Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy

There are a variety of techniques for gastrostomy tube placement. Endoscopic and radiologic approaches have almost entirely superseded surgical placement. However, an aging population and significant advancements in modern healthcare have resulted in patients with increasingly complex medical issues...

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Bibliographic Details
Published in:Current gastroenterology reports 2016-09, Vol.18 (9), p.46-46, Article 46
Main Authors: Thaker, Adarsh M., Sedarat, Alireza
Format: Article
Language:English
Subjects:
Abdomen
Catheters
Contraindications
Endoscopy
Enteral nutrition
Enteral Nutrition - methods
Esophagus
Gastroenterology
Gastroscopy - methods
Gastrostomy - adverse effects
Gastrostomy - methods
Humans
Ischemia
Laparoscopy
Laparoscopy - methods
Medicine
Medicine & Public Health
Ostomy
Peritonitis
Radiography, Interventional - methods
Section Editors
Stomach
Stomach and Duodenum (J Pisegna and J Benhammou
Surgery
Topical Collection on Stomach and Duodenum
Visualization
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Summary:There are a variety of techniques for gastrostomy tube placement. Endoscopic and radiologic approaches have almost entirely superseded surgical placement. However, an aging population and significant advancements in modern healthcare have resulted in patients with increasingly complex medical issues or postsurgical anatomy. The rising prevalence of obesity has also created technical challenges for proceduralists of many specialties. When patients with these comorbidities develop the need for long-term enteral nutrition and feeding tube placement, standard approaches such as percutaneous endoscopic gastrostomy (PEG) by endoscopists and percutaneous image-guided gastrostomy (PIG) by interventional radiologists may be technically difficult or impossible. For these challenging situations, laparoscopic-assisted PEG (LAPEG) is an alternative option. LAPEG combines the advantages of PEG with direct intraperitoneal visualization, helping ensure a safe tube placement tract free of intervening organs or structures. In this review, we highlight some of the important factors of first-line gastrostomy techniques, with an emphasis on the utility and procedural technique of LAPEG when they are not feasible.
ISSN:1522-8037
1534-312X
DOI:10.1007/s11894-016-0520-2