Full laparoscopic pediatric 2-port gastrostomy using the U-stitch technique
Epublication WebSurg.com, Nov 2014;14(11). URL: http://websurg.com/doi/vd01en4376
This video illustrates a 2-port laparoscopic technique for gastrostomy button placement in a 2-year-old boy with spastic quadriparesis secondary to prolonged cardiorespiratory arrest and hypothermia. The laparoscopic approach for G-tube or G-button placement offers several advantages when compared to the percutaneous technique such as: - an accurate choice of the site for tube placement (both on the gastric and on the abdominal wall); - allows direct placement of a G-button, thus avoiding the need of an intragastric bumper and of a second anesthesia for its removal; - additionally, it allows for blunt or sharp adhesiolysis when needed as for example in cases of previous abdominal surgery or when a ventriculoperitoneal shunt is in place. The procedure is easily accomplished and requires a short learning curve to be reproduced. Additionally, it proves safer than the percutaneous techique particularly in patients with distorted anatomy due to kyphoscoliosis or visceromegaly, which entail the risk of injury to interposed organs.