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Laparoscopic gastrostomy in infants and children
J T Tomicic1, F I Luks, L Shalon
1Divisions of Pediatric Surgery and Pediatric Gastroenterology and Nutrition, Hasbro Children's Hospital and Brown Medical School, Providence, Rhode Island, USA.
Summary
Laparoscopic gastrostomy offers a safe and effective method for placing feeding tubes in children, including infants. This minimally invasive technique combines benefits of percutaneous endoscopic gastrostomy and open surgery, allowing early feeding initiation.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Gastrostomy is a common pediatric procedure.
- Percutaneous endoscopic gastrostomy (PEG) has risks in small children.
- Laparoscopic gastrostomy aims to combine PEG advantages with open surgery safety.
Purpose of the Study:
- To report experience with laparoscopic gastrostomy in children.
- To evaluate safety and efficacy in various pediatric age groups and conditions.
- To compare outcomes with existing gastrostomy methods.
Main Methods:
- Laparoscopic gastrostomy using umbilical and subcostal ports.
- Stomach fixation with T-anchors and Seldinger technique for tube placement.
- Endoscopic confirmation of intragastric position before tube insertion.
Main Results:
- 54 procedures in 51 children (0-19 years), including neonates and low-weight infants.
- Mean operative time: 33.6 minutes (gastrostomy only); 76.5 minutes (with Nissen fundoplication).
- Early feeding initiation (next day); short hospital stay (3.3 days); low complication rate (2 perforations, 2 dislodgments).
Conclusions:
- Laparoscopic gastrostomy is a quick, simple, and safe technique for pediatric feeding tube placement.
- Direct visualization ensures accuracy, even in the smallest infants.
- Minimizes operative risks and allows rapid resumption of feeding.