I did not want Emily to get the PEG first; I felt strongly about her having one procedure and the button from the start. However, not all drs will do it this way so you need to ask about it ahead of time.
In our case, the GI she had been seeing starts with the long PEG (placed endoscopically and then a small incision is made and it's pulled out through the stomach wall.) Then about 6wks later it's replaced with a MicKey button. Since I did NOT want Emily to have to walk around with a long tube for half the summer when I knew she could go straight to the button from the start, I made an appt with someone in the ped surgery clinic, where they do the procedure to place them as buttons right from the start.
There are buttons that can be placed endoscopically as well as laparoscopically (small incision through the belly button to guide the procedure and the small incision through the stomach wall to place the tube.) As it turned out, Emily had both- her first button was placed endoscopically and when she ran into trouble with that one, it was replaced with a MicKey laparoscopically. Given the choice to do it again, I'd have gone with a laparoscopic procedure to place a MicKey right off.
I felt that getting used to tube feedings was going to be enough for Emily to handle. I did not want to subject her to a big long thing hanging out of her body (did not want her feeling more self-conscious than she had to, have it be impossible to hide, etc) when it was not medically necessary to do so.
eta> out of the various buttons out there, I'd want the MicKey or the one that's MicKey equivalent (can't remember the name of it) that is held in place with a balloon on the inside. Why? Because if it breaks, you will always have a replacement kit on hand at home and you can replace it yourself, no ER or dr required... the others can only be replaced by medical professionals. This is why I would, given the chance to do it again, opt to have gone straight to a MicKey for Emily.