Two port video-assisted gastrostomy and jejunostomy: technical simplification and clinical results

Abstract

BackgroundPatients presenting upper gastrointestinal obstruction, difficulty or inability in swallowing, may need nutritional support which can be obtained through gastrostomy and jejunostomy.AimTo describe the methods of gastrostomy and jejunostomy video-assisted, and to compare surgical approaches for video-assisted laparoscopy and laparotomy in patients with advanced cancer of the esophagus and stomach, to establish enteral nutritional access.MethodsWere used the video-assisted laparoscopic techniques for jejunostomy and gastrostomy and the same procedures performed by laparotomies. Comparatively, were analyzed the distribution of patients according to demographics, diagnosis and type of procedure.ResultsThere were 36 jejunostomies (18 by laparotomy and 17 laparoscopy) and 42 gastrostomies (21 on each side). In jejunostomy, relevant data were operating time of 132 min vs. 106 min (p=0.021); reintroduction of diet: 3.3 days vs 2.1 days (p=0.009); discharge: 5.8 days vs 4.3 days (p= 0.044). In gastrostomy, relevant data were operative time of 122.6 min vs 86.2 min (p= 0.012 and hospital discharge: 5.1 days vs 3.7 days (p=0.016).ConclusionsThe comparative analysis of laparotomy and video-assisted access to jejunostomies and gastrostomies concluded that video-assisted approach is feasible method, safe, fast, simple and easy, requires shorter operative time compared to laparotomy, enables diet start soon in compared to laparotomy, and also enables lower length of stay compared to laparotomy.

Minimally invasive technique for gastrostomy tube insertion: A novel laparoscopic approach

“…Since the 1990s, laparoscopic equipment and techniques have advanced, enabling gastrostomy to be performed using minimally invasive approaches, and many modified techniques have been reported. [10][11][12][13] Here, we introduce a new laparoscopic technique for GT insertion that uses only two trocars and smaller incisions than common laparoscopic approaches.…”

“…However, it is not feasible in some situations, so surgeons must choose either a laparoscopic or open technique to place the GT. Since the 1990s, laparoscopic equipment and techniques have advanced, enabling gastrostomy to be performed using minimally invasive approaches, and many modified techniques have been reported …”