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A simplified laparoscopic technique for enteral access in cancer patients
Sükrü Aydin Düzgün1, Mikdat Bozer, Ali Coskun
1Harran University, School of Medicine, Department of Surgery, Sanliurfa, Turkey. saduzgun@ixir.com
Background/Aims:
A feeding jejunostomy may be required for cancer patients who have obstructed upper gastrointestinal tract. Numerous minimally invasive techniques have been described for laparoscopic enteral access. We presented here a simple technique for laparoscopic jejunostomy that requires only two ports and no specialized tools.
Methodology:
Seven patients with laryngeal and foregut tumors underwent laparoscopic feeding jejunostomy. Briefly, umbilical port houses the camera and a second port placed at the proposed jejunostomy site are used to identify the appropriate segment of jejunum and exteriorize through the port opening. After jejunostomy a catheter is placed in the usual fashion, intestine segment is returned to the abdomen, then the jejunostomy site is secured to fascia edges by several non-absorbable sutures. Operative time and postoperative complications were evaluated.
Results:
All patients tolerated the procedure well. Average operative time was 35 min. The only complication seen after the procedure was minor skin extrusion in two patients.
Conclusions:
This technique appears as a minimally invasive, safe, quick and easily applicable method for enteral access in selected patients.