Laparoscopic surgical transmesocolic jejunostomy: A new surgical approach

Özet

In cancer patients with tumors of the upper gastrointestinal tract, dysphagia and cachexia require gastrostomy orjejunostomy as the only options for enteral access for long-term feeding. In this article, the authors describe a modifiedplacement of laparoscopic feeding jejunostomy applied during laparoscopic oncology layering technique. Afterperforming an exploratory laparoscopy, a feeding jejunostomy is performed using a Foley silicon catheter, throughan eyelet in the mesentery of the descending colon. After completing the introduction of the jejunal probe accordingto the Witzel technique, the intestinal segment of jejunum is attached to the internal sheath of the mesocolonusing sutures polysorb 2/0, with the aim of removing the possible internal hernia and a jejunal torque that couldcause an intestinal obstruction. There were no intraoperative complications or mortality. The technique describedhere provides most of the benefits of laparoscopic jejunostomy feeding, avoiding the possible internal hernia.