Dear Tom, apparently there are several kinds of feeding tubes and methods of implantation. To be honest, we don't really know how John's peg was implanted, but it was removed in the surgeon's office by his nurse-very quick yank- John says it felt like a body punch for about 10 seconds and then-no more discomfort- we were sent home with instructions on how to keep the wound clean until it healed and now he has a great time with our 18 mo old granddaughter counting "bellybuttons" She can't figure out why he has 2 and she only has 1 Amy