Abstract
1. Patients under consideration for long-term enteral access require thorough nutritional assessment. When possible, maximize oral nutrition prior to surgical intervention. 2. Multiple types of enteral access exist and the decision regarding which type to utilize depends on patient factors and the duration of anticipated need for enteral access. Patients requiring greater than 3 months of enteral support should be evaluated for surgical gastrostomy tube placement. Gastrostomy tubes may be placed with the aid of endoscopy: percutaneous endoscopic gastrostomy (PEG) or surgically either open or laparoscopically. The appropriate approach depends heavily on patient factors. 3. Other, less commonly utilized types of enteral access exist and are indicated in patients with specific pathologies. For example, patients with high aspiration risk or severe GERD may benefit from post-pyloric feeding. 4. Timing of use of tubes after placement vary based on surgeon preference. Caregiver education regarding routine maintenance and use of tubes is essential. 5. Complications of tube placement are generally minor (skin break down, tube clogging), etc.) and can be managed with supportive care and proper tube maintenance. Major complications (tube dislodgement) are rare but can become a surgical emergency. 6. Timing and setting of tube removal and exchange vary depending on the type of tube in place. Surgical intervention may be necessary if tubes are still leaking 4 weeks post-removal. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.