Same-day Discharge After G-tube Placement

Placement of a gastrostomy tube (G-tube) is a common procedure performed in children. This can be performed safely and efficiently through a minimally invasive approach. Historically, children were admitted after surgery to allow for G-tube teaching and initiation of tube feeds.

At Children's Mercy, we challenged the previously held notion that a child's tube feeds must be started several hours after surgery and advanced slowly in a regimented fashion. Through the development of a FASTDischarge (Feeding Advancement and Simultaneous Transition to Discharge) protocol, we proved it was safe to allow a child's tube feeds to be started four hours after surgery and advanced to their goal rate as tolerated. Our findings were published in the Journal of Pediatric Surgery.

We then developed a same-day discharge protocol for interested parents, which entails teaching a family about the G-tube at their pre-operative visit. Following surgery, a child is admitted to our surgical observation floor; tube feeds are started four hours after surgery and advanced to goal as tolerated. From August 2017 to September 2019, we identified 62 eligible patients and 82% were ultimately discharged home successfully on the same day of surgery. Only 11 patients required postoperative admission, most commonly so parents could receive extra education and practice using the tube. These findings were also published in the Journal of Pediatric Surgery.

This change in practice highlights our commitment to providing evidence-based care that focuses on getting a child back to their normal environment as quickly and safely as possible. We are currently examining parent satisfaction with same-day discharge after G-tube placement.

Read the publication on same-day discharge for laparoscopic gastrostomy in children.