Related Experiment Video
Updated: Jul 7, 2026
Laparoscopic Repair of Para-Esophageal Hernia Using Absorbable Biosynthetic Mesh
Published on: September 11, 2021
Laparoscopically supervised PEG at time of Nissen fundoplication: a safe option
Lena Perger1, Libby Watch, Robert Weinsheimer
1Department of Surgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA.
Insights
Laparoscopically supervised percutaneous endoscopic gastrostomy (PEG) tube placement during laparoscopic Nissen fundoplication (LNF) is safe and effective for children with GERD. This combined approach minimizes complications and allows for fundoplication evaluation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Procedures
Background:
- Gastroesophageal reflux disease (GERD) in children often necessitates feeding gastrostomy insertion during antireflux surgery.
- Options for gastrostomy include laparoscopic gastrostomy, percutaneous endoscopic gastrostomy (PEG), and open gastrostomy.
Purpose of the Study:
- To describe the experience with laparoscopically supervised PEG tube placement during antireflux procedures.
- To evaluate the safety and efficacy of this combined approach.
Main Methods:
- Retrospective chart review of pediatric patients undergoing PEG tube placement concurrent with laparoscopic Nissen fundoplication (LNF).
- Recording and analysis of perioperative complications.
Main Results:
- Forty-four patients underwent attempted PEG placement during LNF.
- Laparoscopic supervision was critical in preventing complications in 3 (7%) cases.
- No major PEG-related complications occurred; minor issues were transient and managed outpatient.
Conclusions:
- Percutaneous endoscopic gastrostomy (PEG) placement during laparoscopic Nissen fundoplication (LNF) is a safe and effective procedure.
- A combined laparoscopic and endoscopic approach reduces complications and allows for comprehensive fundoplication assessment.
Background/Purpose:
Children with gastroesophageal reflux disease (GERD) often have associated feeding difficulties that warrant the insertion of a feeding gastrostomy at the time of the antireflux procedure. Options for gastrostomy tube insertion at the time of laparoscopic Nissen fundoplication (LNF) include laparoscopic gastrostomy, percutaneous endoscopic gastrostomy (PEG), and classic open gastrostomy. The complication rate of PEG may be decreased if it is placed under laparoscopic supervision. The purpose of this paper is to describe our experience with laparoscopically supervised PEG tube placement at the time of antireflux procedure.
Methods:
A retrospective chart review was conducted on all children undergoing a PEG tube placement at the time of the LNF. Perioperative complications were recorded.
Results:
Forty-four patients had attempted PEG tube placement at the time of the LNF. In 3 (7%) cases, laparoscopic supervision was crucial in the prevention of a complication. No major PEG-related complications were recorded. In 43% of patients, minor PEG tube problems arose in the postoperative period: all were transient and/or easily correctable. Management of all these problems was in an outpatient setting. Follow-up ranged from 11 to 41 months.
Conclusions:
PEG tube placement at the time of a LNF is safe and effective. A combined laparoscopic and endoscopic approach minimizes complications. This method also allows for an intra- and extraluminal evaluation of the fundoplication at its completion.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease