Interventional Radiology and Fluoroscopy
What is a RIG?
A RIG is a Radiologically Inserted Gastrostomy tube. This is a short tube that is placed through the skin directly into the stomach. The tube will enable you to be fed directly into your stomach without taking food through your mouth.
Are there any risks?
Complications are very uncommon RIG insertion is a safe procedure.
- There may be some leakage of stomach contents into the abdominal cavity which may cause and infection.
- Infection may also occur where the tube passes through the skin into the stomach. If these occur antibiotics may be given to treat these infections.
- A reaction to the drugs or contrast that may be used in the procedure.
- Bleeding can occur where the tube passes through the skin into the stomach.
- Non-target injury; the abdomen is a busy area with lots of other organs within (such as liver and large intestine). These may, in rare cases, get injured and if this happens, surgery may be necessary to rectify.
The radiologist or radiographer will discuss the possible risks with you before you have the procedure. Please ask them if you have any concerns or would like any further information.
What do I need to do to prepare for the procedure?
You will come into hospital onto a ward the day before the examination to have a RIG inserted.
- The day before the procedure if you do not already have one, a fine soft tube will be placed through your nose into your stomach (NG tube). A liquid that shows up on x-ray (Barium) will be put through this tube the evening before the examination, this is in order to see the bowel loops during your examination so they can be avoided.
- You will usually need to have a blood test to measure full blood count and clotting profile before the procedure. These are needed to ensure you are not at increased risk of bleeding. Your doctor will organise these on the Ward.
- Please let us know if you are taking any medicines that thin the blood (for example Warfarin, Rivaroxaban, Dabigatran, Apixaban), as these may need to be withheld temporarily before the procedure. Call the Radiology Day Unit Sister for advice as soon as you get your appointment letter on 01642 854332.
If you are taking aspirin or clopidogrel, then please continue taking these as normally.
- You will be kept Nil By Mouth on the day of the examination, and the Ward will give you some antibiotics just before you are collected from the ward for you examination in the x-ray department.
- After you have arrived at the radiology day unit, you will be examined and assessed by a radiology nurse. You will be seen by a radiologist (a health care professional who uses imaging machines to diagnose and treat illnesses) who will discuss the procedure with you. You will be given the opportunity to ask any questions you have.
Giving my consent (permission)
The staff caring for you will ask your permission to perform the procedure. If you decide to go ahead, you will be asked to sign a consent form that says you have agreed to the procedure and that you understand the benefits, risks and alternatives. If there is anything you don’t understand or you need more time to think about it, please tell the staff caring for you.
How is the dialysis line inserted?
You will be taken into the x-ray room and asked to lie flat on the table. A medication will be given through the veins to relax the stomach in preparation for the procedure. This medication can make you feel like your heart is racing; this is to be expected. However, if you have any allergies or hearth rhythm problems, please let one of the members of staff know.
Air will then be pumped into your stomach through the NG tube to make the stomach more visible and move it into the right position. X-rays are used to find the best position for the tube.
Local anaesthetic will be injected into the selected site on your tummy and stitches are put around the site to hold your stomach in position, these will then dissolve and fall off on their own after 7 to 10 days.
A small cut is made in the centre of these stitches and the Gastrostomy tube is inserted into your stomach. All this is done under local anaesthetic so you should not feel sharp pain.
At the end of the procedure there will be a small balloon in your stomach which will be filled with water which stops your Gastrostomy tube falling out. This water will need to be changed every 10 to 14 days and your District Nurse can do this. You will not be able to feel this balloon.
When a feed is due, a feeding tube will be attached to your tube through which the feed is given.
Will I feel any pain?
As you are given a local anaesthetic, you should not feel any pain during the procedure. You may however feel some discomfort after the procedure when the local anaesthetic wears off. You may also like to have some paracetamol. If you cannot take this orally, then you can talk to the doctors on the ward to prescribe some to be given through the veins. You may also have a little bruising.
What happens after the dialysis line insertion?
After the RIG is placed you will be returned to the ward. Then the NG tube will be removed at the end of the same day or the day after.
While you are still in hospital you will be shown how to care for and use your RIG. You will be seen by the Dietitian and home enteral feeding team prior to your discharge.
You will be advised of your length of stay in hospital by the staff on the Ward.
Taking care of your dialysis line at home
- It takes about two weeks for the channel or ‘stoma’ to form around the tube. There may be a little discharge during this time and a small dressing may be necessary.
- You will be able to shower soon after the RIG is inserted and after two weeks you can bath or even go swimming.
- You can go out and you will find the RIG is unobtrusive under your clothes.
- In some circumstances you may be able to eat and drink. The medical staff will advise you.
The RIG is designed to last about six months before it needs to be changed, this can be done without the need for a visit to the X-ray department and if it is no longer required it could be easily removed.
If the RIG falls out accidentally, you should attend the nearest A&E for the tract or stoma to be saved with a new tube. This tract or stoma can close very quickly if you ignore it once the tube is out.
Radiation dose and risk
X-rays use ionising radiation which can cause cell damage that may, after many years or decades, turn cancerous. The risk of this happening is very small compared to the normal lifetime risk of developing cancer which is 1 in 2.
We are also all exposed to background radiation every day. The risk of long-term effects is considered when the healthcare team decide whether someone needs an x-ray examination and radiation doses are kept as low as possible.
For this examination radiation dose levels are typically equivalent to around 1 to 2 years of background radiation. The associated risk is less than 1 in 1000 – Low.
Is there anything I should tell the staff?
For patients who have ovaries and are between the ages of 12 and 55, the x-ray department has a legal responsibility to ensure that this examination is performed within TEN DAYS of the first day of your menstrual period.
Contact us
If you require further information, please contact us on:
Telephone: 01642 854822
Email: [email protected]
Patient experience
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.
To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.
T: 01642 835964
E: [email protected]