Laparoscopic jejunostomy using T-fasteners as retractors and anchors
Q. Y. Duh and L. W. Way
Department of Surgery, University of California, San Francisco.
We developed a new technique for performing laparoscopic jejunostomies
using T-fasteners to secure the jejunum to the abdominal wall. The proximal
jejunum is identified with laparoscopy. Four T-fasteners are introduced
percutaneously into the jejunal lumen for retraction, and an 8F catheter is
inserted through a peel-away introducer via a J-wire. The jejunum is drawn
up against the abdominal wall by pulling on the T-fasteners. Tube placement
is checked with laparoscopy and roentgenography. We performed laparoscopic
jejunostomies in five patients using this method, and the results were
excellent. Jejunostomies can be performed safely, easily, and reliably this
way.
