Initial experience with the changeable skin-level port-valve: a new concept for long-term gastrointestinal access

Experience with a new multipurpose system for long-term enteral access is reported. At the core of the concept is a changeable, skin-level "port" (SL port) that incorporates a valve accessible through a locking, right-angle feeding adapter. The new system allows conversion of a previously-inserted, long gastrointestinal catheter into a "button-type" skin-level device without removal of the long catheter, thereby eliminating pain, tract damage, and the risk of separation of the viscus from the abdominal wall.

Sixty-four SL ports were used in 44 children (ages 2 weeks to 19 years). Conversion from long tube to skin-level device was performed 33 times, either immediately after the catheter placement or some time thereafter (percutaneous endoscopic gastrostomy, 18; Stamm gastrostomy, 6; laparoscopic gastrostomy, 7; jejunostomy, 2). Insertion as an assembled button-type device in an established tract was performed seven times. Twenty SL ports showing signs of leakage were replaced with an identical device without catheter removal. SL ports remained in place from 1 week to 15 months.