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Abstract

Introduction:

We present a novel transabdominal suture technique for laparoscopic gastrostomy tube placement. This technique may help reduce the risk of tube dislodgement in the early postoperative period.

Methods:

Two ports are utilized: one umbilical/camera port and one working port that becomes the site for the G-tube. Transabdominal Georgeson sutures are placed through the stomach wall. The stomach entered using a transabdominal needle under direct vision. After serially dilating the tract over a wire, two additional Stamm-like sutures (absorbable) are placed using our novel transabdominal technique. The needle passes through the incision and stomach opening, through the stomach and abdominal walls; however, before the swage edge of the needle exits the skin, the needle is backed through the left upper quadrant incision subcutaneously.

Results and Conclusions:

These transabdominal Stamm-like sutures secure the stomach to the abdominal wall even after the Georgeson sutures are released. The added fixation ensures that the stomach will not fall away from the abdominal wall, even if the gastrostomy tube is dislodged in the early postoperative period. The Georgeson sutures can be removed on POD1 or before discharge and the Stamm-like sutures remain in place indefinitely.