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Laparoendoscopic approaches to enteral access.
1Gallbladder and Laparoscopic Surgery Center of Miami, Baptist Hospital, Miami, FL 33176, USA. DEdelnamMD@aol.com
Seminars in Laparoscopic Surgery
|October 6, 2001
Summary
Long-term enteral feeding access to the stomach can be achieved through various safe and effective methods. Laparoscopic techniques offer advantages for patients unsuitable for percutaneous endoscopic gastrostomy (PEG).
Area of Science:
- Surgical Procedures
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Various methods exist for long-term gastric access, including laparotomy, gastroscopy, laparoscopy, and fluoroscopy.
- Percutaneous endoscopic gastrostomy (PEG) has become a preferred method for enteral nutrition.
- Laparoscopic gastrostomy offers an alternative for patients who are not candidates for PEG placement.
Purpose of the Study:
- To review methods for gaining gastric or intestinal access for surgeons.
- To highlight the benefits of laparoscopic techniques in specific patient populations.
Main Methods:
- Review of existing literature on surgical and endoscopic methods for gastric access.
- Comparison of percutaneous endoscopic gastrostomy (PEG) with laparoscopic gastrostomy.
- Identification of patient criteria making PEG unsuitable and laparoscopic approaches advantageous.
Main Results:
- Laparoscopic or laparoendoscopic placement allows direct visualization for accurate tube positioning.
- Laparoscopy is beneficial for patients with contraindications to PEG, such as head and neck cancer or esophageal obstruction.
- Laparoscopic surgery reduces the risk of injury to surrounding structures and allows for identification of concomitant diseases.
Conclusions:
- Multiple safe and effective methods are available for long-term enteral access.
- Laparoscopic gastrostomy provides a valuable alternative for patients unable to undergo PEG placement.
- Surgical visualization during laparoscopy enhances safety and allows for comprehensive patient assessment.