Single-Center Experience of Laparoscopically Assisted Percutaneous Endoscopic Gastrostomy Placement

Charlesworth, Paul; Hallows, M.R; Avoirt, A.Van der

doi:10.1089/lap.2009.0057

Cited by 9 publications

(8 citation statements)

References 18 publications

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“…[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.…”

Section: Discussionmentioning

confidence: 99%

“…12 Many variations on this technique have been described since then. [13][14][15][16][17][18][19][20][21][22][23][24] These include: the use of gastropexy versus no gastropexy, gastrostomy using a PEG tube versus a balloon-dependent device and "pull" versus "push" techniques to insert the gastrostomy tube. The LAPEG approach described here is similar to the Georgeson technique, which involves large, transabdominal U-stitches to affix the stomach to the abdominal wall.…”

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%

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

Livingston

Pepe

Jones

et al. 2015

cjs

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“…23,[27][28][29] A colocação de uma PEG assistida por laparoscopia é uma alternativa que se tem revelado eficaz na prevenção de complicações graves, nomeadamente minimizando/anulando o risco de lesão de órgãos adjacentes e permitindo uma melhor escolha da localização da gastrostomia. 24,25,[30][31][32][33][34] Cerca de ¾ dos orifícios de gastrostomia encerram espontaneamente após a remoção da sonda/botão. A obliteração é, por vezes, tão rápida que no caso de exteriorização acidental se deve recomendar a reintrodução imediata ou, caso tal não seja exequível, a introdução de uma sonda de Foley.…”

Section: Gastrostomiasunclassified

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Estevão‐Costa

2014

Acta Med Port

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RESUMOO aporte nutricional adequado é crucial na abordagem terapêutica de múltiplos estados mórbidos, o que justifica o recurso frequente e crescente a vias de acesso específicas para nutrição entérica e parentérica. No presente artigo é realizada uma revisão da literatura relevante acerca de indicações, modalidades, eficácia e complicações das vias de acesso entérico na criança. Os fatores a considerar na decisão entre acesso gástrico e acesso pós-pilórico, e entre colocação de sonda nasogástrica e gastrostomia são criteriosamente discutidos. Perante indicação para acesso gástrico de longa duração, a gastrostomia endoscópica percutânea é a técnica mais utilizada dada a sua eficácia e segurança, embora a morbilidade associada não seja desprezível; a colocação de gastrostomia laparoscópica emerge como uma alternativa potencialmente vantajosa. Palavras-chave: Criança; Nutrição Entérica; Intubação Gastrointestinal; Gastrostomia; Jejunostomia; Laparoscopia. ABSTRACTAppropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible; laparoscopic gastrostomy emerges as a potentially advantageous alternative.

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“…The stomach is held up to the anterior abdominal wall and a needle is passed into its lumen under endoscopic and laparoscopic vision (Figure 6). The wire or string is passed through the needle to the stomach, grasped and withdrawn through the mouth for attachment to the PEG tube and pulled back down into position as per Gauderer-Ponsky (Charlesworth et al 2010). Whilst the substantial benefits of this procedure are that neighbouring viscera can be clearly seen and thus avoided and the position of the site for PEG can be carefully chosen, the major potential pitfall is insufflation of too much air into the stomach prior to having laparoscopic control of the organ.…”

Section: Fig 6 Clear Views Obtained During Laparoscopic Assisted Frmentioning

confidence: 99%

Advances in Gastrostomy Placement and Care in Children

Adams¹,

Mahomed²

2011

Gastrostomy

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Single-Center Experience of Laparoscopically Assisted Percutaneous Endoscopic Gastrostomy Placement

Abstract: Laparoscopically assisted PEG placement is a safe alternative to conventional methods. This technique provides direct visualization of the gastrostomy placement, avoiding other viscera, and allowing for the ideal siting of the GT.

Cited by 9 publications

References 18 publications

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

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

Vias para Nutrição Artificial na Criança (I): Acessos Entéricos

Advances in Gastrostomy Placement and Care in Children

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