Laparoscopic gastrostomy in children.
During a 30-month period, 28 children aged 6 months-15 years underwent fashioning of a laparoscopic gastrostomy. Indications for operation included: feeding difficulties and failure to thrive in neurologically impaired children (13); chronic renal failure (9); and others (6). There were 17 conventional tube and 11 button gastrostomies. Twelve children had insertion of a gastrostomy alone; the others underwent a concomitant laparoscopic Nissen fundoplication (NFP). The average operation time for gastrostomy alone was 65 min (range 35-104) and for gastrostomy plus NFP 155 min (range 130-246). There were no specific laparoscopic complications. Two patients who required large volumes of eternal drugs and peritoneal dialysis from the 1st post-operative day developed minor external leaks from their stomas. It appears that laparoscopy provides for safe and precise positioning of any standard balloon or button gastrostomy. It is a particularly attractive technique for use in patients already undergoing a laparoscopic fundoplication and those in whom other minimally invasive techniques are contraindicated or fail.
Humphrey
G M
GM
Department of Paediatric Surgery, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK.
Najmaldin
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D018662:Fundoplication; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D013997:Time Factors