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HighlightsPectus excavatum is the most common chest wall deformity.Correction involves placement of a steel pectus bar(s) in a substernal position.Historically, there has been concern that a pectus bar prevents effective CPR.Successful CPR with a pectus bar in place was achieved in the field.

We compare our experience of percutaneous endoscopic gastrostomy, introducer technique (PEG) and laparoscopic technique (LapGT) at a tertiary care pediatric hospital. MethodsIsolated PEGs and LapGTs placements were reviewed at our institution from August 2016 through January 2018. Demographics, procedure time, operative charges, and 30-day complications were reviewed. Means of quantitative values were compared using the student's t test. Categorical values were compared using the X 2 test. Results93 isolated gastrostomy tubes were placed in children aged 2 weeks to 19 years. There were 56 PEGs (60%) and 37 LapGTs (40%), based on surgeon preference. There was no signi cant difference in demographics between the two groups. Mean operative time for PEG was 59% shorter (14 vs. 33 minutes, p < 0.001). Operating room charges averaged $4,500 less in the PEG group ($11,400 vs. $15,900, p < 0.001). Neither group had complications that required a return to the operating room within 30 days postoperatively. There was no difference in the rate of fundoplication after gastrostomy tube placement. In two cases PEGs were converted to LapGTs after safety criteria for PEG were not met. ConclusionThe PEG introducer technique, when used with clearly de ned safety criteria, decreased operative time and cost without compromising safety.Level of evidence: level III HighlightsRetrospective comparison of percutaneous and laparoscopic gastrostomy, both using xation of the stomach to the abdominal wall, Seldinger technique and MIC gastrostomy tubes.Percutaneous gastrostomy has decreased cost, shorter operative times, and no difference in major complications.Percutaneous endoscopic gastrostomy is safe and effective in children compared to laparoscopic gastrostomy.