Question: Is there any reason why a long gastro tube would be inserted into a patient rather than a low profile Mic-Key button for feeding? Is different equipment used for the placement of these tubes? Is specific training needed for initial placement of the low profile "button type" port?

My 96 year old mother had to have a tube replacement yesterday as the site of her previous tube was very "angry", irritated,sore and seemed to have infection. When the Dr replaced/relocated the tube, he changed from a low profile Mic-Key type to the normal or long tube. When I questioned the reason for the change he advised that the necessary equipment to place the low profile tube was not available at the hospital that he was working in. I am very much aware that an endoscopy procedure must be performed to initiate a new site but I see absolutely no reason that the low profile type could not be placed with basically the same equipment. This is the second time that he has placed the long tube in my mother. After the first time, I requested changing to the low profile because she is very active and the bulkiness of the long tube, as well as having to use tape to keep it from being pulled on by her clothing, naturally causing constant irritation of other tissue on the abdomen. He did the swap to the low profile at about 6 months after the original placement. Needless to say, anytime removal and reinsertion takes place a certain amount of discomfort is involved. Why put a person her age through 2 procedures when 1 would suffice? As I stated earlier, his response was "that the facility did not have the necessary equipment". What is so different in an endcoscopy procedure from one to the other. Both require site location from outside, insertion of camera/endoscope, wire insertion, attachment and pull through of feeding tube appliance. Depending of type, inflation of balloon on low profile type or setting of retainer on the long tube. Am I missing something that requires any major equipment for the to placement of the low profile tube? Just simply do not understand the explanation that I received. As further conversation went..."we can change to the low profile when she come back to see me in 2 months". Just simply do not like this approach. Back to square one: Put normal/long tube in for several months and do another procedure and change to low profile later! My husband had a Mic Key PEG placed at the very start of tube feedings and kept the low profile type for 8 years (of course changing when necessary). Never had the regular long type. Never had to go through 2 procedures. Do not understand his explanation or reasoning on the need for 2 procedures!

No, I apparently didn't make myself clear on what actually took place. The Dr. said the hospital did not have the "necessary equipment to instal the Mic-Key into the abdomen". The actual Mic-Key appliance that is to be put in when we come back in 2 months was physically given to us and we were told to bring it with us when we came back for our 2 month visit. Makes me wonder why he has done this type of procedure on both occasions. Put one type in...given us the low profile type before she was discharged from the hospital (which meant the appliance was available at the time the procedure was performed) and instructed us to bring it with us when we returned for the 2 month visit and informed us that it would be changed them.

Thank you. I was beginning to think I was completely stupid. Over the 8 year period that my husband had his feeding tube (Mic-Key) I changed it probably 15-20 times. At the time of initial placement his doctor instructed me verbally and with a video on how to change it whenever I saw the need after performing the weekly check test. As bad as I hate to say it, I feel like this doctor that I am dealing with is really in the "dark ages" and hasn't kept up with new procedures or is very "money hungry". Sorry about expressing my feelings in this manner, but at least now I have a little more insight into what his actions might be. Probably will make some changes soon. Not very confident in his general ethics or professionalism. Thanks so very much for your input it was most helpful.