Laparoscopically Supervised PEG at Time of Nissen Fundoplication: A Safe Option

Abstract

PEG tube placement at the time of a LNF is safe and effective. A combined laparoscopic and endoscopic approach minimizes complications. This method also allows for an intra- and extraluminal evaluation of the fundoplication at its completion.

Innovative Techniques Associated with Traditional Abdominal Surgery in Complex Pediatric Cases: A Tertiary Center Experience

“…Moreover, neurologically impaired children often present a deviation of the spinal column that makes the laparo-assisted approach the safest choice for the gastrostomy positioning. In line with the literature reports [9,10], this approach is safe and becomes crucial in some difficult cases where anatomy might vary due to the underlying disease.…”

Does Gastrostomy Placement With Concurrent Fundoplication Increase the Risk of Gastrostomy‐related Complications?

“…The last patient had persistent diarrhoea and the PEG was found in the transverse colon. Malinsertion via the PEG technique is a wellknown complication reported at 0.3% to 6.7% (5,7,14,21). There compared with the fixed bolster device (Bard Button).…”

Single-Center Experience of Laparoscopically Assisted Percutaneous Endoscopic Gastrostomy Placement

“…This was first described by two separate researchers in 1995 14,15 and is the method of choice for gastrostomy placement during laparoscopic fundoplication. 6 The techniques described in the literature mainly use a three-port technique, 14,16,17 with some researchers reserving this technique for complex or difficult patients in which conventional PEG placement carries an increased risk of complications. 15,18 The largest series to use this technique placed gastrostomies in 34 children experiencing no major complications.…”

“…[1][2][3] With the introduction of laparoscopy, there are five main techniques for gastrostomy placement: 1) conventional open (Stamm) gastrostomy; 2) PEG; 3) fluroscopy-guided gastrostomy 4 ; 4) laparoscopic gastrostomy without endoscopy 5 ; and 5) laparoscopic-assisted PEG. 6 In 2006, our institution experienced two episodes of colocutaneous fistula following conventional PEG placement. This complication led to a change in technique.…”