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| Laparoscopic gastrostomy |
| CAI Kai-lin, SHEN Li-ming |
| Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China |
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Abstract Gastrostomy is a main enteral nutrition access for patients who needed long term tube feeding, or who cannot swallowing. Open surgical procedure of gastrostomy had been used for more than 100 years and had been proved safe and effective, but resulting in large trauma. With the wide application of endoscopic and laparoscopic technique, many minimally invasive gastrostomy technique had been used in clinical. Percutaneous endoscopic gastrostomy operation had almost replaced the surgical procedure, because of its simple steps, small trauma, fast recovery, rare complications, and also avoidable of general anesthesia. But for those patients with throat or oesophageal obstruction or patients are unable to tolerate gastrointestinal endoscopy, surgical operation is necessary. Laparoscopic gastrostomy has advantages of minimally invasive surgery than traditional open surgery. Here we evaluated the common used minimally invasive gastrostomy operations and introduced our experience on the laparoscopic gastrostomy. We prefered the janeway procedure when making a gastrostomy. The fistula tube was made by the anterior wall along the large curvature of gastric body. With a bridge of the fistula tube between the anterior gastric wall and the abdominal wall, the gastric body dose not need to be stretched up with tension which could be symptomatic. With normal mucosal lining in the fistula tube, the feeding catheter could be changed easily, or be easily put away in occasion of taking in oral pills or capsules through the fistula tube. A foley’s urine catheter was competent for feeding and also for securing the fistula tube when the balloon was inflated.
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