Gastrointestinal Radiology > Procedures > CT-Guided Perc. Gastrostomy > CT-Guided Perc. Gastrostomy (7)

CT-Guided Percutaneous Gastrostomy: A Tutorial

Step 8: Remove the introducer needle over the guidewire and trailing suture needle. The 0.018 inch diameter mandril wire section (back-end)  of the guidewire must be positioned adjacent to the suture needle (within the introducer needle) to allow removal of the introducer needle.

Transition (arrow)  0.035 inch guidewire to 0.018 inch mandril wire section (bare end, arrowheads) of guidewire

Step 9: Maintaining access to the stomach with the guidewire, pull back on the gastrointestinal anchor thread to bring the anterior wall of the stomach against the abdominal wall.

 

Passing gastropexy needle through introducer needle

Simulation of gastric anchor needle (large arrow) through wall . Simulation of T-bar (small arrow) deployment. Note guidwire (arrowhead) adjacent to T-bar anchor.

 

If the anchor is not correctly deployed in the gastric lumen, the second anchor can be loaded. After insufflation, the stomach can be punctured again.

Loading the second gastric anchor into introducer needle (if necessary)