Primary Gastrojejunostomy tube placement using laparoscopy with endoscopic assistance: a novel technique
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Read the article on jpedsurg.org ↗Article · Nov 2020 · 1 min read
In brief
In brief
Novel laparoscopic technique for primary gastrojejunostomy tube placement uses endoscopic visualization to minimize hollow viscus injury risk and fluoroscopy exposure. Study of 11 pediatric patients (5 months-17 years) demonstrated zero complications within 30 days and minimal radiation use.
Written by the GCMD Library team from the article.
Abstract
Background
Gastrojejunostomy (GJ) tubes are commonly used to provide postpyloric enteral nutrition in pediatric patients who cannot tolerate gastric feeds. Most techniques depend on a preexisting gastrostomy tube (GT) site to convert to a gastrojejunostomy. Several minimally invasive techniques have been described; however, their risk profile varies widely.
Description of the operative technique
We present a technique for primary laparoscopic GJ tube placement that minimizes the risk of hollow viscus injury and the use of fluoroscopy through endoscopic assistance.
Results
Eleven GJ tubes were placed using this technique in patients ranging from 5 months to 17 years of age and weighing 6.3 to 46.0 kg. Endoscopy through the gastrostomy site allowed direct visualization of wire and tube placement. There were no intraoperative or postoperative complications within 30 days of operation. Use of fluoroscopy was limited with minimal total radiation exposure.
Conclusion
The described technique of laparoscopic primary gastrojejunostomy tube placement with endoscopic assistance was associated with a low complication rate and minimal use of fluoroscopy.
Level of evidence
IV