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How to place an esophagostomy tube in veterinary medicine | VETgirl Veterinary Continuing Education Videos

Please note: this video is from 2014 and we no longer use these spring-loaded mouth gags (as demonstrated in this 10 year old video). If you have these spring-loaded mouth gags in your veterinary clinic, consider accidentally throwing them in the recycling bin. That’s because they have been associated with blindness. Check out this reference here.

In this VETgirl online CE video, we demonstrate how to place an esophagostomy tube (commonly called the “E-tube”). This type of feeding tube can be placed rapidly under general anesthesia (including endotracheal tube placement) in dogs and cats.

The patient should be placed in right lateral recumbency and sterile technique should be utilized. An appropriately-sized tube should be used; the length should be adjusted appropriately and marked with a permanent marker (Sharpie) so one knows how far in to insert the tube to (approximately the 9-10th ICS). If using a red rubber catheter, the tip should be cut off to open the diameter of the lumen (instead of using the narrow side port). A lighter can be used to briefly burn the tip to smooth the edges out.

A Kelly hemostat should be placed into the mouth, with the curved tips pressed up against the left esophageal wall. Careful attention should be used to avoid the major vessels (e.g., carotid, jugular, etc.) running along the lateral neck. A sterile scalpel should be used to create an opening directly over the hemostat tips, and the e-tube grabbed and pulled in through the incision (into the mouth). Using digital manipulation, the e-tube is then folded back and inserted back down the esophagus. The e-tube should be sutured in place with a Chinese finger trap, and a light neck wrap placed.

For more information, check out our picture tutorial in our blog here.

P.S. No seriously, we we ideally no longer use these spring-loaded mouth gags (Again, this is a much older video), so if you have them in your clinic, consider accidentally throwing them in the recycling bin. That’s because they have been associated with blindness. Check out this reference here.

Mouth gags

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