I’ve Got 99 Problems, and a G Tube is One

  • In this episode of Behind the Knife, Dr. Patrick Georgoff sits down with Dr. Keri Seymour and Dr. Joey Lew to tackle the complex world of gastrostomy tubes. What may seem like a routine and straightforward procedure is anything but—full of nuanced patient considerations, timing dilemmas, technical challenges, and potential complications that can turn a “simple” consult into a 2 a.m. call you won’t forget. From who truly needs a G tube and when to managing difficult post-op issues like dislodgement and buried bumper syndrome, this episode breaks down the practical, evidence-based approach every surgeon should know. Whether you’re managing stroke patients, trauma cases, or navigating the tricky administrative obstacles around enteral access, this episode will equip you with the insights and strategies to confidently dominate your G tube consults.

Target Audience

  • Nurses
  • Nurse Practitioners
  • Physicians
  • Physician Assistants

Learning Objectives

  • Understanding the nuanced indications for gastrostomy tube (G tube) placement.
  • Learning which patients truly benefit from G tubes, and when enteral access is not appropriate or indicated.
  • Appreciating the importance of goals of care discussions, assessment of comorbidities, and decision-makers—especially in neurocritical and elderly populations.
  • Knowing evidence-based timing for gastrostomy tube placement in stroke, TBI, and other complex scenarios.
  • Understanding guideline recommendations and the clinical reasoning behind trial periods of nasogastric feeding versus early G tube placement.
  • Describing technical approaches to G tube placement and how to tailor the method to patient anatomy and clinical context.
  • Solidifying knowledge of when to choose endoscopic, laparoscopic, open, or interventional radiology-guided placement.
  • Recognizing, managing, and striving to prevent common and serious complications of G tubes, including early and late dislodgement, buried bumper syndrome, infection, bleeding, and gastrocutaneous fistula.
  • Discussing perioperative considerations, including anticoagulation, patient stability, and post-procedural care.
  • Understanding why routine suturing of the G tube or bumper is not recommended, and how administrative and facility factors can drive clinical decisions.
  • Gaining practical pearls and quick decision trees to dominate G tube consults and troubleshooting, day or night.
Course summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 ANCC
  • 0.50 Attendance
  • 0.50 IACET CEU
Registration Opens: 
11/15/2025
Registration Expires: 
11/14/2027
Rating: 
0
Virtual, NC
United States
  • Dr. Patrick Georgoff
  • Dr. Keri Seymour 
  • Dr. Joey Lew
  • AMA PRA Category 1 Credit(s)
  • ANCC
  • Attendance
  • JA Credit - AH

Available Credit

  • 0.50 AMA PRA Category 1 Credit(s)™
  • 0.50 ANCC
  • 0.50 Attendance
  • 0.50 IACET CEU
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