GASTROSTOMY

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my operations

How I did It?

Operative Technique

Ø      Patient supine under General Anesthesia

Ø      Asepsis and antisepsis technique

Ø      Sterile drapes placed

Ø      Midline incision made

Ø      Stomach identified, and exposed

Stamm Gastrostomy

Ø      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

Ø      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.

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

Ø      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

Ø      Foley Catheter inserted into the stomach

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

Ø      A second purse-string suture made

Ø      Foley catheter balloon inflated

Ø      Stomach drawn to the anterior abdominal wall

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

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

Ø      Fascia including peritoneum closed with continuous vicryl 0 suture

Ø      Subcutaneous approximated with inverted T suture using chromic 2-0

Ø      Skin closed interruptedly using silk 4-0 sutures

Ø      Betadine paint

Ø      Dry sterile dressing placed