Which G-tube method has fewer leaks?

We've been working with the literature team from the Chilean Society of Pediatric Surgeons to hunt down articles relevant to pediatric surgery beyond JPS. With their help, we chose to highlight a few articles this month focused on the foregut. So Todd, my the article that I looked at was from Charlotte Kubasnowski and Air Lipsgar and colleagues at Cohen Children's Medical Center looking at techniques for laparoscopic G2 placement. So Todd, how do you do your G-tubes? I do laparoscopic and I pull out the stomach and do a stem. So, according to this study, that would be the modified open technique. So, at Cohen Children's Medical Center, they had two surgeons who did it using the sellinger technique and five that did it modified open like you, and they felt like there's more leaking for their patients had it done by the modified open technique. So they looked retrospectively at the minor complications and essentially found that there's an odds ratio of 5.6 in favor of leak after your modified open technique. So, they said if you're going to do modified open technique, you should try to make the incision in your stomach and your abdominal wall as small as possible to avoid that complication. This was a good study. It's been highly debated about which technique is better and a lot of people have suspected there may be more leaking with the open laparoscopic approach. So I think it's good that they finally studied it. Things that this study may not point out though are some of the disadvantages of both. For example, with the Seldinger technique, there are stitches that are in place, that are gastric cutaneous stitches for four or five days, which can turn the wound red and sometimes even get infected. There also can be complications with the needle and wire going through the stomach. So there's pros and cons to both. I'm not sure that this article is definitive enough to say that we should be doing one technique over the other.