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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 November;174(11):499-503
Evaluation of forces required for removal of percutaneous endoscopic gastrostomy (PEG) devices
Iqbal R. 1, Cox K. 2, Fang J. C. 2
1 Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA;
2 Division of Gastroenterology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
AIM: PEG tubes have various types of internal retention devices to help prevent inadvertent tube removal. These primarily consist of inflatable balloons or solid mushroom shaped retention devices. It is not known which type of retention device requires more force for removal or for balloon type PEGs whether the volume of water insufflated affects the amount of force required for removal.
METHODS: Solid internal bolster PEGs were initially placed into two adult swine. Eleven days later, the initial PEGs were removed and replacement balloon PEGs were placed and removed immediately. Force of external traction removal was measured using strain gauge meter in Newtons. 4 initial placement solid internal bolster PEGs and 28 replacement balloon type PEGs were tested. For balloon type PEGs the balloons were left inflated when removal forces were tested.
RESULTS: The force required to remove balloon type PEGs was significantly greater than the force required removing the solid internal bolster PEGs (15.2±0.6 vs. 7.4±1.7 respectively) (P=0.0004). The force required to remove balloon type PEGs was not significantly different whether the balloons burst or not upon removal (16.1±3 psi vs. 14.4±2.7 P= NS). The volume of the balloon was significantly associated with the force required to remove the PEG (P<0.0001).
CONCLUSION: Balloon type PEG’s required significantly more force to remove than solid internal bolster PEG’s. The force for removing balloon type replacement PEG’s did not differ whether retention balloons burst (vs. not bursting) during traction removal but did significantly differ by volume of the balloon.