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Feeding Jejunostomy – Laparoscopic

Goals/Objectives

Anatomy and Physiology Review
Indications
Technical considerations

Laparoscopic Feeding Gastrostomy and Jejunostomy

Cedric S.F. Lorenzo
Kenric M. Murayama

From Frantzides CT, Carlson MA: Atlas of Advanced Minimally Invasive Surgery, 1st edition (Saunders 2009)

F igure 20-1-1, Algorithm for obtaining enteral access. GI, gastrointestinal; NG, nasogastric; OG, orogastric; PEG, percutaneous endoscopic gastrostomy.

F igure 20-1-2, T-fastener and introducer needle.

F igure 20-1-3, T-fastener being placed transabdominally and into the stomach.

F igure 20-1-4, Four T-fasteners elevating the anterior abdominal wall of the stomach.

F igure 20-1-5, Four T-fasteners elevating the anterior wall of the stomach with the Seldinger needle penetrating the wall of the stomach.

F igure 20-1-6, Four T-fasteners with the gastrostomy tube placed in the elevated stomach.

F igure 20-1-7, External view of the completed gastrostomy tube with the four cotton bolsters in place and the metal crimps just external to the bolsters.

F igure 20-1-8, Cross section of T-fastener elevating the jejunum to the anterior abdominal wall.

F igure 20-1-9, Jejunostomy tube in the jejunum with four T-fasteners in place.

F igure 20-1-10, External view of the completed jejunostomy tube with the four in-line cotton bolsters of the T-fasteners in place.

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