How to insert a naso-enteric tube using an ultrathin scope

Enteral feeding is the delivery of nutrients directly into the stomach or small intestine via a tube. It is indicated in any patient who cannot meet their nutritional requirements by oral intake and who has a functioning and accessible gastrointestinal tract. Most patients who need enteral feeding can be fed with a naso-gastric tube. However, there are patients who cannot tolerate naso-gastric feeding, who do not have a stomach and who have gastric outlet obstruction. In these patients, a naso-enteric tube (NET) is appropriate. In this study, we describe our optimal technique for insertion of an NET using an ultrathin scope. Although not a technically challenging procedure, we have refined our technique over the past two decades to achieve a 100% success rate with placement of a NET in the small intestine without radiological guidance.