The Passport(TM), a new, low-profile gastrostomy device, was evaluated for primary performance of patient or caregiver ease of use, incidence of inadvertent removal by patient, and incidence of clogging. (Wilson-Cook Medical, Inc. Winston-Salem, NC) Secondary performance of the device was evaluated for length of physician placement time and ease of physician placement. Longevity of the device was compared to a standard replacement balloon gastrostomy tube. Means and standard deviations were computed for all performance tests. Over the course of the 18 month study, 20Passport(TM) devices were non-randomly and non-consecutively placed in 16 patients ranging in age from 11 to 88 years (2 children, 14 adults, 9 men, and 5 women). All Passport(TM) devices were placed without the use of endoscopy with one failed attempt. Mean ease of use score was 0.60+/-0.68 with a range of 0 to 2 on a five point scale with zero being easy. There were no reported incidences of inadvertent removal or clogging of the device. Mean physician placement time of the device was 7.5+/-3.1minutes and mean reported ease of placement was 2.05+/-1.79 as measured on a scale of one to ten with one being easy. Mean longevity of the device using all incidences was 141+/-75 days. Kaplan-Meirer survival curves were used to assess differences in longevity between the Passport(TM) and the CompatTM replacement balloon gastrostomy tube (Sandoz Nutrition Corp., Minneapolis, MN). No significant differences in longevity were noted (p=0.09). Further study of the Passport(TM) using a larger study sample is needed to adequately assess primary and secondary performance of the device. In addition, a study comparing the Passport(TM) to the Bard Button(TM) or other similar low-profile gastrostomy device for complications and longevity would be beneficial.