What is the surgicalprocedure for gastrostomy?

A gastrostomy is a surgical procedure in which a tube is inserted through the abdomen into the stomach to provide a way for nutrition and medications to be delivered directly into the stomach. The procedure is typically performed under general anesthesia and involves the following steps:

1. The patient is positioned on the operating table and the abdomen is cleaned and sterilized.

2. A small incision is made in the abdomen, usually on the left side, and the stomach is located.

3. A small opening is made in the stomach and the tube is inserted through the opening and into the stomach.

4. The tube is secured in place with sutures or a special device called a "button" that sits flush against the skin.

5. The incision is closed with sutures or surgical staples.

After the procedure, the patient may need to stay in the hospital for a few days for monitoring and to ensure that the gastrostomy tube is functioning properly. The tube can be used to deliver liquid nutrition, medications, and fluids directly into the stomach, bypassing the mouth and esophagus.

Surgical Procedure for Gastrostomy

Indications:

- Inability to tolerate oral intake
- Bowel obstruction
- Esophageal strictures or tumors
- Tracheal or laryngeal injuries

Types of Gastrostomy:

- Percutaneous Endoscopic Gastrostomy (PEG): Performed endoscopically through the abdominal wall
- Laparoscopic Gastrostomy: Performed laparoscopically through small incisions in the abdomen
- Open Gastrostomy: Performed through a surgical incision in the abdomen

PEG Procedure:

1. Preparation: The patient is given general anesthesia or IV sedation. The abdomen is shaved and cleaned.
2. Gastroscope Insertion: A gastroscope is inserted through the mouth and into the stomach.
3. Stomach Wall Grasping: The endoscope is positioned against the anterior stomach wall, and forceps are used to grasp the tissue.
4. External Incision: A small incision is made in the abdominal wall where the gastrostomy tube will be placed.
5. Stomach Wall Puncture: A needle is inserted through the abdominal wall into the stomach, and a guidewire is passed through the needle.
6. Dilation of the Tract: A series of dilators are used to widen the tract between the stomach and the abdominal wall.
7. Tube Placement: A gastrostomy tube is passed over the guidewire into the stomach.
8. Tube Fixation: The tube is secured to the abdominal wall with a bumper or locking device.

Laparoscopic Gastrostomy Procedure:

1. Laparoscopic Access: Small incisions are made in the abdomen, and laparoscopic trocar ports are inserted.
2. Stomach Identification: The laparoscope is used to locate the anterior stomach wall.
3. Stomach Wall Incision: A small incision is made in the stomach wall.
4. Tube Placement: A gastrostomy tube is inserted into the stomach through the incision.
5. Tube Fixation: The tube is secured to the stomach wall and abdominal wall.

Open Gastrostomy Procedure:

1. Open Incision: A surgical incision is made in the abdomen to expose the anterior stomach wall.
2. Stomach Wall Incision: A small incision is made in the stomach wall.
3. Tube Placement: A gastrostomy tube is sutured into the stomach wall.
4. Tube Fixation: The tube is secured to the abdominal wall with sutures or a fistula ring.