Percutaneous Cecostomy Insertion - Continuing Care -

At approximately 6 weeks post primary tube insertion, the tract has healed and the catheter is changed for a Chait Trapdoor™ catheter (Figure 27) (Chait, 1997).  This is performed as an outpatient procedure with seldom the need for sedation. No antibiotic coverage is given for this exchange. The position of the existing tube is checked and once the new tube has been placed over a wire, position of the trapdoor is confirmed with contrast. This device provides a low-profile catheter that is easily hidden under clothing or a small dressing, allowing the patient to lead a normal life (Figure 28). These catheters have been left in place up to three years between changes, but may become concreted and more difficult to remove over time. Our current technique for exchanging the trapdoor device (see below) is to clamp the catheter with forceps, cut off the trapdoor and introduce a wire into the catheter. The new catheter is then advanced over the wire, pushing the old catheter fragment into the cecum, where it passes in a few days.               Click on an image to see it magnified.

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