Patients receive a general anesthetic. In the course of performing a major abdominal operation the surgeon will cut into the abdominal wall entering the abdominal cavity. This is called a laparotomy. During this procedure the stomach is exposed and a small incision is made in the wall of the stomach. The gastrostomy tube is placed through a small cut in the abdominal wall and into the stomach. A balloon on the end of the tube is inflated inside the stomach. Traction is placed on the tube to elevate the stomach against the abdominal wall where it is secured with sutures. Sometimes a second smaller tube is threaded through the stomach tube into the first part of the intestine. This is called a jejunostomy tube and is used to feed or administer medications to patients further down the gastrointestinal tract beyond the stomach. This smaller tube may reduce the risk of regurgitation or reflux of contents into the stomach, esophagus, and lung. Following the tube placement the abdominal wall incision is closed and the patient is taken to the recovery room.