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Laparoscopic Gastrojejunostomy

Laparoscopic Gastrojejunostomy

Gastrojejunostomy�is performed by inserting a tube directly into the stomach to the small intestine of a person who has a blockage in the duodenum and cannot take food or medicine by mouth.�Gastrojejunostomy can be done surgically in order to bypass the duodenum. In certain cases the duodenum or part of it is also removed. Gastrojejunostomy can also be performed through an Interventional Radiology (IR) technique called “Percutaneous Gastrojejunostomy”, which requires only a tiny incision in the skin. Percutaneous Gastrojejunostomy can be performed safely in adults and children.

Some Gastrojejunostomies are performed to provide a route for feeding in people who are unable to eat and swallow normally. Gastrojejunostomies may also be placed for people with Chronic Bowel Obstruction who cannot tolerate a nasogastric tube (a tube inserted through the nose into the Stomach).

BRIEF ABOUT THE PROCEDURE

The procedure is performed using a small sedative and local anesthesia. In rare cases, general anesthesia is used. An Interventional Radiologist will work with the Anesthesiologist to monitor you during the procedure. Once you are in the Interventional Radiology area, an intravenous line will be placed in your arm to deliver the anesthetic, or sedation, analgesics (medication to prevent pain) and an antibiotic (medication to prevent infection) if needed. An ultrasound of the stomach area may be performed to assist your Interventional Radiologist in selecting the correct placement of the gastronomy tube. This is usually below the rib cage.

The stomach is inflated with air. The air is delivered to the stomach through a�nasogastric tube�that is inserted through the nose and into the Stomach.�
The skin over the procedure area will be cleansed with an antiseptic solution and draped with sterile cloths. A local anesthetic will be injected into the skin to numb the area where the tube will be placed. The stomach is first fastened to the abdominal wall by inserting small devices through the skin. These are later removed.

The tube (called�t-fasteners) will be inserted by the Interventional Radiologist through a very tiny incision in the skin (approximately � inch). This procedure takes about one hour to perform. The procedure is generally painless, but there may be some mild discomfort related to the temporary expansion of your stomach and placement of the gastrojejunostomy tube. Pain medication will be given in case of any discomfort.

After the procedure the patient is advised rest in the hospital and will be discharged the next day. The fasteners will be removed approximately seven days after the procedure. Suitable instructions will be given on gastrojejunostomy tube care, feedings, warning signs, possible problems etc

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