A New Method for Laparoscopic Stamm Gastrostomy

Area of Science:

• Minimally invasive surgery
• Pediatric surgery
• Gastroenterology

Background:

• Laparoscopic gastrostomy tube (GT) placement often involves separate steps for stomach fixation and purse-string suturing.
• Existing methods may require complex maneuvers or extensions of port incisions.

Purpose of the Study:

• To present a new, simplified laparoscopic technique for gastrostomy tube placement.
• To achieve simultaneous purse-string suturing and stomach fixation to the abdominal wall.
• To adapt the classical Stamm method for laparoscopic application.

Main Methods:

• An intracorporeal purse-string suture is created on the anterior stomach wall.
• Threads are passed extracorporeally, allowing external knotting after GT insertion.
• The stomach is punctured, the GT inserted, and sutures are secured externally without extending port incisions.

Main Results:

• The technique was prospectively applied to 16 pediatric patients (average age 5 years).
• Most patients had neurological developmental delay, a common indication for GT.
• No complications were observed during or after the procedure.

Conclusions:

• The described method is a feasible approach for laparoscopic gastrostomy tube placement.
• It effectively combines purse-string suturing and stomach fixation simultaneously.
• The technique avoids the need to extend port incisions, enhancing minimally invasive benefits.