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Journal of Long-Term Effects of Medical Implants

ISSN for PRINT: 1050-6934

Institutional price:	$1021.00
Issues per year:	6

Best Paper Award Selection - Editorial Board Site

2004, Volume14

82 pages

DOI: 10.1615/JLongTermEffMedImplants.v14.i1

Issue price - $175.00

Laparoscopic Gastrostomy and Jejunostomy

Alexander P. Nagle, MD
Noгthwestern University Feinberg School of Medicine, Department of Surgery, Chicago, Illinois, USA

Kenric M. Murayama, MD, FACS
Director, Minimally Invasive Surgery Program. Northwestern Memorial Hospital Associate Professor of Surgery Northwestern University Medical School, Chicago IL 60611; University of Hawaii, John A.Burns School of Medicine,Dept of Surgery,Honolulu,Hawaii,USA

ABSTRACT

Background: The percutaneous/endoscopic gastrostomy (PEG) has rapidly replaced the surgical gastrostomy as the preferred route for enteral access. In patients who are not candidates for a PEG, we prefer a laparoscopic gastrostomy to an open gastrostomy. Similarly, in patients who require a surgical jejunostomy, we prefer a laparoscopic approach. Minimally invasive techniques have several advantages over the standard open surgery. The purpose of this article is to review the indications, various techniques, and outcomes of laparoscopic gastrostomy and jejunostomy tubes. Data Sources: Medline search from 1959-2002. Conclnsions: The PEG remains the procedure of choice for placement of a gastrostomy. Laparoscopic gastrostomy is an excellent choice for patients who are not candidates for a PEG. Similarly, laparoscopic jejunostomy is an excellent choice for patients who require enteral access, but have contraindications to a gastrostomy tube. Placement of laparoscopic gastrostomy andjejunostomy tubes can be safely performed, and the success and complication rates of these procedures compare favorably with those of the corresponding open surgical procedure. Laparotomy is rarely needed to place enteral feeding tubes. Cost analysis has shown that laparoscopic procedures are similar to open procedures.