Laparoscopic Placement of a Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube

Raaf, John H.; Manney, Maruthi; Okafor, Emmanuel; Gray, Lawrence G.; Chari, V.

doi:10.1089/lps.1993.3.411

Cited by 47 publications

(12 citation statements)

References 8 publications

(1 reference statement)

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“…Laparoscopic surgery for gastrostomy can be classified as laparoscopic PEG and LAPEG. 12 LAPEG is a relatively recent technique and was first described in 1993 by Raff et al 13 Presently, laparoscopic surgery is regarded as the standard operation in cholecystectomy, with indications expanded to other abdominal surgeries, and regarded as a general procedure. To date, we widely performed cholecystectomy, gastrectomy, colon resection, and other abdominal surgery laparoscopically, and the surgical technique and safety was thereby established.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Percutaneous Endoscopic Gastrostomy Is Useful for Elderly

Tanaka

Ueda

Yokoyama

et al. 2019

JSLS

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Background: In recent years, enteral nutrition has become relatively easy to perform through the penetration of percutaneous endoscopic gastrostomy (PEG). However, there have been reports of complications, such as mispuncture of other organs at the time of performing PEG. Previously, we had constructed a gastrostomy under the laparotomy for difficult PEG cases, and 2 years ago, we introduced laparoscopically assisted PEG. This study aimed to clarify the feasibility and safety of LAPEG for elderly people over 65 years old. Methods: We evaluated the perioperative outcomes in 7 elderly patients who underwent LAPEG during these 2 years. In these subjects, the safety of LAPEG was evaluated retrospectively based on the surgical outcomes, perioperative complications, and postoperative course using the clinical archives. Results: The subjects' mean age was 81.1 ± 8.03 years. LAPEG was successful in all 7 patients. The median operation time was 38 minutes (range, 31–71 minutes). Intraoperative and postoperative early or late complications from LAPEG were not observed in our cases. Enteral nutrition was commenced 2 days after PEG placement in all cases without complications. Conclusion: We summarized the LAPEG cases performed at our institution for the elderly, and have reported its feasibility and safety. The strongest advantage of LAPEG was that it allowed placement of the PEG without any complication under direct observation of the intraperitoneal cavity to confirm the safety of each organ.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Percutaneous Endoscopic Gastrostomy Is Useful for Elderly

Tanaka

Ueda

Yokoyama

et al. 2019

JSLS

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“…28,230 A combined laparoscopic-assisted PEG technique can be used in patients who may have other organs interposed between the stomach and anterior abdominal wall. 159,[231][232][233][234] Laparoscopy can also be used in the situation of early dislodgment of a PEG or PRG tube if repeat PEG or PRG is not possible or the patient has signs of peritonitis after repeat PEG or PRG. If necessary, a permanent Janeway-like Lap G can be performed at that time.…”

Section: Laparoscopic Gastrostomy (Lap G)mentioning

confidence: 99%

Ins and Outs of Enteral Access: Part 2—Long Term Access—Esophagostomy and Gastrostomy

Vanek

2003

Nut in Clin Prac

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Access techniques for long-term enteral nutrition (over 4 to 6 weeks) includes cervical esophagostomy and pharyngostomy, gastrostomy, and jejunostomy. Cervical esophagostomy and pharyngostomy are rarely used since the advent of better long-term enteral access techniques that are easier to care for and have fewer complications; they are briefly reviewed only for historical completeness and to condemn their use. The different techniques of gastrostomy tube insertion and their indications, contraindications, advantages, and disadvantages are discussed. Part III (to be published in a later issue) of this series will review feeding jejunostomy.

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“…Despite its minimal invasiveness and operative time, major complications such as gastrocolic fistula or intra‐abdominal organ injury have been reported 2,3 . Laparoscopy‐assisted PEG (LAPEG) placement has been introduced to reduce the complications associated with PEG placement 4,5 . LAPEG allows visualization of PEG placement, which provides the precision necessary to avoid intra‐abdominal organ injury and determine the optimal placement of the gastrostomy tube 6 .…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of laparoscopy‐assisted percutaneous endoscopic gastrostomy in infants and small children weighing less than 10 kg: A comparison with larger patients

Zenitani

Nose

Sasaki

et al. 2020

Asian J Endoscop Surgery

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Introduction: Laparoscopy-assisted percutaneous endoscopic gastrostomy (LAPEG) can reduce the risk of percutaneous endoscopic gastrostomy-related complications, such as intra-abdominal organ injury, and determine the optimal position for placement of the gastrostomy tube. We first employed LAPEG 10 years ago but limited its application to elderly patients. Indications for LAPEG have now expanded to small children. This retrospective study aimed to determine the feasibility of LAPEG in children weighing <10 kg. Methods: Our LAPEG procedure for small children involves three essential techniques: gastric insufflation with CO 2 to prevent intestinal dilation, a T-fastener device to overcome the difficulties of gastropexy, and primary placement of a button gastrostomy to create less torque than tube gastrostomy at the insertion site and to prevent early tube dislodgement. The medical records of 48 patients with physical and mental disabilities who underwent LAPEG between 2010 and 2018 were evaluated. The outcomes of LAPEG in patients weighing <10 kg (group A, n=11) and ≥10 kg (group B, n=37) were compared. Results: The LAPEG procedure was completed in all cases without intraoperative complications or open conversion. The median bodyweight of group A was 6.3 kg (range, 3.6-8.2 kg). None of the patients in group A developed postoperative complications such as stomal infection or dislodgement. The operative time was significantly shorter in group A than in group B (P < .05). Conclusion: By improving surgical techniques for small children, our LAPEG procedure might be feasible and safe for treating children weighing <10 kg, including those weighing as little as 3.6 kg.

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Laparoscopic Placement of a Percutaneous Endoscopic Gastrostomy (PEG) Feeding Tube

Cited by 47 publications

References 8 publications

Laparoscopic Percutaneous Endoscopic Gastrostomy Is Useful for Elderly

Laparoscopic Percutaneous Endoscopic Gastrostomy Is Useful for Elderly

Ins and Outs of Enteral Access: Part 2—Long Term Access—Esophagostomy and Gastrostomy

Safety and efficacy of laparoscopy‐assisted percutaneous endoscopic gastrostomy in infants and small children weighing less than 10 kg: A comparison with larger patients

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