The PEG procedure involves the use of an endoscope, a flexible tube with a camera, which is inserted through the mouth into the stomach. The stomach is inflated with air, and the endoscope guides the surgeon to the optimal site for tube placement. A small incision is made in the abdomen, and the tube is inserted through this opening directly into the stomach. The procedure is typically performed under general anesthesia in children to ensure comfort and immobility.