LAPAROSCOPIC JEJUNOSTOMY WITH AN 18-MM TROCAR

We describe our technique to perform laparoscopic jejunostomies with a n 18-mm trocar. This procedure facilitates the exteriorization of the proximal bowel and construction of the jejunostomy. We describe our la paroscopic technique in nine patients with severe neurologic condition s (two in the postoperative period of a cerebral aneurysm in a coma, t hree patients with severe head injury, and four patients with cerebrov ascular strokes). The operative time ranged from 20 to 75 min (average , 44.38 min). Nutrition was initiated 24 h after the placement of the jejunostomy. Tolerance of the enteral nutrition was excellent in all c ases, One major complication occurred, minor leakage around the feedin g tube 3 weeks after the jejunostomy was constructed. The jejunostomy was removed without further consequences. Laparoscopy is an effective technique for the creation of feeding jejunostomies. We believe that t his minimally invasive approach is an alternative for patients requiri ng long-term postpyloric enteral feeding.