Pediatric Laparoscopic Gastrostomy Tube Placement: A Case Series in a Tertiary Care Center

Introduction: Laparoscopic gastrostomy (LG) tube placement is a minimally invasive technique increasingly used in pediatric patients requiring long-term enteral nutrition. While various approaches exist, technique standardization remains limited. This study aims to describe our institution's standardized LG technique and evaluate its surgical outcomes. Methods: We conducted a retrospective review of pediatric patients who underwent LG tube placement at a tertiary care center between August 2017 and September 2022. All procedures were performed using a uniform laparoscopic technique involving a purse-string suture and multiple fascial anchoring sutures. Clinical and perioperative data, including patient demographics, operative time, and time to first feed, were analyzed. Statistical analyses included Spearman correlation and Mann-Whitney U tests. Results: Twenty-five patients (56% female) with a median age of 48 months (range: 7-204 months) underwent LG placement. Neurological impairment was present in 76% of cases. The median operative time was 71 minutes, and the median time to first feed was within the same postoperative day. Notably, no patients experienced intraoperative or postoperative complications. There were no conversions to open surgery, no aborted procedures, and no requirement for postoperative anti-reflux surgery. Mann-Whitney U analysis showed no statistically significant differences in operative time or time to first feed based on neurological status (P = .086 and P = .568, respectively). Conclusion: Our standardized LG technique is safe, reproducible, and effective, with no complications and favorable outcomes across pediatric subgroups. This approach may offer a reliable alternative to percutaneous endoscopic gastrostomy or open gastrostomy placement in children.