Laparoscopic surgical transmesocolic jejunostomy: A new surgical approach
Alberto Pagan, Alessandro Bianchi
, José Antonio Martínez, Marina Jiménez, Xavier Francesc Gonzalez
Department of General Surgery, Hospital Universitario Son Espases, Palma De Mallorca, Spain
Abstract
In cancer patients with tumors of the upper gastrointestinal tract, dysphagia and cachexia require gastrostomy or jejunostomy as the only options for enteral access for long-term feeding. In this article, the authors describe a modified placement of laparoscopic feeding jejunostomy applied during laparoscopic oncology layering technique. After performing an exploratory laparoscopy, a feeding jejunostomy is performed using a Foley silicon catheter, through an eyelet in the mesentery of the descending colon. After completing the introduction of the jejunal probe according to the Witzel technique, the intestinal segment of jejunum is attached to the internal sheath of the mesocolon using sutures polysorb 2/0, with the aim of removing the possible internal hernia and a jejunal torque that could cause an intestinal obstruction. There were no intraoperative complications or mortality. The technique described here provides most of the benefits of laparoscopic jejunostomy feeding, avoiding the possible internal hernia.
Keywords: Jejunostomy, enteral nutrition, upper gastrointestinal tumors
Cite this paper as: Pagan A, Bianchi A, Martínez JA, Jiménez M, Gonzalez XF. Laparoscopic surgical transmesocolic jejunostomy: a new surgical approach. Turk J Surg 2018; 34: 155-157.
Written informed consent was obtained from patients who participated in this study.
Externally peer-reviewed.
Concept - A.P.; Design - A.P., A.B.; Supervision - X.F.G.; Resource - A.P., A.B.; Materials - A.B.; Data Collection and/or Processing - A.B., M.J.; Analysis and/or Interpretation - A.P., A.B.; Literature Search - A.B., J.A.M., M.J.; Writing Manuscript - A.P., A.B.; Critical Reviews - X.F.G.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.
The technical assistance of the nurse staff of the General Surgery Department is gratefully acknowledged.