title: Gasless laparoscopic gastrostomy.
abstract: Percutaneous endoscopic gastrostomy (PEG) is the procedure of choice in the nutritional management of patients requiring gastrostomies. Laparoscopic gastrostomy is usually performed when PEG is contraindicated, for example, in patients with esophageal strictures, large gastric tumors, or a history of multiple abdominal surgery. We report herein a case of gasless laparoscopic gastrostomy performed for carcinoma associated with a severe respiratory distress syndrome in a malnourished patient with a tight esophageal stricture. The gasless technique uses the Laparolift System (Laparolift, Origin Medsystem, Inc.), a device composed of a fan-shaped retractor and a mechanical lifting arm that produces an abdominal wall distention resembling a truncated pyramid. Gasless laparoscopy was a safe alternative approach to CO2 pneumoperitoneum in this patient.
authors.affiliation: Department of Surgery, Ospedale di Abbiategrasso, Milano, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Viani
authors.forename: R V
authors.initials: RV
authors.lastname: Poggi
authors.forename: A
authors.initials: A
authors.lastname: Pinto
authors.forename: G
authors.initials: G
authors.lastname: Fusai
authors.forename: S M
authors.initials: SM
authors.lastname: Andreani
authors.forename: R A
authors.initials: RA
authors.lastname: Marvotti
mesh_terms: D002245:Carbon Dioxide; D002277:Carcinoma / Q000150:complications; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods; D004938:Esophageal Neoplasms / Q000150:complications; D004940:Esophageal Stenosis / Q000150:complications / Q000209:etiology; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial
chemical_list: D002245:Carbon Dioxide