Modified laparoendoscopic gastrostomy tube (LEGT) placement

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Minimally Invasive Procedures

Background:

• Gastrostomy tube placement is common in pediatric patients requiring long-term enteral nutrition.
• Traditional methods may involve risks of complications and suboptimal cosmetic results.

Purpose of the Study:

• To evaluate the outcomes of a modified Laparoscopic-Assisted Enteral Gastrostomy Tube (LEGT) technique in children.
• To assess the safety, efficacy, and cosmetic results of this modified LEGT procedure.

Main Methods:

• Retrospective review of 26 pediatric patients who underwent the modified LEGT technique.
• Utilized combined gastroscope and laparoscope visualization for precise placement.
• Employed a subcutaneous 'T'-Fastener fixation technique for gastric pexy.

Main Results:

• Median follow-up of 9 months with no major complications reported.
• Five patients experienced minor gastrostomy site infections, successfully treated with antibiotics.
• The technique ensured accurate G-button placement within the gastric lumen.

Conclusions:

• The modified LEGT technique is a safe and effective method for primary gastrostomy button/tube placement in children.
• Laparoscopic visualization minimizes risks like gastro-enteric fistula formation.
• Subcutaneous fixation offers optimal gastric-abdominal wall adhesion, avoids suture removal, and provides superior cosmetic outcomes.