title: Laparoscopic gastrostomy according to Janeway.
abstract: Percutaneous endoscopic gastrostomy is not suitable for all patients requiring gastrostomies. Patients with endoscopically impassable tumors require a safe and effective alternative procedure for paraesophageal alimentation. We present the surgical technique and results of the laparoscopic gastrostomy according to Janeway. Using an endoscopic stapling device a gastric tube is created from a stomach fold, led out through the trocar site, and fixed to the skin in the left upper quadrant. Via an inserted catheter enteral alimentation can be performed intermittently since the gastrostoma is continent. Between July 1995 and November 1996 laparoscopic gastrostomy was performed in 15 patients (10 male, five female) with tumors in the pharynx or esophagus. Mean operation time was 35 min. One stoma necrosis developed; the other postoperative courses were complication-free. All gastrostomies were continent. Laparoscopic gastrostomy is easy to perform and involves minimal discomfort and complications for the patient.
authors.affiliation: Department of General, Vascular and Thoracic Surgery, University Hospital Benjamin Franklin, Free University of Berlin, Hindenburgdamm 30, 12200 Berlin, Germany.
authors.forename: J P
authors.initials: JP
authors.lastname: Ritz
authors.forename: C T
authors.initials: CT
authors.lastname: Germer
authors.forename: H J
authors.initials: HJ
authors.lastname: Buhr
mesh_terms: D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D013525:Surgical Instruments; D013536:Suture Techniques / Q000295:instrumentation; D016896:Treatment Outcome