Figure 16 - Method of percutaneous endoscopic gastrostomy.

a: Transillumination of stomach to identify puncture site. b: Transabdominal insertion of needle into stomach under endoscopic visualization. c: Guidewire is passed into stomach and then grasped with snare. d: Guidewire is pulled caudally until it exits the mouth. e: Gastrostomy tubed passed over the guidewire until the tapered end exits the anterior abdominal wall. (Source: Kudsk KA, Jacobs DO. Nutrition. In: Surgery: Basic Science and Clinical Medicine. Norton JA, et al., eds. New York: Springer-Verlag, 2001(2) Part 7, Section 91:136., with permission)