Percutaneous Endoscopic Gastrostomy (PEG) | Direct Stomach Feeding
When a loved one is unable to swallow food orally - whether due to a stroke, neurological disease, or tumor - the body weakens rapidly, and risks increase.
PEG (Percutaneous Endoscopic Gastrostomy) is a feeding tube inserted directly into the stomach through the abdominal wall via a short and simple endoscopic procedure.
Dr. Vosko and his team perform this procedure with great sensitivity, understanding that this is not merely a technical procedure but a significant change in the quality of life for the patient and their family.
We offer rapid implementation to prevent suffering, along with patient and supportive family training to allow you to care for the tube at home with confidence and ease.
Need urgent nutritional assistance?
Contact us for rapid and compassionate coordination.
Who is this treatment for?
The procedure is intended for patients with a functional digestive system who cannot swallow safely by mouth (dysphagia) for a prolonged period (over a month).
The main indications include:
- Neurological Swallowing Disorders: Patients post-stroke (CVA) or suffering from advanced degenerative diseases (such as ALS, Parkinson's, and dementia), who are at risk of food aspiration into the lungs.
- Mechanical Obstructions: Patients suffering from head and neck tumors or esophageal tumors that physically block the passage of food.
- Nutritional Support: Patients (oncological or nursing) suffering from severe malnutrition requiring caloric supplementation that is not possible through normal eating.
- Decompression (Drainage): In specific cases of intestinal obstruction, the device is used to release pressure from the stomach and provide relief to the patient.
A nasogastric tube (nose tube) is a temporary and irritating solution. PEG is a comfortable, long-term solution.
- Availability & Urgency: We understand that the need for nutrition is often urgent and are prepared to coordinate the procedure quickly.
- Safety: Utilization of the safe "Pull" technique and visual endoscopic inspection throughout the procedure to prevent injury to adjacent organs.
- Training & Follow-up: Our greatest advantage is our ongoing support. A registered nurse will instruct you exactly how to use the tube, clean the area, and handle malfunctions, so you never feel alone.
- Humanity: Dr. Vosko understands family distress and performs the procedure with high availability to prevent nutritional deterioration.
- Gentle Technique: Use of the safe Pull Method, under sedation adapted to the patient's medical condition.
- Support System: The connection does not end with the procedure. The team is available for questions regarding tube blockages, dressing changes, and types of feed.
Quality of life and nutritional support for your loved one.
Dr. Vosko and the team are here for rapid and professional PEG insertion.
How is the treatment carried out?
How is the consultation conducted?
The procedure is performed endoscopically (without abdominal surgery) and takes about 20 minutes.
First, Dr. Vosko inserts an endoscope through the mouth into the stomach and illuminates through the abdominal wall with a strong light source to mark the precise and safest location.
Second, a tiny incision (approx. 5 mm) is made in the abdominal skin, through which a flexible silicone feeding tube is inserted directly into the stomach.
The tube is gently secured with internal and external discs to prevent displacement.
How should I prepare for treatment?
How should I prepare for the consultation?
- Fasting: A full fast from food is required for 8 hours prior to the procedure. Clear water may be consumed up to 3 hours before.
- Medications: You must inform us if you are taking blood thinners (such as Aspirin, Plavix, Eliquis, etc.). These must be stopped several days before the procedure, only in consultation with the treating physician.
- Antibiotics: In most cases, a single dose of intravenous antibiotics will be given before the procedure to prevent infection at the incision site.
What to expect the day after? (Recovery and recuperation)
- Recovery: The patient remains for short observation and is usually discharged the same day or the following day.
- Initiating Feeding: Water administration via the tube begins about 4 hours after the procedure. If there are no side effects, liquid nutrition (medical formula) is gradually introduced within 24 hours, reaching the full required amount within two to three days.
- Daily Care: Flush the tube with water before and after every feeding and rotate it gently once a day to prevent adherence to the skin.
Are there risks or side effects?
The procedure is considered very safe. Possible side effects include:
- Local pain at the incision site for the first two days (responds to simple painkillers).
- Redness or mild infection around the opening (treated topically or with antibiotics).
- Rare: Bleeding or tube displacement.
Information for patients from abroad (medical tourism)
The unit is equipped to receive international patients and collaborates with agents for a full logistical envelope.
Direct inquiries are also welcomed for rapid and efficient coordination.
We assist families wishing to provide quality supportive care for their loved ones, even if they are not residents, including guidance in Hebrew, English, or Russian.
Dr Vokso is fluent in Hebrew, English and Russian.
Is the tube visible under clothing?
The tube can be easily concealed under a regular shirt. There are also "button" (Mic-Key) tubes, which lie completely flat against the abdomen and can be switched to after a few months for improved comfort and aesthetics.
Is this permanent?
Not necessarily. In reversible situations (such as recovery from a stroke or following radiation therapy), the PEG is temporary. Once the patient is able to eat independently and maintain weight, the tube can be removed in a quick procedure, and the opening in the abdomen closes on its own within 24 hours.
What should you do if the tube is accidentally pulled out?
This is an urgent but manageable situation. The opening in the abdomen tends to close very quickly (within hours). You must go immediately to the emergency room or clinic to insert a new tube before the site closes. We will provide you with precise instructions on what to do in such a case and supply emergency equipment.
Is it permitted to shower or enter a swimming pool?
During the first two weeks, the area must be kept dry (sponge bath only). After the wound has completely healed (approximately 3-4 weeks), you may shower normally and even go to the sea or enter a pool, provided the area is thoroughly dried afterward.
Can I still eat by mouth?
An excellent question. For many patients (such as those with early-stage ALS or cancer), the PEG is intended solely as a nutritional supplement. If your swallowing mechanism allows it safely (without aspiration), you may certainly continue to enjoy tastings or small meals by mouth in addition to tube feeding.
We are with you - from the very first call, we understand that on the other end of the line is a person who may be concerned or in pain, waiting for answers. Therefore, we have built a service system that truly sees you:
- High Availability: A live service center is active Sunday-Thursday from 09:00 AM to 07:00 PM and on Fridays from 09:00 AM to 02:00 PM. In urgent cases, we are available beyond these hours.
- Direct WhatsApp Line: Do you have a question about fasting? Did you forget to ask something about your medications? Our customer service is available via WhatsApp for a quick response.
- Peace of Mind from Bureaucracy: Our team is highly experienced in working with insurance companies and supplemental health plans. We will assist you in preparing the necessary paperwork and authorizations so that you can focus entirely on your health.
Insertion of gastric feeding tube with endoscopic access - PEG
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