Advances in Pediatric Research
Open Access
ISSN: 2385-4529
ISSN: 2385-4529
Nikolay F Shchapov
Ilyinskaya Hospital, Russia
Scientific Tracks Abstracts: Adv Pediatr Res
Aim of the Study: To present a modified technique of laparoscopic gastrostomy by Kader in children. Background: Laparoscopic gastrostomy has the following disadvantages: leakage around the tube, balloon rupture by the needle, difficulty to fix the stomach behind the tube. Materials and Methods: From 2018 to 2022 16 children underwent both traditional and laparoscopic gastrostomy. Laparoscopic procedure was performed in 11 patients: by traditional (n=5) and modified (n=6) technique. Description of the method: We used three laparoscopic ports (3 and 5 mm manipulators). We punctured abdominal wall in the epigastric area to introduce suture into abdomen. We made a purse-string suture on the stomach and a Roeder knot by manipulators. The needle was cut off and removed through the trocar. Another suture was introduced into the abdomen the same way but at the area above the supposed gastrostomy. The free end was left outside and the second purse-string suture on the stomach was performed 4 mm apart. Then we punctured the abdominal wall from inside very close to the first puncture and pull the needle out. We used sharp scissors to place the gastrostomy tube and inflated its balloon. Then we tied the Roeder knot and the free suture end left outside helped to make it easy and safe. We knotted the two ends of the second purse-string suture left outside the abdomen and fix the stomach behind the tube well enough. It allowed us to deflate the balloon and apply two additional sutures to fix the stomach, with no risk of puncturing the balloon. Results: Mean operation time was 25, 3±5,35 minutes, we had no complications (1 year follow-up). Patients received feeding on the 1 day after the procedure. Conclusions: Our modification of laparoscopic gastrostomy by Kader is a safe and efficient technique for children with high risk of complications.
Nikolay F Shchapov is a lead pediatric surgeon of the Pediatric Surgery Department Ilyinskaya hospital. Surgical areas of activity: neonatal surgery, thoracic surgery, abdominal surgery, pediatric urology, anorectal malformations, surgical innovations. Labor activity: Head of the Clinic for Pediatric Surgery of the Moscow Regional Research and Clinical Institute ("MONIKI") 2021– 2022; Head of the Neonatal and Infant surgery Department of the Moscow Regional Center for Maternity and Childhood Healthcare 2017–2021; Pediatric surgeon of the Department of Neonatal and Infant surgery Filatov Children’s City Clinical Hospital 2012–2017; Chief pediatric surgeon of the Ministry of Health of the Moscow region 2018–2022.