Friday, July 25, 2014

Surgical Procedure 4 Gastrostomy


4.  Gastrostomy
Objective
In case of:
•   Esophageal obstruction, e.g. carcinoma esophagus or cardiac to deliver nutrition.
•   Prolonged ileus or severe pancreatitis to provide gastric drainage (as an alternative to nasogastric intubation).
Position
Supine.
Anesthesia
General or local.
Procedure
•   Small midline incision.
•   Left arterior wall of stomach between two Babcock’s forceps midway between greater and lesser curvature.
•   Two purse string sutures at one and two cm radius from an imaginary center.
•   Incise the stomach at the centre and insert a 14 F Foley’s catheter and tie the two purse strings to produce an inkwell effect.
•   Bring out the tube through a stab in the anterior abdominal wall.
•   Anchor the stomach to peritoneum and rectus sheath using interrupted 20 silk sutures.
Instruments
•   Gastrointestinal set, 1
•   Foley’s catheter, 14 F.
Any questions be sent to drmmkapur@gmail.com
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