The role of endoscopy in the correct and rapid positioning of feeding tubes.

The recognition of the importance of the enteral route for (hyper) alimentation led us to develop three methods for enteral placement of feeding tubes using endoscopic techniques. With these three treatment modalities it was possible to carry out enteral administration of nutrients in a group of patients, in whom otherwise only total parenteral feeding or enteral feeding by needle catheter jejunostomy was considered feasible. The use of endoscopic equipment permitted correct placement of tubes beyond the stomach either in the duodenum, at the ligament of Treitz or into the jejunum. Also simultaneous distal feeding combined with proximal intestinal drainage in the case of fistula, perforation, anastomotic leakage, or gastric dysfunction was achieved using this endoscopic approach.