title: Laparoscopic secondary antireflux procedure after PEG placement in children. Percutaneous endoscopic gastrostomy.
abstract: BACKGROUND
  This study investigates the feasibility of performing a subsequent laparoscopic antireflux procedure after former placement of a percutaneous endoscopic gastrostomy (PEG).
  
  
  METHODS
  Between 1997 and 1998, five patients with a gastrostomy in place presented with an indication for laparoscopic antireflux procedure due to persisting vomiting.
  
  
  RESULTS
  All patients were managed laparoscopically with a four-trocar technique.
  
  
  CONCLUSIONS
  Primary PEG placement has no adverse effects on a later secondary antireflux procedure. In some cases, four rather than five trocars can be used.
authors.affiliation: Department of Pediatric Surgery, KE 04.140.5, Wilhelmina Children's Hospital, University Medical Center, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
authors.forename: D C
authors.initials: DC
authors.lastname: van der Zee
authors.forename: N M
authors.initials: NM
authors.lastname: Bax
authors.forename: B M
authors.initials: BM
authors.lastname: Ure
mesh_terms: D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D005774:Gastrostomy / Q000379:methods*; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D012086:Reoperation / Q000379:methods; D013536:Suture Techniques