Totally laparoscopic feeding jejunostomy

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Surgical Techniques

Background:

• Nutritional support via feeding jejunostomy is crucial for select patients.
• Existing minimal-access jejunal tube placement often requires specialized equipment.
• A technique for totally laparoscopic jejunostomy tube (LJT) placement using standard operating theater equipment is described.

Purpose of the Study:

• To describe a technique for totally laparoscopic jejunostomy tube (LJT) placement.
• To evaluate the safety and efficacy of this LJT technique using commonly available equipment.

Main Methods:

• Thirty-five patients underwent LJT placement over 12 months for various indications.
• The technique involved three trocar incisions and one small incision for tube insertion.
• A 16-Fr T-tube was placed transabdominally into the jejunum, with secure closure and fixation.

Main Results:

• All 35 patients tolerated the procedure well, with no operative deaths.
• Five LJTs were electively removed postoperatively.
• One patient required reoperation for intractable pain, though the LJT remained intact.

Conclusions:

• The described technique allows for safe placement of laparoscopic jejunostomy tubes.
• No significant morbidity or mortality was observed in this series.
• This approach is suitable for patients requiring jejunal access for feeding.