Laparoscopic-assisted percutaneous endoscopic gastrostomy

Stringel, Gustavo; Geller, Evan; Lowenheim, Mark

doi:10.1016/0022-3468(95)90024-1

Cited by 33 publications

(13 citation statements)

References 5 publications

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“…G astrostomy tube insertion in children can be performed via open surgery, percutaneous endoscopic gastrostomy (PEG), laparoscopic gastrostomy, or percutaneous radiologic gastrostomy. [1][2][3][4][5] Percutaneous endoscopic gastrostomy insertion remains popular in many centres because it can be performed quickly and does not require incisions. 1,2 This approach provides visualization of the stomach but not the peritoneal cavity, which can lead to injuries to the colon, small bowel, liver and spleen.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] The combined approach is known as laparoscopic-assisted PEG insertion (LAPEG). 5,12 This technique appears to be associated with reduced complications, but does not necessarily negate the need for postoperative tube exchanges for a skin-level device. 5,12 As a result, there have been recent efforts to perform LAPEG in a single procedure.…”

Section: Discussionmentioning

confidence: 99%

“…5,12 This technique appears to be associated with reduced complications, but does not necessarily negate the need for postoperative tube exchanges for a skin-level device. 5,12 As a result, there have been recent efforts to perform LAPEG in a single procedure. 15 This approach requires a single anesthetic and allows for placement of a skin-level device that can be used immediately.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic-assisted percutaneous endoscopic gastrostomy: insertion of a skin-level device using a tear-away sheath

Livingston

Pepe

Jones

et al. 2015

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Background: This study describes our experience with the placement of a skin-level gastrostomy device (MIC-KEY) in a single procedure. Methods:We identified infants, children and young adults who underwent laparoscopicassisted percutaneous endoscopic gastrostomy (LAPEG) tube insertion between October 2009 and June 2013. The steps of this procedure include upper endoscopy, single-port laparoscopy, gastropexy via percutaneous T-fasteners and placement of a skin-level gastrostomy device (MIC-KEY) using a "push" technique with a tearaway sheath. Results:We included 92 patients in our study. Mean age was 3.7 years (range 3 wk-5 yr), and mean weight was 11.2 (range 2.8-54) kg. Median procedural time was 20 (range 12-76) minutes. Total median duration for the most recent 25 procedures was lower than that of the first 25 (62 v. 79 min, p = 0.004). There were no intraoperative complications or conversions to open surgery. Postoperative complications were observed in 6 (6.5%) patients. Three retained T-fasteners were assessed endoscopically (n = 1) or removed via local excision (n = 2). Two patients experienced early dislodged feeding tubes that were replaced via interventional radiology (n = 1) or repeat LAPEG (n = 1). There was also 1 intra-abdominal fluid collection that was drained percutaneously but ultimately required a laparotomy and washout. There were no major complications in the most recent 50 procedures. Conclusion:Our results suggest that LAPEG is a safe, minimally invasive procedure for infants, children and young adults. This approach allows for immediate use of a skin-level gastrostomy device without the need for postoperative tube exchanges.Contexte : Cette étude décrit notre expérience avec la pose d'un dispositif de gastrostomie au niveau de la peau (MIC-KEY) en une seule intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopic-assisted percutaneous endoscopic gastrostomy: insertion of a skin-level device using a tear-away sheath

Livingston

Pepe

Jones

et al. 2015

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“…10,11,13 The third possible alternative, which is the technique adopted by us, is the addition of a laparoscope (with or without working ports) to conventional PEG placement. This was first described by two separate researchers in 1995 14,15 and is the method of choice for gastrostomy placement during laparoscopic fundoplication. 6 The techniques described in the literature mainly use a three-port technique, 14,16,17 with some researchers reserving this technique for complex or difficult patients in which conventional PEG placement carries an increased risk of complications.…”

Section: Discussionmentioning

confidence: 98%

Single-Center Experience of Laparoscopically Assisted Percutaneous Endoscopic Gastrostomy Placement

Charlesworth

Hallows

Avoirt

2010

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…This enables avoidance of injury to neighbouring viscera and the other reported benefit is that PEG placement can be achieved specifically into the lesser curvature of the stomach which has been seen by some to decrease the risk of developing gastro-oesophageal reflux subsequent to PEG placement, this is of particular relevance in neuro-developmentally delayed children (B. G. Stringel et al 1995).…”

Section: Laparoscopic-assisted Peg +/-Laparoscopic Fundoplicationmentioning

confidence: 99%