Establishing enteral feeding in high-risk infants with significant gastroes
ophageal reflux is a difficult challenge. Some patients are considered at v
ery high risk for fundoplication and gastrostomy due to unstable medical co
nditions, dense upper-abdominal adhesions due to previous surgical procedur
es, or unfavorable anatomy. We describe a less invasive operation that prov
ides jejunal feeding in a way that is safe, reliable, and convenient for th
e family.