Complications After Laparoscopic G-tube Placement

Infographic · Oct 2019 · 1 min read

In brief

Prospective study of 92 laparoscopic gastrostomy placements found modified open technique resulted in significantly higher leak rates (26.8%) compared to Seldinger technique (5.6%), though other complications were similar. Surgeons using modified open approach should carefully control gastrotomy size to minimize leakage risk.

Modified open technique (MOT) for laparoscopic G-tube placement resulted in significantly higher leak rates (26.8%) vs Seldinger technique (5.6%).
Overall complication rates were similar between techniques: 37% granulation tissue, 19.6% dislodgment, 6.5% infection regardless of approach.
Surgeons using MOT should pay careful attention to gastrotomy size during surgery to minimize postoperative leaking complications.
Both techniques are common for laparoscopic GT placement, but technique selection may impact specific complication profiles over 6-month follow-up.

Written by the GCMD Library team from the infographic.

The slide uses a blue gradient background with three main sections. The left panel lists four complication types with icons (infection, granulation, dislodgment, complication). The center features a detailed anatomical illustration of the modified open technique with a large upward arrow and odds ratio. The right side shows the Seldinger technique illustration with a warning triangle and percentage. Medical journal citation appears at bottom.

Laparoscopic gastrostomy tube (GT) placement is a common procedure and frequent cause of morbidity. Some surgeons perform a Seldinger technique (ST), while others perform a modified open technique (MOT). We hypothesized that the modified open technique would result in more complications.

METHODS:
A prospective study of primary GT placed 12/2016-06/2018, ensuring at least 6 months follow up. We assessed any episode of granulation tissue, troublesome leaking, tube dislodgment, and infection requiring antibiotic or drainage.

RESULTS:
92 GT were placed, with 56 were placed as modified open (60.9%). 34 children (37.0%) developed granulation tissue, 18 children (19.6%) experienced tube dislodgment, and 6 children (6.5%) developed a site infection, with no difference depending on technique (P = 0.56, 0.29, and 0.76, respectively). Following ST, 2 children developed leakage (5.6%), whereas 15 children (26.8%) had leakage following the MOT (P = 0.01).

CONCLUSION:
MOT resulted in significantly more leaks. Other complications were similar between groups. Surgeons choosing MOT should be mindful of the size of gastrotomy at time of surgery, as this may result in increased complications.

Visual abstract created by Alejandra M Casar Berazaluce, MD - Pediatric Surgery Research Fellow at Cincinnati Children's Hospital Medical Center.

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