Closure of persistent gastrocutaneous postpercutaneous endoscopic gastrostomy fistula by simple percutaneous suturing with endoscopic assist Takako Tasaki,

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Presentation transcript:

Closure of persistent gastrocutaneous postpercutaneous endoscopic gastrostomy fistula by simple percutaneous suturing with endoscopic assist Takako Tasaki, MD, Yoshitatsu Arakaki, MD Gastrointestinal Endoscopy Volume 76, Issue 3, Pages 699-700 (September 2012) DOI: 10.1016/j.gie.2012.03.1404 Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 A schematic illustration of percutaneous endoscopic suturing of the gastrocutaneous fistula. A, A trocar is passed through the abdominal wall into the gastric lumen next to the fistula. A suture is then inserted into the trocar. B, The gastric end of the suture is externalized by using forceps under endoscopic observation. C, The procedure is repeated to insert a total of 2 sutures in the abdominal wall. D, A surgical knot is made with the 2 sutures outside the fistula. E, The cutaneous ends of the sutures are pulled back and the surgical knot is moved into the stomach through the fistula. F, Another surgical knot is tied outside at the skin level to obliterate the fistula. Gastrointestinal Endoscopy 2012 76, 699-700DOI: (10.1016/j.gie.2012.03.1404) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 The gastric end of the suture inserted through trocar is externalized by using forceps under endoscopic observation. After this method is repeated, a surgical knot is made with the 2 sutures outside of the abdominal wall. Gastrointestinal Endoscopy 2012 76, 699-700DOI: (10.1016/j.gie.2012.03.1404) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions