The endoscopic U-stitch technique for primary button placement: an institution's experience

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Minimally Invasive Procedures

Background:

• Gastrostomy tube placement is crucial for nutritional support in pediatric patients.
• Various techniques exist, but the endoscopic U-stitch offers primary button placement without laparoscopy.
• Evaluating the efficacy and safety of this specific technique is essential.

Purpose of the Study:

• To assess the success rate of primary gastrostomy button placement using the endoscopic U-stitch technique.
• To determine the incidence of complications associated with the endoscopic U-stitch gastrostomy.
• To compare the outcomes of the endoscopic U-stitch technique with other established methods.

Main Methods:

• A retrospective review of all gastrostomy procedures performed between February 2001 and September 2008.
• Data extraction from both paper and electronic medical records for endoscopic U-stitch procedures.
• Analysis of completion rates, operative times, and postoperative complications.

Main Results:

• The endoscopic U-stitch technique achieved primary button placement in 115 out of 121 patients (95%).
• Six cases (5%) required conversion to an open procedure.
• A low complication rate of 7% was observed, with no procedure-related deaths. Complications included hematemesis, cellulitis, colonic perforation, granulation tissue, and fistula closure. Average operative time was 18 minutes.

Conclusions:

• The endoscopic U-stitch technique is a safe and effective method for primary gastrostomy button placement in pediatric patients.
• Its complication profile is favorable when compared to laparoscopic and open gastrostomy techniques.
• This minimally invasive approach offers a viable alternative for gastrostomy tube insertion.