Percutaneous endoscopic gastrostomy, or PEG for short, is a “traction” gastrostomy performed under endoscopic guidance without opening the abdomen. It is a minimally invasive procedure that is less damaging to the body, combining many advantages such as no opening, easy operation, long retention time of gastric feeding, few complications, cost-effectiveness, and easy care. For those patients who need long-term enteral nutrition, such as: oral, facial, pharyngeal, laryngeal tumors or after surgery and radiotherapy; trauma or esophageal tumors causing difficulty in feeding; various neurological diseases (such as multiple cerebral infarction, acute stroke, etc.) resulting in long-term loss of swallowing function, unable to feed through the mouth or nasal feeding; esophageal perforation, esophageal-tracheal fistula causing Difficulty in eating, etc. It has significant efficacy in all cases. The following is a brief procedure for PEG. Before the procedure begins, the patient is wheeled into the endoscopy room, and then the lights in the room are dimmed and the patient is placed in a flat position, which helps the later operation. The surgical puncture site is first selected, usually 3-5 cm outside the midline of the abdomen below the left upper abdominal rib cage, corresponding to the lower and middle part of the anterior wall of the gastric body. Entering the endoscope, the endoscope is advanced into the stomach through the patient’s mouth, pharynx and esophagus to observe the stomach wall for tumors, ulcers and esophageal varices that affect the gastric wall puncture. Inject air into the stomach until the patient’s stomach wall is sufficiently filled up so that the anterior wall of the stomach is tightly pressed against the abdominal wall. The endoscope lens is adjusted so that the lens is aimed at the anterior wall of the gastric body, and the red spot formed by the endoscopic light through the abdominal wall can be seen outside the abdominal wall, which can be used as the puncture point of the abdominal wall. Immediately afterwards, the selected puncture site is gently pressed with the middle finger, and the puncture is performed when there is a significant fluctuation of the gastric wall under the endoscope. Routine surgical field disinfection is performed, a sterile surgical cavity towel is laid, and the skin and subcutaneous tissue are anesthetized locally with 0.5% lidocaine. After successful anesthesia, a skin incision of approximately 0.5 cm in length is made with a scalpel, followed by puncture of the trocar needle through the abdominal wall and gastric wall into the patient’s gastric cavity at the incision, removal of the trocar needle core, leaving the outer casing, and feeding of the pre-prepared loop guide wire into the gastric cavity through the previously retained outer casing needle. The endoscope holding forceps were fed into the patient’s stomach through the lateral hole of the endoscope, and the looped guidewire was grasped and pulled out of the stomach together with the guidewire, while the other end of the guidewire was fixed to the external trocar and left outside the abdominal wall. Then the guidewire pulled from the mouth is tied to the guidewire of the PEG tube outside the mouth, and the other end of the guidewire left outside the abdominal wall is tugged to pull the PEG tube into the stomach through the mouth, pharynx and esophagus until the PEG tube penetrates the abdominal wall through the puncture point of the trocar needle, and the round head of the PEG tube is tightly attached to the inner wall of the stomach. After pulling the tube tightly, a fixation disk outside the abdominal wall is placed over the PEG tube and tightly attached to the abdominal wall, but the appropriate degree of tightness should be mastered when fixing. Finally, the operations are completed by retaining a moderate length of PEG tube according to the patient’s actual condition and attaching the feeding interface to the PEG tube. PEG technique is not recommended for patients with the following conditions: expected survival time less than 30 days; complete oropharyngeal and esophageal obstruction; extensive abdominal wall injury, trauma infection; severe and uncorrectable disorders of bleeding and coagulation mechanisms; large amount of ascites; gastric disorders, especially anterior gastric wall lesions affecting the surgical operation; too small residual stomach after major gastrectomy, etc. Although percutaneous endoscopy-guided gastrostomy is quite common as a routine treatment, it should be performed strictly according to all surgical procedures and postoperative care to ensure surgical results and prevent complications.