title: SLiC technique. A novel approach to percutaneous gastrostomy.
abstract: BACKGROUND
  Percutaneous endoscopic gastrostomy (PEG) has been an invaluable method for obtaining long-term enteral access and represents one of the first forays in the field of minimally invasive surgery. However, the traditional "pull" method for PEG tube placement continues to have some disadvantages, especially in patients with near-obstructive head and neck cancers.
  
  
  METHODS
  We describe a new "SLiC" technique for establishing percutaneous gastrostomy using a radially expandable trocar.
  
  
  RESULTS
  This technique is initially developed and refined on a porcine model and then successfully implemented on five human patients.
  
  
  CONCLUSIONS
  The SLiC technique can be done safely and efficiently with a pediatric-sized gastroscope and avoids the need for radiation from fluoroscopy. It is a good alternative for obtaining enteral access in patients who would otherwise not be well suited for a traditional PEG tube.
authors.affiliation: Minimally Invasive Surgery Center, Department of General Surgery, Cleveland Clinic Foundation, George Washington University, Washington, DC, USA. adheesh@adheesh.com
authors.forename: A
authors.initials: A
authors.lastname: Sabnis
authors.forename: R
authors.initials: R
authors.lastname: Liu
authors.forename: B
authors.initials: B
authors.lastname: Chand
authors.forename: J
authors.initials: J
authors.lastname: Ponsky
mesh_terms: D000368:Aged; D000818:Animals; D003680:Deglutition Disorders / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D004867:Equipment Design; D020699:Gastroscopes; D005773:Gastroscopy; D005774:Gastrostomy / Q000295:instrumentation / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008875:Middle Aged; D013552:Swine; D016896:Treatment Outcome