What is a Witzel jejunostomy?

The Witzel approach is often the preferred one during open surgery for several reasons. Placing the exit to the skin far from the entrance of the tube into the bowel is a way to reduce the occurrence of reflux of the bowel contents from the skin orifice, which usually causes inflammation, granulation and infection.

How do you use a Witzel AJ tube?

A “bite” is taken from the bowel on one side of the tube, then the bowel on the other side of the tube, and finally the needle is passed through the abdominal wall. This allows small bowel to cover the tube and be fixed firmly to the abdominal wall. This is repeated until the tube is completely covered.

How do you feed a jejunostomy?

Feeding jejunostomy refers to a surgically inserted tube, preferably in the proximal jejunum, to provide enteral nutrition or administer medications. This is different from a definitive jejunostomy, which is commonly done as part of gastric resection by a Roux-en-Y technique.

What is a Witzel tunnel?

The Witzel technique is used to prevent extravasation of enteric contents at the exit site of the jejunostomy tube. This involves placing the tube along the length of the bowel for about 5 cm proximally and creating a serosal tunnel to imbricate the tube into position.

Can you bolus feed J tube?

A G-J tube can only be used for “continuous” feeds (slow feeding rate that is easier to tolerate for the stomach) because the small intestine cannot handle large amounts of fluid quickly. You cannot give bolus feeds into the J-port of a GJ tube.

How often do you flush a jejunostomy tube?

Flushing the J-tube To reduce the risk of tube clogs always use lukewarm water to flush the tube. Flush every 4-6 hours, if feeding is continuous. Flush whenever a feeding is interrupted. Flush every day the J-tube does not get used.

Do you aspirate a jejunostomy tube?

Do not aspirate the NJT as this can cause collapse and recoil of the tube.

Can you do bolus feeds through J-tube?

DON’T BOLUS FEED INTO THE J-PORT It is very important never to bolus feed the J-port of a GJ-tube. The intestine is not able to hold a large volume like the stomach can. It is not uncommon to see continuous feeds of 20 hours a day or more with GJ-tubes, especially in the beginning.

How do you check placement of a jejunostomy tube?

The DDS Health Services Directors have determined that the minimal standard method of checking j-tube or g/j- tube placement that shall be expected to be performed is by the visualization and comparison of tube markings or the measurement of tube length outside the skin if there are no markings on the tube.