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Updated: Nov 24, 2025

Colonial Wig Pancreaticojejunostomy
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Laparoscopic Witzel jejunostomy.

Marco Lotti1, Michela Giulii Capponi2, Denise Ferrari2

  • 1Advanced Surgical Oncology Unit, Department of General Surgery 1, Papa Giovanni XXIII Hospital, Bergamo, Italy.

Journal of Minimal Access Surgery
|December 23, 2020
PubMed
Summary
This summary is machine-generated.

This study introduces a novel laparoscopic jejunostomy technique for malnourished cancer patients needing enteral nutrition. The method simplifies the Witzel approach using a single barbed suture for secure placement.

Keywords:
Enteral nutritiongastric cancerjejunostomylaparoscopic jejunostomyoesophagogastric junction cancer

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Malnourished patients with gastric and oesophagogastric junction cancer require enteral nutritional support via feeding jejunostomy.
  • Laparoscopic jejunostomy (LJ) is a viable option during staging laparoscopy.
  • The Witzel approach for LJ is underutilized due to perceived technical difficulties.

Purpose of the Study:

  • To describe a novel, simplified technique for laparoscopic jejunostomy using the Witzel approach.
  • To address the perceived difficulties associated with securing the jejunostomy tube in the Witzel technique.

Main Methods:

  • A novel laparoscopic jejunostomy technique is described.
  • The technique utilizes a single barbed suture for bowel fixation and tunnelling.
  • It follows the principles of the Witzel approach for jejunostomy catheter placement.

Main Results:

  • The described technique facilitates secure placement of the jejunostomy tube.
  • It simplifies the Witzel approach for laparoscopic jejunostomy.
  • A single barbed suture effectively secures the bowel and tunnels the catheter.

Conclusions:

  • This novel technique offers a simplified and secure method for laparoscopic jejunostomy via the Witzel approach.
  • It may encourage wider adoption of the Witzel technique for jejunostomy placement in selected patients.
  • Improved enteral nutrition support can be achieved in malnourished cancer patients.