Single-access gastrostomy (SAG) dispenses endoscopy or laparoscopy: a simple method under local anesthesia

Area of Science:

• Surgical Innovation
• Gastroenterology
• Medical Devices

Background:

• Transendoscopic gastrostomy is standard but limited by equipment and specialist availability in many regions.
• Community hospitals in Brazil face challenges accessing endoscopy for gastrostomy procedures.

Purpose of the Study:

• To describe the Surgical Single-Access Gastrostomy (SAG) technique.
• To evaluate the feasibility and outcomes of SAG as an alternative to endoscopic gastrostomy.

Main Methods:

• SAG was performed on 19 patients under local anesthesia with a 1-cm incision.
• Gastric wall localization was done under direct vision, with purse string sutures for valve creation.

Main Results:

• SAG was successfully performed in all patients.
• Minor complications were observed in 3 patients.
• Mean operative time was 44.2 minutes; feeding was initiated at a mean of 27.8 hours.

Conclusions:

• SAG is a feasible, reproducible, and effective feeding gastrostomy method.
• It can be performed without endoscopy or laparoscopy.
• SAG is a valuable alternative in developing countries lacking endoscopic resources.