Laparoscopic Witzel feeding jejunostomy: a procedure overlooked!

Area of Science:

• Surgical techniques
• Minimally invasive surgery
• Gastrointestinal surgery

Background:

• Feeding jejunostomy (FJ) is crucial for enteral nutrition in upper gastrointestinal disorders.
• Minimally invasive surgery offers benefits like reduced pain and faster recovery.
• Comparing laparoscopic and open FJ techniques is important for optimizing patient care.

Purpose of the Study:

• To describe a total laparoscopic Witzel feeding jejunostomy technique.
• To compare the outcomes of laparoscopic FJ with open FJ.

Main Methods:

• Retrospective analysis of patients undergoing laparoscopic (n=20) or open (n=21) FJ.
• Utilized standard nasogastric tubes and laparoscopic instruments for the laparoscopic approach.
• Analyzed perioperative data and postoperative outcomes.

Main Results:

• Laparoscopic FJ had a longer median operative duration (180 min) compared to open FJ (60 min, p=0.01).
• Postoperative hospital stay was shorter for laparoscopic FJ (3 days) versus open FJ (4 days, p=0.08).
• Fewer complications, including tube issues and infections, were observed in the laparoscopic group during follow-up.

Conclusions:

• Laparoscopic Witzel FJ is a safe and feasible procedure.
• Outcomes are comparable to the open technique, with potential advantages in complication rates.
• Careful patient selection is recommended to manage the learning curve associated with laparoscopic FJ.