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Also, the wonderful thing about using the Button (MicKey) is that it has a non reflux valve inside the "keyhole" site where you align the removable tubing for the actual feeding/bolus administration. It prohibits the gastric juices from spilling out onto the abdomen. Gastric juices are very caustic and the original peg tube placement as stated before has a longer extension which can get in the way, be pulled out accidentally as in the case of confused or defiant patients. In our practice, the most common patient populations requiring placements of the tubes were post CVA patients. They are often confused or maybe annoyed by the longer extension of tubing and required using an abdominal binder of sorts just to keep them from pulling out the initial tube. I am a practicing GI nurse (15 yrs in the field) and have an adult daughter with a TBI who I just so happened to change out the MicKey for this evening. From personal experience, I always encouraged my physicians to replace older pegs with the MicKey or similar devices (low profile) as we call them. They also are less noticeable underneath clothing. Hope this helps.