Système gastro-intestinal et digestif

Abstrait

Single Port Laparoscopic Gastrostomy

Mariano Palermo, Pablo Acquafresca, Guillermo Duza, Luis Antonio Blanco, Mario Luis Domínguez and Mariano Giménez

Introduction: Since the first classic descriptions of surgical gastrostomies for feeding by supraumbilical medial incisions, patients were operated under general anesthesia, with prolonged time of surgery, these were patients in poor health status, undernourished due to inadequate intake or to neurological or tumor involvement, with prolonged hospitalization, both for the recovery of the intestinal motility as well as for the recovery of post-surgical wounds. Material and Methods: Between July 2012 and December 2013, 10 patients underwent a single port laparoscopic gastrostomy. Six were females and 4 males. The range of age was from 54 to 87 y/o with a mean age of 72. Results: The mean time of the procedure was 43 minutes. Nine patients underwent glucose intake tolerance test after 12 hours and one 24 hours later. Enteral feeding was indicated after the glucose intake tolerance. No complications related with the procedure were observed.f Discussion: Nowadays, the gold standard technique to perform a gastrostomy is the percutaneous approach. In patients with head and neck disorders when is not possible to insert a nasogastric tube to insuflate the stomach, a laparoscopic gastrostomy would be indicated. We describe a new technique, step by step, to perform less invasive laparoscopic surgery by a single port laparoscopic gastrostomy. Conclusion: The lumen created is the same than with open techniques but with a minimally invasive approach, that allows to start feeding earlier providing high quality feeding