Primary laparoscopic button gastrostomy in infants and children

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2007 (EN)
Primary laparoscopic button gastrostomy in infants and children (EN)

T. Tsang, M. Ververidis,

SUMMARY Aim: Laparoscopic gastrostomy in children has recently become an established minimally invasive alternative to endoscopic insertion. The authors describe a method of primary laparoscopic button gastrostomy, in order to emphasize certain technical modifications that make it safer, simpler and more effective than previously reported techniques. Materials and methods: The medical records of 17 children who underwent primary laparoscopic button gastrostomy are reviewed. The Seldinger technique was used for the button insertion and the stomach was fixed to the epigastrium with two U-sutures. The modifications of our technique as compared to others are: 1) the tract is minimally dilated to permit a snug fit of the button, 2) a size 12 Fr button is used in all cases and 3) a Tuohy needle stabilizes the device to negotiate the tight gastric tract. Results: The mean age at operation was 25 months (range 3 months to 13 years). The main indication for gastrostomy was inability to swallow secondary to neurological impairment (82%). Four patients had concommitant laparoscopic antireflux procedure. The mean hospital stay for gastrostomy alone was three days. The mean follow-up was six months. There was no perioperative mortality or major life-threatening complications associated with the gastrostomy. No complication was serious enough to require removal of the button or hospitalization. There were no leaks. The nutritional status improved remarkably in the majority of patients. Conclusions: A primary button gastrostomy can be performed safely under laparoscopic guidance via a single umbilical port with minimal morbidity. The use of a Tuohy needle for the stabilization of the button facilitates the introduction of even the smallest size of gastrostomy device. Key words: Gastrostomy, Button, Laparoscopy, Children (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 17, No 1 (2004) (EN)

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