GASTROSTOMY

Operative Technique

Patient supine under General Anesthesia

Asepsis and antisepsis technique

Sterile drapes placed

Midline incision made

Stomach identified, and exposed

Stamm Gastrostomy

Circular purse-string suture made on the midportion of the stomach closer to the greater than to the lesser curvature using silk 2-0 atraumatic suture

External opening for tube created at the area of left rectus muscle at the level of the purse-string suture

Left side of linea alba grasped with Kocher clamp, stab wound made on the middle third of left rectus muscle, Kelly forcep passed from peritoneum outward.

A Fr.24 foley catheter was grasped by the Kelly forcep drawing it inside the abdominal cavity

With the use of electrocautery a stab wound was created into the anterior gastric wall in the middle of the previously placed purse-string suture

Foley Catheter inserted into the stomach

Purse-string suture tightened so as to invert the gastric serosa

A second purse-string suture made

Foley catheter balloon inflated

Stomach drawn to the anterior abdominal wall

Lembert sutures made in four quadrants around the foley catheter to the sew the stomach to the anterior abdominal wall around the stab wound

Foley catheter secured on the skin using silk 2-0 suture

Fascia including peritoneum closed with continuous vicryl 0 suture

Subcutaneous approximated with inverted T suture using chromic 2-0

Skin closed interruptedly using silk 4-0 sutures

Betadine paint

Dry sterile dressing placed