Totally laparoscopic feeding jejunostomy – a technique modification
In oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy orjejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modifiedtechnique of laparoscopic feeding jejunostomy applied during the...
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Format: | Article |
Language: | English |
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Termedia Publishing House
2011-12-01
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Series: | Videosurgery and Other Miniinvasive Techniques |
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Online Access: | http://www.termedia.pl/Totally-laparoscopic-feeding-jejunostomy-a-technique-modification,42,17858,1,0.html |
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author | Maciej Bobowicz Wojciech Makarewicz Tomasz Polec Arkadiusz Kopiejć Tomasz Jastrzębski Jacek Zieliński Janusz Jaśkiewicz |
author_facet | Maciej Bobowicz Wojciech Makarewicz Tomasz Polec Arkadiusz Kopiejć Tomasz Jastrzębski Jacek Zieliński Janusz Jaśkiewicz |
author_sort | Maciej Bobowicz |
collection | DOAJ |
description | In oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy orjejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modifiedtechnique of laparoscopic feeding jejunostomy applied during the staging laparoscopy. A 48-year-old male patient withgastroesophageal junction tumour and a 68-year-old male patient with oesophageal tumour were operated on usingthe described technique. Exploratory laparoscopy was performed. Then the feeding jejunostomy was made usinga Cystofix® TUR catheter. The jejunum was fixed to the abdominal wall with four 2.0 Novafil™ transabdominal stitches.Two additional sutures were placed caudally about 4 cm and 8 cm from the jejunostomy, aiming at prevention ofjejunal torsion. Total operating time was 45 min. There was no blood loss. There were no intraoperative complications.The only adverse event was one jejunostomy wound infection that responded well to oral antibiotics. There were nomortalities. The described technique has most of the benefits of laparoscopic feeding jejunostomy with some stepsadded from the open operation making the procedure easier to perform as part of a staging operation with a relativelyshort additional operating time. The proposed transabdominal stitches make the technique easier to apply. Two additional‘anti-torsion sutures’ prevent postoperative volvulus. Use of the Cystofix catheter allows easy introduction of thecatheter into the peritoneal cavity and the jejunal lumen, providing a good seal at the same time. Further studies onlarger groups of patients are required to assess long-term outcomes of the proposed modified technique. |
first_indexed | 2024-04-12T11:54:42Z |
format | Article |
id | doaj.art-5aecbd270bab419ab3fa8766efac12d0 |
institution | Directory Open Access Journal |
issn | 1895-4588 |
language | English |
last_indexed | 2024-04-12T11:54:42Z |
publishDate | 2011-12-01 |
publisher | Termedia Publishing House |
record_format | Article |
series | Videosurgery and Other Miniinvasive Techniques |
spelling | doaj.art-5aecbd270bab419ab3fa8766efac12d02022-12-22T03:34:02ZengTermedia Publishing HouseVideosurgery and Other Miniinvasive Techniques1895-45882011-12-0164256260Totally laparoscopic feeding jejunostomy – a technique modificationMaciej BobowiczWojciech MakarewiczTomasz PolecArkadiusz KopiejćTomasz JastrzębskiJacek ZielińskiJanusz JaśkiewiczIn oncological patients with upper gastrointestinal tract tumours, dysphagia and cachexy necessitate gastrostomy orjejunostomy as the only options of enteral access for long-term feeding. In this article the authors describe a modifiedtechnique of laparoscopic feeding jejunostomy applied during the staging laparoscopy. A 48-year-old male patient withgastroesophageal junction tumour and a 68-year-old male patient with oesophageal tumour were operated on usingthe described technique. Exploratory laparoscopy was performed. Then the feeding jejunostomy was made usinga Cystofix® TUR catheter. The jejunum was fixed to the abdominal wall with four 2.0 Novafil™ transabdominal stitches.Two additional sutures were placed caudally about 4 cm and 8 cm from the jejunostomy, aiming at prevention ofjejunal torsion. Total operating time was 45 min. There was no blood loss. There were no intraoperative complications.The only adverse event was one jejunostomy wound infection that responded well to oral antibiotics. There were nomortalities. The described technique has most of the benefits of laparoscopic feeding jejunostomy with some stepsadded from the open operation making the procedure easier to perform as part of a staging operation with a relativelyshort additional operating time. The proposed transabdominal stitches make the technique easier to apply. Two additional‘anti-torsion sutures’ prevent postoperative volvulus. Use of the Cystofix catheter allows easy introduction of thecatheter into the peritoneal cavity and the jejunal lumen, providing a good seal at the same time. Further studies onlarger groups of patients are required to assess long-term outcomes of the proposed modified technique.http://www.termedia.pl/Totally-laparoscopic-feeding-jejunostomy-a-technique-modification,42,17858,1,0.htmlfeeding microjejunostomyenteral feedinglaparoscopyminimally invasive surgerytechnique modificationoncology |
spellingShingle | Maciej Bobowicz Wojciech Makarewicz Tomasz Polec Arkadiusz Kopiejć Tomasz Jastrzębski Jacek Zieliński Janusz Jaśkiewicz Totally laparoscopic feeding jejunostomy – a technique modification Videosurgery and Other Miniinvasive Techniques feeding microjejunostomy enteral feeding laparoscopy minimally invasive surgery technique modification oncology |
title | Totally laparoscopic feeding jejunostomy – a technique modification |
title_full | Totally laparoscopic feeding jejunostomy – a technique modification |
title_fullStr | Totally laparoscopic feeding jejunostomy – a technique modification |
title_full_unstemmed | Totally laparoscopic feeding jejunostomy – a technique modification |
title_short | Totally laparoscopic feeding jejunostomy – a technique modification |
title_sort | totally laparoscopic feeding jejunostomy a technique modification |
topic | feeding microjejunostomy enteral feeding laparoscopy minimally invasive surgery technique modification oncology |
url | http://www.termedia.pl/Totally-laparoscopic-feeding-jejunostomy-a-technique-modification,42,17858,1,0.html |
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