G tubes: Corflo PEG tube

Gastrostomy tubes (G tubes) are feeding devices that provide liquid nutrition, medication, fluids or blended diet directly into the stomach. G tubes are placed through a surgical opening in your child's belly (abdomen) called a stoma. The tunnel from the outside into the stomach is called the tract. A Corflo PEG tube is one type of G tube.

Inserting the Corflo PEG tube

T-bar/crossbar fixation device

TThe Corflo PEG tube is placed by an interventional radiologist using image guidance. There is a round bolster on the inside of the stomach that helps prevent the tube from being pulled out. A T-bar/crossbar fixation device on the outside of the stomach helps prevent the tube from moving into the stomach.

Caring for the Corflo PEG tube

After the insertion of a Corflo PEG tube, your child's stoma will be left dry and open to the air. There is no need for a dressing. Occasionally, the interventional radiologist who placed the tube may apply a small gauze on the site, if they think it is necessary. If there is no leaking or discharge, the gauze can be removed.

Follow these instructions to care for your child's Corflo PEG tube:

• Wash the stoma with soap and water daily, beginning 24 hours after the tube is inserted.
• Your child may begin to take baths 48 hours after primary tube insertion.
• • You may wish to secure the tube to the stomach with tape. This is not a requirement, however the weight of the tube can sometimes lead to stoma issues if it always sits in the same spot. Taping the tube and rotating where it is taped daily can help prevent this.
• For the first two weeks after insertion, do not adjust the T-bar/crossbar. Contact the G tube specialist (at SickKids, this is the G Tube Resource Nurse) if you have concerns about the placement of the cross bar. For example, it might appear to sit too loose or too tight against your child's belly.
• After two weeks, the T-bar/crossbar can be adjusted by you at home if it is too tight or too loose (see instructions below). If your child is still in hospital, a nurse can help you adjust the device.
• Your child may participate in their regular activities if they are feeling well and not experiencing severe pain or discomfort.
• Your child may go swimming two weeks after the tube insertion if the stoma has healed.
• For any tube or stoma issues, including infection, hypergranulation tissue and leakage, call the G tube specialist.

How to adjust the T-bar/crossbar

The T-bar/crossbar should sit close to your child’s stoma, but it should not be too tight or too loose. Parents or caregivers can adjust the T-bar/crossbar after the Corflo PEG tube has been in place for more than two weeks. To adjust the fit of the T-bar/crossbar, gently slide the round piece above the T-bar/crossbar and the T-bar/crossbar itself up or down the tube. Do not pull on the tube as this can lead to it being accidently pulled out of the tract and stoma.

Corflo PEGY-adaptor (repair kit)

The Corflo PEG tube utilizes a Y-adaptor. The Corflo PEG Y-adaptor allows access for tube feeding, fluids, medication and blended diet administration. The Y-adaptor is attached to the end of your child's feeding tube and can be changed if needed (e.g., if the tube is broken).

Changing the Corport Y-adaptor

To change your child's Y-adaptor, follow these instructions:

1. Clamp the tube in order to prevent the stomach content from spilling out
2. Untwist the skirt from the Y-adaptor
3. Remove the Y-adaptor
4. Clean the end of tube
5. Replace the Y-adaptor, inserting it back into the tube
6. Twist the skirt onto the new adaptor until tight

How to change the clamp

1. Clamp the tube in order to prevent the stomach contents from spilling out
2. Untwist skirt from Y-adaptor
3. Remove the Y-adaptor
4. Remove the skirt
5. Unclamp and remove the clamp
6. Clean the end of tube
7. Replace the clamp with a new one
8. Replace the skirt, making sure the narrow end of the skirt is closest to the clamp
9. Replace the Y-adaptor, inserting it back into the tube
10. Twist the skirt onto the adaptor until tight

What to do if your child's Corflo PEG tube is accidentally pulled out

Although it is very unlikely, your child's Corflo PEG tube may be accidentally pulled out. To learn what to do if your child's G tube is completely accidentally pulled out, please see the article What to do if your child's feeding tube is pulled out.

If the tube is only partially pulled out, the bolster on the end of the tube may become stuck in the tract. If this has happened, you may notice the following.

• Significant pain in the G tube area
• A visible hard plastic bulge (the bolster) that does not go away when you move the tube
• You may be able to feel a hard bulge (the bolster) in the tract or stoma
• Formula leaking from the stoma

If you are concerned that the tube has been partially pulled out and the bolster is stuck, call your G tube specialist right away. On the weekend/after hours, go to the Emergency Department.

Replacing the Corflo PEG tube

To replace the dislodged, broken, or blocked tube, or to exchange it for a low-profile tube:

• Contact your child's G tube specialist to make an appointment for the tube replacement or exchange.
• A general anesthetic or sedation may be needed to remove a blocked or broken Corflo PEG tube or to exchange to a low-profile tube.
• Your child's Corflo PEG tube can be exchanged for a low-profile tube three months after the primary insertion date.

At SickKids

For SickKids patients, to replace a Corflo PEG tube, an appointment must be made in the Image Guided Therapy (IGT) Department. Contact the G Tube Resource Nurse to schedule an appointment.

G Tube Resource Nurse contact info:

Phone 416-813-7177

g.tubenurse@sickkids.ca

On the weekend/afterhours, you may need to come to the Emergency Department for an alternate method of feed/fluids/medication administration.