  • 5cc syringe
  • Beta clamp
  • 60cc syringe
  1. Obtain the Foley catheter or tube you have in your emergency kit
  2. Coat the end of the tube with lubricant (surgilube or K-Y jelly)
  3. Insert the end of the tube into the opening in the abdominal wall, gently about 3-4in
  4. Using a 5cc syringe, fill the balloon with 5cc of tap water into the port that inflates the balloon
  5. Pull back gently on the tube until you meet some resistance
  6. Secure the tube with tape
  7. Attach a 60cc syringe and aspirate stomach contents to assure proper placement of tube, and verify placement with the free-flow of a small amount of water
  8. You can still administer feedings through this tube for the time being, until you can be seen in our office or obtain a more permanent gastrostomy tube if you don't already have one
  9. If unable to replace your child's gastrostomy tube take your emergency kit to the nearest ER or call the Pediatric Surgery Clinic at (734)-764-4151, Monday - Friday, 8am - 5pm
  10. This emergency kit should be with your child at all times, at school, if traveling, or even on a long day of errands

For problems, call the Pediatric Surgery Clinic, (734) 764-4151 Monday through Friday, 8:00am to 5:00pm.

Weekends and evenings go to UMMC Pediatric Emergency Room, or to the local hospital emergency room. Take the extra tube (Foley) that you were given in the hospital. This may be used as the replacement.

This information is provided by the University of Michigan Department of Surgery, Section of Pediatric Surgery and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact your health care provider or our offices.