Primary laparoscopic placement of gastrostomy buttons for feeding tubes - A safer and simpler technique

Background: During a 4-year period, 240 gastrostomy buttons were placed in children, as the initial surgical feeding tube, using laparoscopic techniqu es. Materials and methods: The technique requires the use of a minilaparoscope (1.6-mm) and a single 5-mm trocar placed at the exit site for the gastrosto my button. It can also be performed in addition to a laparoscopic fundoplic ation using the same trocar sites. The technique requires no special instru mentation or kits. When performed alone, operative times average 15 min. Wh en performed with fundoplication, it adds similar to 5-10 min to the time f or the procedure. Results: There were no intraoperative complications and five (2.1%) postope rative complications. Conclusions: This technique has proven to be simple and effective. It allow s primary placement of a gastrostomy button that is cosmetically and functi onally superior to a gastrostomy tube.