Golisano Children's Hospital / Pediatric Gastroenterology, Hepatology and Nutrition / G-Tube Home Care / Long MIC G-Tube

Long Balloon Type - MIC G-Tube

The Long Balloon Type Tube (MIC G-Tube) is a long clear tube with markings along the tubing, a silicone bolster (plastic disk) outside, and a balloon inside. This tube does not need to be replaced surgically and can be changed at home or in the office. There are 3 ports at the end of the tube: a large clear port for feedings, a small clear port for medications, and a numbered (white) port which is the balloon port. There is not a clamp on this tube; instead you must kink/pinch the tubing to prevent leakage.

Long Mic G-tube diagram

Caring for the Long Balloon Type Gastrostomy Tube and Site

Watch video of G-tube care.

Cleaning the Site

Wash your hands with soap and water before touching the G-tube site
Use warm soapy water on a Q-tip to clean around the G-tube once a day (more often if needed).
May use ½ strength hydrogen peroxide instead if there is crusting around the tube that is difficult to remove with soap and water or if it is becoming reddened around the tube. If using ½ strength hydrogen peroxide be sure to rinse with plain water after cleansing.
Pat dry
After 2 weeks from original tube placement/surgery, may have regular baths (submerge in water)
Do not use heavily scented soaps or cleansers
Do not apply ointments or medications to the area unless instructed by your healthcare provider

Dressing

Keep a split gauze around the tube at all times. (You should not use a button buddy with this type of tube)
Change it daily or when it becomes soiled/moist
Be sure to turn the tube in the tract at least once daily (about ¼ of a turn) to avoid the external silicone bolster from irritating the skin in the same spot.

Securing the Tube

Movement and pulling on the G-tube site should be minimized to prevent trauma and leakage.

White Cinch securement device

You should always use some sort of securement device, such as a Grip-Lok or Cinch, or medical tape, such as Micropore (paper tape) or Hypafix, to secure the length of this tube because the end is heavy.
Onesies, one-piece sleepers, overalls, or other one-piece clothing will help keep the G-tube from being pulled out.
Stretchy gauze/netting used to cover abdomen
ACE bandage: May be used similar to an abdominal binder for younger children/infants. If using ACE wrap, cut it in half lengthwise and be sure not to pull it tightly around the abdomen or it will compress the G-tube into your child’s skin
Abdominal binder: may be used for older children/adolescents
Use a “tape tag” and safety pin to pin the tube to your child’s clothing to prevent accidental pulling at the G-tube site. (If using, be careful when undressing your child. You MUST remove the safety pin first!)

Bathing and Swimming

May swim in a chlorinated pool 2 weeks after surgery as long as the exit site well healed
May swim in a lake/ocean 2 months after surgery

Activity

Your child may not participate in strenuous activities (contact sports, gym class, playground equipment, etc) for 1 month. After 1 month, your child may participate in strenuous activities if they keep the G-tube covered/secured (minimally for the first 3 months) to prevent dislodgement. After 3 months, your child should remain mindful of the G-tube, but an abdominal binder/cover is not required.
Tummy time is okay for young infants. Your child may sleep or spend time on his/her belly. Make sure the G-tube is taped securely.
If your child does physical therapy/occupational therapy, they may resume 2 weeks after surgery. Until then they may do exercises that do not place them on their belly or use core muscles.

Using the Long Balloon Type G-Tube - Mic G-Tube

Giving Medications or Flushing a MIC G-Tube (Long Clear Tube with External Bolster)

Supplies needed: medications in liquid form, water for flushing, catheter tip or oral syringe plunger syringe

Fill syringe with water (amount to be determined by your health care provider)
Open the cap on the small medication port or feeding tube port (NOT the white balloon port) and attach the tip of the filled syringe
Slowly push the water into the tube
If no issues flushing the tube, may repeat process with the medications. Be sure to kink/pinch the tube between each medication and flushes to prevent leakage of medications/flushes since there is no clamp.
Flush the tubing with water after giving medication
Cap the tube if not in use

Feeding Through a Mic G-Tube (Long Clear Tube with External Bolster)

Supplies needed: Feeding pump, feeding pump tubing/bag, IV pole, formula at room temperature.

Supplies for MIC G-tube feeding

Hang feeding bag on IV pole
Fill feeding bag with formula. (No more than 8 hours of formula at a time)
Place tubing into the pump. Prime tubing (run the formula through the tubing) as instructed.
Set the pump settings as instructed
Kink/pinch the tube to prevent leakage since there is no clamp
Connect pump tubing to the G-tube feeding/medication port. (NOT the white balloon port)
Start the pump, making sure to unclamp the G-tube extension set
Once the feeding is completed, flush the G-tube as instructed, and rinse feeding bag and tubing with warm tap water.
Discard or wash the feeding bag and tubing every 24h or as instructed

Venting a Mic G-Tube (Long Clear Tube with External Bolster)

Venting is done to release air from the child’s stomach (when the child’s belly looks big/distended, the child seems uncomfortable, or the child needs to burp)
Place a 60mL catheter tip syringe without the plunger on the end of the G-tube (on the feeding/medication port)
Allow air to come out through the tube into the syringe (1 – 2 Minutes).
If air does not come out… remove the syringe, place the plunger back into the syringe.
Then place syringe with plunger into the G-tube feeding/medication port.
Gently pull back on the plunger to get the air out of the child’s stomach.
Formula may come back into the syringe during venting, be sure to give any formula that backs up in the syringe back to the child taking care not to push in any air.
Once you are done remove the syringe and cap the end of the G-tube