[Minimally invasive surgical gastrostomy]

Description of a simple surgical gastrostomy technique fulfilling minimally-invasive surgery criteria and presentation of the results obtained with the same, compared with those of other surgical gastrostomies and percutaneous techniques.

Patients from various wards in the Miguel Servet Teaching Hospital in Zaragoza, whether admitted or out-patients, all seen by the Hospital Nutrition Unit and where food-restricting gastrostomy is indicated.

Prospective study including the first fifteen successive patients in whom a minimally-invasive surgical gastrostomy technique has been applied between January 1st, 2001, and June 30th, 2002, and in whom it was not possible, for a variety of reasons, to perform any kind of percutaneous gastrostomy. The technique was applied in the operating theatre, under local anaesthetic, using a Flexiflo 20 F gastrostomy probe and with antibiotic prophylaxis (Amoxicillin-Clavulanic Acid: 2 g i.v. pre-operatively). Patients were assessed as out-patients by the Nutrition and Surgery Unit after 10, 30 and 60 days.

The procedure could be successfully completed in all cases. The mean time of the procedures duration was 45 minutes. In 5 patients, the procedure was performed without admission to hospital. The functionality of the device was 100% and it was effective from 10 days after the operation. Morbidity: 6.6%. Mortality after 60 days: 0%.

This is a procedure which is safe, simple, economic and capable of being performed as an out-patient procedure, thus complying with the criteria for minimally-invasive techniques. It is complementary or an alternative to percutaneous techniques in selected cases or where these are impossible, have failed or are contraindicated.