Minimally Invasive Technique for Gastrostomy Tube Insertion: A Novel Laparoscopic Approach Publisher Pubmed



Sayadi Shahraki M¹ ; Berjis N² ; Bighamian A³ ; Mahmoudieh M¹ ; Shahabi Shahmiri S¹ ; Sheikhbahaei E⁴
Source: Asian Journal of Endoscopic Surgery Published:2020

Abstract

Introduction: Percutaneous endoscopic gastrostomy (PEG) is the most common way of inserting a gastrostomy tube. If PEG is not appropriate for a patient, then the laparoscopic or open technique should be used. Here, we introduce a new laparoscopic technique for inserting a gastrostomy tube. Material and Surgical Technique: We used this new laparoscopic approach in 21 patients for whom PEG was not suitable. After marking on the abdominal skin and inserting the trocars, two 2-0 silk sutures were passed. Two stitches were placed 2 cm apart in the stomach with one hand. Each suture was pulled out with the fascia closure, the stomach was pulled out with a Babcock, and a purse-string suture using a round 2-0 silk suture was placed outside the stomach, creating a mushroom-retained gastrostomy. Conclusion: This new laparoscopic technique is minimally invasive. It provides full control through only two trocars and required smaller incisions than common laparoscopic approaches. This method can be used to insert a gastrostomy tube in indicated patients when PEG placement is not suitable. © 2020 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and John Wiley & Sons Australia, Ltd.