Gastrostomy: A percutaneous laparoscopic technique.

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• No standard technique exists for concomitant gastrostomy during major abdominal surgery.
• Existing methods may have limitations or require specialized equipment.

Purpose of the Study:

• To present a novel percutaneous laparoscopic gastrostomy technique.
• To evaluate its safety, efficacy, and feasibility in conjunction with Nissen fundoplication.

Main Methods:

• Combines laparoscopic instruments with percutaneous endoscopic gastrostomy kit.
• Gastrostomy performed in three stages using a 'pull' technique with a guide-wire.
• Utilizes laparoscopic visualization for site selection and puncture, eliminating the need for a gastroscope.

Main Results:

• The technique is simple, brief (approx. 21 minutes), and well-tolerated.
• No intraoperative or postoperative complications were reported.
• Stitches to affix gastric and abdominal walls were unnecessary due to proper stoma alignment.

Conclusions:

• This percutaneous laparoscopic gastrostomy is a safe, reproducible, and cost-effective alternative.
• It offers potential advantages over traditional 'push' methods for gastrostomy tube placement.
• The technique requires no exceptional surgical skills and simplifies concomitant gastrostomy procedures.