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Laparoscopic-Assisted Takedown of a Gastrocutaneous Fistula

Victoria J. Grille, MD1; Eric M. Pauli, MD, FACS, FASGE2
1Jersey Shore University Medical Center
2Penn State Milton S. Hershey Medical Center

1. Introduction

  1. Pre-op CT Scan

2. Injection of Local Anesthetic

3. Incision and Laparoscopic Access to the Abdomen

4. Placement of Remaining Ports

5. Lysis of Adhesions and Making Windows Around Gastrostomy

6. Takedown of Stomach

7. Endoscopy

8. Staple Transection

9. Leak Test and Check for Bleeding

10. Open Portion and Excision of Gastrocutaneous Fistula Tract

11. Abdominal Wall Defect Closure

12. Final Inspection

13. Port Sites Closure Leaving Fistula Tract Wound Packed Open

14. Post-op Remarks