My first and third PEGs don't have much of a flange on them and it's not stitched down -- I can slide it up on the tube for easy access to the stoma for cleaning the gunk that accumulates there -- With my second PEG, the surgeon stitched it down and the nurse practitioner cut the stitches away, saying that they usually wind up getting infected.
There seem to be a number of PEGs on the market -- My current one does not have a deflatable balloon, just a small one the Doc yanks out -- My second PEG was longer and had nothing on the end except an exit hole that was too small...
This photo is a lot like my current PEG, although it has a larger flange (which is pulled up for cleaning around stoma) and doesn't have a shut-off valve:
http://la.indymedia.org/uploads/2004/07/peg_tube.jpgHere's a partial photo of PEG similar to my poor second one -- Note end of PEG only has small hole, so as junk clogs it, the junk builds up and clogs the side ports one by one -- In my case, this type PEG was small enough that it actually fits inside the other PEG!
http://www.cookmedical.com/di/content/lg_thumbnail/di_wogs.jpg 
