Laparoscopy-guided percutaneous button gastrostomy in children after previous abdominal surgery

Percutaneous endoscopic gastrostomy in children

Percutaneous endoscopic gastrostomy has been a valuable tool in nutritional rehabilitation since its inception in 1980. Although it was originally described in children, a large sector of the adult population is dependent on it for nutritional support. Percutaneous endoscopic gastrostomy tube insertion is generally a safe procedure. Nevertheless, variable incidence rates of complications have been reported. The present review highlights the up-to-date indications, contraindications and complications of percutaneous endoscopic gastrostomy in children, along with a discussion of issues that need further exploring through future research.

Current concepts in minimal access surgery for children

Since the introduction of minimal access surgery to general surgeons in the 1980s, pediatric surgeons have been employing this innovative technology to perform surgery on children. Video technology and miniaturized instruments have brought the laboratory to the operating room; in many cases several small incisions are the only access necessary to perform complicated procedures that would otherwise require a large wound. Additional benefits of minimal access surgery may include reduced postoperative analgesic requirements, shortened length of stay, and faster resumption of normal activities. Increased operative costs offset some of these gains. The pediatric surgical community has embraced minimal access techniques for some operations; others remain controversial.

Laparoscopic surgery in children

The surgeon should be aware of the extensive applications of endoscopic surgery in the pediatric patient. The ability to provide surgical care in association with either outpatient or short-stay hospitalizations appear to be cost-effective and appropriate state-of-the-art medical care. Because the array of surgical instruments continues to evolve, new and innovative endoscopic procedures will continue to become increasingly available.