Video-assisted gastrostomy

Abstract

Surgical centers that treat esophageal cancer need to create a simple and easy method to feed patients who suffer from complete occlusion of the upper alimentary tract. The purpose of this work is to present our own modification of a laparoscopic feeding gastrostomy, which is based on our own experience and previously published methods. Our system requires only two trocars and can be done under general or local anesthesia. It consists of exteriorizing a stomach fragment through a 12-mm opening in the skin under video control. The newly created gastrostomy forms a channel in the abdominal wall that is long narrow and enough to allow a 24-F catheter to be inserted without serious leakage. The method was applied satisfactorily to 11 patients, with a mean observation time of 3.5 months. It offers the patient an ongoing nutrition gastrostomy for early use. After 3 weeks, the gastrostomy can be used on a temporary basis by inserting the catheter during the feeding time and afterward withdrawing it with the gauze pad still attached. We have found this procedure to be a simple, easy, and cost-effective alternative to supplying nutrition to patients with complete upper alimentary tract stenosis. Moreover, it is superior to previously described methods.

Primäre operative Gastrostomie oder perkutane endoskopische Gastrostomie (PEG) beim fortgeschrittenen inoperablen Ösophaguskarzinom?

“…Alle Karzinome waren fortgeschritten Bezüglich der Frage, ob eine primäre operative Gastrostomie mittels Minilaparotomie oder als minimal invasiver Eingriff angelegt werden sollte, weist das Literaturstudium sehr gute Ergebnisse für laparoskopischen Gastrostomien auf, wobei verschiedene Methoden erfolgreich getestet wurden, die sich vornehmlich in den Kosten unterschieden [11,14,15]. Um den Eingriff so wenig invasiv wie möglich zu gestalten, sollte eine Laparoskopie einer Laparotomie vorgezogen werden.…”