title: Laparoscopic placement of a percutaneous endoscopic gastrostomy (PEG) feeding tube.
abstract: Patients may have abnormal anatomic relationships between the stomach and adjacent organs, particularly when there is a history of abdominal surgery and adhesion formation. Routine placement of a percutaneous endoscopic gastrostomy tube can then be unsafe and result in inadvertent colon perforation, small bowel enterotomy, or injury to other structures. Described herein is a 94-year-old malnourished male in whom the colon lay directly anterior to the greater curvature of the stomach. A new technique was devised--laparoscopically-directed PEG placement--which proved to be a safer alternative approach in this patient.
authors.affiliation: Department of Surgery, Meridia Huron Hospital, Cleveland, Ohio 44112.
authors.forename: J H
authors.initials: JH
authors.lastname: Raaf
authors.forename: M
authors.initials: M
authors.lastname: Manney
authors.forename: E
authors.initials: E
authors.lastname: Okafor
authors.forename: L
authors.initials: L
authors.lastname: Gray
authors.forename: V
authors.initials: V
authors.lastname: Chari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D005773:Gastroscopy / Q000379:methods; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male