title: Laparoscopically monitored percutaneous endoscopic gastrostomy (PEG) in children: a safer procedure.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy (PEG) has now become the preferred technique for facilitating enteral nutrition in children with inadequate caloric intake. Because many problems related to PEG insertion have recently been reported, we were motivated to reassess this established technique. We have therefore added a new step--laparoscopic monitoring--to the classic PEG procedure.
  
  
  METHODS
  Fifteen children who required PEG during the previous year were studied. Their ages ranged from 2 months to 18 years. Six children were < 1 year old at the time of operation. In 11 patients, the PEG was performed at the end of a laparoscopic Nissen fundoplication. In the others, it was done as a single procedure.
  
  
  RESULTS
  In all 15 children, the PEG was performed safely and quickly, without complications.
  
  
  CONCLUSIONS
  The addition of 'laparoscopic monitoring' to the classic PEG procedure introduced by Gauderer et al. changes the first and last parts of the procedure from an almost 'blind' undertaking to a well-controlled and safer procedure.
authors.affiliation: Department of Pediatric Surgery, Assaf Harofeh Medical Center, 70300, Zerifin, Israel. gadlotan@yahoo.com
authors.forename: G
authors.initials: G
authors.lastname: Lotan
authors.forename: E
authors.initials: E
authors.lastname: Broide
authors.forename: Y
authors.initials: Y
authors.lastname: Efrati
authors.forename: B
authors.initials: B
authors.lastname: Klin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition; D018662:Fundoplication; D005773:Gastroscopy / Q000009:adverse effects / Q000379:methods*; D005774:Gastrostomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007223:Infant