The Laparoscopic Janeway Gastrostomy. An Alternative Technique When Percutaneous Endoscopic Gastrostomy Is Impractical

R. Raakow; R. Hintze; S. Schmidt; A. Adler; P. Neuhaus

doi:10.1055/s-2001-15309

Endoscopy, Table of Contents

Endoscopy 2001; 33(7): 610-613
DOI: 10.1055/s-2001-15309

Short Communication

The Laparoscopic Janeway Gastrostomy. An Alternative Technique When Percutaneous Endoscopic Gastrostomy Is Impractical

R. Raakow¹ , R. Hintze² , S. Schmidt¹ , A. Adler² , P. Neuhaus¹

¹ Department of Surgery, Charité Virchow-Clinics, Berlin, Germany
² Department of Gastroenterology, Charité Virchow-Clinics, Berlin, Germany

Abstract

Background and Study Aims: Today, percutaneous endoscopic gastrostomy (PEG) is the standard procedure for ensuring safe feeding access. In the case of advanced hypopharyngeal and esophageal carcinomas, it may not be feasible to pass an existing stenosis by endoscopy. The aim of this prospective study was to investigate the laparoscopic Janeway gastrostomy as an alternative technique for guaranteeing feeding access in these instances.

Patients and Methods: Between May 1993 and December 1999, 21 patients underwent laparoscopic Janeway gastrostomies. Indications were extended incurable tumors of the hypopharnyx (n = 12) and esophagus (n = 9) which rendered oral nutrition impossible and did not allow passage by the endoscope.

Results: The mean operative time was 38 minutes (range 24 - 50). No procedure-related intraoperative or postoperative complications were observed. All patients recovered quickly from surgery and the gastrostomies functioned well in all cases until the death of the patients.

Conclusion: The laparoscopic Janeway gastrostomy is a safe and simple technique for palliative feeding access, avoiding a laparotomy in patients in whom percutaneous endoscopic placement is impractical.

Full Text

References

1 Witzel O. Zur Technik der Magenfistelanlegung. Zentralbl Chir. 1891; 18 601-604
2 Kader B. Zur Technik der Gastrostomie. Zentralbl Chir. 1896; 23 665-667
3 Stamm M. Gastrostomy: new method. Med News. 1894; 65 324-328
4 Gauderer M WL, Ponsky J L, Izant R J. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg. 1980; 15 872-875
5 Janeway H H. Eine neue Gastrostomiemethode. MMW. 1913; 60 1705-1708
6 Grant J P. Comparison of percutaneous endoscopic gastrostomy with Stamm gastrostomy. Ann Surg. 1988; 207 598-604
7 Stern J S. Comparison of percutaneous endoscopic gastrostomy with surgical gastrostomy at a Community Hospital. Am J Gastroenterol. 1986; 81 1171-1173
8 Hull M A, Rawlings J, Murray F E, et al. Audit of outcome of long-term enteral nutrition by percutaneous endoscopic gastrostomy. Lancet. 1993; 341 869-872
9 Raakow R, Keck H, Neuhaus P. Ergebnisse der laparoskopischen Appendektomie im Vergleich zur konventionellen Operationstechnik. Langenbecks Arch Chir. 1993; Suppl. (Kongreßbericht) 180-182
10 Schlag P M, Hünerbein M, Rau B. Diagnostic and operative laparoscopy in oncology. Onkologie. 1994; 17 226-232
11 Peitgen K, Walz M K, Krause U, Eigler F W. First results of laparoscopic gastrostomy. Surg Endosc. 1997; 11 658-662
12 Edelman D S, Unger S W. Laparoscopic gastrostomy and jejunostomy: review of 22 cases. Surg Laparosc Endosc. 1994; 4 297-300
13 Edelman D S, Unger S W, Russin D R. Laparoscopic gastrostomy. Surg Laparosc Endosc. 1991; 1 252-253
14 Russel T R, Brotman M, Norris F. Percutaneous gastrostomy: a new simplified and cost effective technique. Am J Surg. 1984; 184 132-137
15 Murayama K M, Johnson T J, Thompson J S. Laparoscopic gastrostomy and jejunostomy are safe and effective for obtaining enteral access. Am J Surg. 1996; 172 591-595
16 Neufang T, Köhler H, Lepsien G, Lüdtke F E. Die perkutane laparoskopische Gastrostomie (PLG). Min Inv Chir. 1992; 1 34-35
17 Horbach T, Reck T, Köckerling F. Perkutane laparoskopische Gastostomie (PLG) unter Verwendung einer laparoskopischen Tabaksbeutelnahtklemme. Min Inv Chir. 1994; 4 179-184
18 Lathrop J C, Felix E J, Lauber D. Laparoscopic Janeway gastrostomy utilizing an endoscopic stapling device. J Laparoendosc Surg. 1991; 1 355-359
19 Haggie J A. Laparoscopic tube gastrostomy. Ann R Coll Surg Engl. 1992; 74 258-259
20 Cossa J P, Marmuse J P, Lecomte P, et al. Gastrostomie tubulé sous coelioscopie. Presse Méd. 1992; 21 1519-1521
21 Arnaud J P, Casa C, Manunta A. Laparoscopic continent gastrostomy. Am J Surg. 1995; 169 629-630
22 Meyer G, Rau H, Strauss T. Die laparoskopische Gastrostomie nach Janeway. Chirurg. 1995; 66 719-723
23 Molloy M, Ose K J, Bower R H. Laparoscopic Janeway gastrostomy: an alternative to celiotomy for the management of a dislodged percutaneous gastrostomy. J Am Coll Surg. 1997; 185 187-189
24 Ritz J P, Germer C T, Buhr H J. Laparoscopic gastrostomy according to Janeway. Surg Endosc. 1998; 12 894-897
25 McGovern B. Janeway gastrostomy in children with cerebral palsy. J Pediatr Surg. 1984; 19 800-803

R. Raakow, M.D.

Dept. of Surgery
Charité Virchow-Clinics

Augustenburger Platz 1
13353 Berlin
Germany

Fax: Fax:+ 49-30-45052900

Email: E-mail:roland.raakow@charite.de