Primary laparoscopic placement of gastrostomy buttons for feeding tubes. A safer and simpler technique.
BACKGROUND
During a 4-year period, 240 gastrostomy buttons were placed in children, as the initial surgical feeding tube, using laparoscopic techniques.


METHODS
The technique requires the use of a minilaparoscope (1.6-mm) and a single 5-mm trocar placed at the exit site for the gastrostomy button. It can also be performed in addition to a laparoscopic fundoplication using the same trocar sites. The technique requires no special instrumentation or kits. When performed alone, operative times average 15 min. When performed with fundoplication, it adds approximately 5-10 min to the time for the procedure.


RESULTS
There were no intraoperative complications and five (2.1%) postoperative complications.


CONCLUSIONS
This technique has proven to be simple and effective. It allows primary placement of a gastrostomy button that is cosmetically and functionally superior to a gastrostomy tube.
Rothenberg
S S
SS
The Hospital for Infants and Children at P/SL, Denver, CO 80218, USA.
Bealer
J F
JF
Chang
J H
JH
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D018662:Fundoplication / Q000379:methods; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy