SURGICAL GASTROSTOMY BASED ON ENDOSCOPIC CONCEPTS

BACKGROUND : Until the early 1980s, Stamm technique was considered standard method to gastrostomy. After description of the endoscopic technique, due to its efficiency and speed, quickly became the method of choice for long-term enteral access. AIM: Describe a technique that combines direct view of the stomach from open surgery with the simplicity and less traumatic endoscopic gastrostomy method. METHOD : In patient supine under spinal anesthesia the technique stars with small epigastric incision to pull up the stomach. A 3 mm incision in the left hypochondrium is made to pass needle puncture to guidewire passage. The stomach is drilled, guidewire is seizured, connection to catheter and percutaneous approach is made with traction of the stomach to the abdominal wall. Purse suture on the anterior gastric wall is not needed. RESULTS : Twenty-eight patients underwent gastrostomy using endoscopy devices; six had local minor complications without the need for re-intervention; there was no death. CONCLUSION : The surgical gastrostomy with minimal incision in the stomach to pull off the catheter using endoscopic gastrostomy devices, proved to be safe, easy to perform, less traumatic, quick, simple and elegant.