A gastrostomy is the formation of an artificial stoma between the stomach and the abdominal wall. It is indicated for nutritional purposes following gastrointestinal surgery, coma, and after some neurological conditions.
Elective gastrostomy can be safely undertaken by endoscopic means - percutaneous endoscopic gastrostomy (PEG).
Open gastrostomy is generally undertaken with a general anaesthetic, but local anaesthetic can be used in slim patients. A small, upper midline incision is made to the anterior aspect of the stomach. A stab incision is made into the stomach around which a few Vicryl purse-string sutures are placed. This permits the stomach to be drawn in on a balloon catheter. The stomach is finally sutured to the anterior abdominal wall - a Stamm gastrostomy.
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