Gastrostomy without Laparotomy: A Percutaneous Endoscopic Technique
Michael W.L. Gauderer, Jeffrey L. Ponsky, Robert J. Izant
Abstract
It has been employed in 12 children (and 19 adults) with minimal morbidity and no mortality. It is interesting to note that, although the percutaneous endoscopic gastrostomy had its origin in pediatric surgery, the astonishing success and spread was primarily due to its application to the adult population. As a colleague of the author commented: 'People think a gastrostomy Button has always existed'. It is interesting that the issue of gastrostomy, which is usually pretty straightforward in the pediatric population (feeding, decompression, medication), has been the subject of much controversy in the adult population, particularly concerning the difficult end-of-life management. Insertion of gastrostomy is one of the most commonly performed surgical procedures in children, and this is the most cited paper in the field. The sheer frequency with which gastrostomy insertion is performed means that resource consumption and morbidity related to open surgery fast become a relevant issue.